Biomedical subjects

R E Reisman

Publications and source records attributed to R E Reisman.

At least 55 records · Page 3Linked to original sources

PubMed1985

Venom skin tests in insect-allergic and insect-nonallergic populations.

Intradermal skin tests with varying concentrations of honeybee, yellow jacket, white-faced hornet, yellow hornet, and Polistes venoms were done on 85 patients with histories of insect-sting anaphylaxis and on 56 insect-nonallergic subjects. Positive skin tests (wheal greater than or equal to 5 to 10 mm and flare greater than or equal to 11 to 20 mm) were present in 67 insect-allergic patients at venom concentrations ranging from 0.001 microgram/ml to 0.1 microgram/ml. Seven additional allergic patients had positive skin tests with the 1.0 microgram/ml venom concentration. Twenty-six nonallergic subjects had positive skin tests at the venom concentration of 1.0 microgram/ml, and two patients had positive skin tests at the lower venom concentrations (0.001 to 0.1 microgram/ml). These results confirm venom skin tests as a highly sensitive method of detecting venom-specific IgE in the evaluation of patients with stinging-insect hypersensitivity. Since a large percentage of insect-nonallergic subjects reacted to the 1.0 microgram/ml concentration, clinical judgment and further in vitro testing should be considered in the evaluation of patients who react only at this venom concentration.

Antibodies, Anti-Idiotypic↗

PubMed1985

Local nasal immunotherapy: efficacy of low-dose aqueous ragweed extract.

In previous studies preseasonal local nasal immunotherapy (LNIT) with moderate doses of aqueous ragweed extract (mean total dose 59 micrograms of AgE and 139 micrograms of AgE) was an effective treatment for ragweed hay fever; however, local adverse reactions during therapy were common. This study evaluated the clinical and immunologic responses to LNIT by use of lower doses of aqueous ragweed extract in order to minimize these adverse reactions. Patients were administered preseasonal LNIT for 7 wk and received a mean total dose of 4.7 micrograms of AgE. During the ragweed season, symptom/medication scores (SMS) of the treated patients were equivalent to SMS of untreated patients. Serum ragweed-specific IgE and nasal secretory ragweed-specific IgA rose slightly in the treated patients but not to the extent observed in previous studies. After the ragweed season treated and untreated patients had a substantial increase in serum ragweed IgE antibody titers. No correlation could be found between antibody responses and SMS. This study indicates that LNIT with lower doses of aqueous ragweed extract is clinically ineffective.

Administration, Intranasal↗

PubMed1985

Insect sting anaphylaxis in patients without detectable serum venom-specific IgE.

Following insect sting anaphylaxis, twenty-five patients of over 500 evaluated, did not have detectable serum venom-specific IgE. Twenty-two were evaluated within 1 year of the reaction, fifteen within 6 months. Anaphylaxis occurred in six patients after their first sting exposure. The clinical features of the sting reaction were typical of the reaction occurring in insect-allergic patients with serum venom-specific IgE. Eleven of the twenty-five patients had negative venom skin tests. These observations suggest that a non-IgE mechanism may be responsible for a minority of insect sting reactions.

Adolescent↗

PubMed1985

Allergenic components of bald-faced hornet (V. maculata) venom.

Bald-faced hornet (V. maculata) venom collected by electrical stimulation was fractionated using molecular exclusion gel-filtration and ion-exchange chromatography. Four fractions were selected for in-depth analysis. These were analyzed for phospholipase, hyaluronidase and protease enzyme activities, antigenicity as measured by reaction with anti-hornet venom rabbit serum, and allergenic activity, as determined by RAST reaction with sera from hornet-sensitive patients. The results of these studies suggest that the fractions containing phospholipase, hyaluronidase and protease possess allergenic activity. In addition, there appear to be other allergenic components in hornet venom. Allergic patients differ in their reactivity to the various allergenic components in hornet venom and may have IgE antibodies to one or more of these components.

Allergens↗

PubMed1985

Comparison of measurements of serum venom-specific IgG by radioimmunoassay and enzyme immunoassay.

Honeybee venom (BV)-, yellow jacket venom (YJV)- and honeybee venom phospholipase A (PLA)-specific IgG were measured by radioimmunoassay (RIA) and enzyme immunoassay (RIA) in 54 sera of insect-allergic patients. In the majority of sera, results of the two tests were similar. Discordant results were found in 1 of 21 sera in tests with PLA, 4 of 23 sera in tests with BV, and 1 of 16 sera in tests with YJV. The RIA measured higher antibody titers in 5 of these 'outlier' sera. The results suggest that with a few exceptions, the two assays are similar for detection of venom- and PLA-specific IgG.

Antibodies↗

PubMed1984

Comparison of the biochemical, immunologic and allergenic properties of vespid venoms collected in early and late summer.

The biochemical, immunologic and allergenic properties of yellow hornet (Vespula arenaria) and bald-faced hornet (Vespula maculata) venoms collected in early and late summer were compared. The phospholipase A content of both hornet venoms decreased in late summer while protease, hyaluronidase and acid phosphatase contents were unchanged. The antigenic and allergenic properties of the two venoms, as measured by their reaction with rabbit antisera and sera from insect-allergic patients, respectively, were unchanged. These results suggest no changes in venom properties during the summer which influence the allergic response to insect stings.

Animals↗

PubMed1984

Further evaluation of local intranasal immunotherapy with aqueous and allergoid grass extracts.

In a double-blind study, 45 grass-allergic patients received local nasal immunotherapy (LNIT) with either aqueous mixed-grass extract, formaldehyde-treated, mixed-grass extract (allergoid), or histamine placebo. Twenty-four patients received LNIT for a second successive year, and 21 patients received LNIT for the first year. The aqueous extract-treated patients had significantly lower symptom-medication scores than either allergoid- or placebo-treated subjects. There was no difference in symptom-medication scores in patients receiving allergoid and placebo treatment or in patients receiving 1 and 2 yr of LNIT. The aqueous extract stimulated a rise in serum grass-specific IgE. There was no serum or local antibody response after allergoid-extract treatment. Postseasonal rises in serum-IgE titers were observed in all three groups. These data suggest that LNIT with aqueous mixed-grass extract significantly reduces the symptoms of allergic rhinitis. The allergoid grass extract was ineffective in the second year of treatment. No cumulative effect of LNIT could be demonstrated in successive years of therapy.

Administration, Intranasal↗

PubMed1984

Natural history of large local reactions from stinging insects.

In ongoing studies of the natural history of stinging-insect allergy, 133 patients with large local reactions have been evaluated over 8 yr; 79 patients returned for reevaluation. Based on RAST analysis with honeybee and vespid venoms, patients were divided into RAST-positive and RAST-negative groups. Sixty-six patients were RAST-negative with positive venom skin tests in 58%. Seventy-five testings in this group led to no systemic reactions and 74 large local reactions. At follow-up RASTs remained negative, and the incidence of positive skin tests was unchanged. Sixty-seven patients had detectable serum venom-specific IgE covering a wide range in antibody titers, indistinguishable from patients with systemic reactions. Twenty-four of 67 patients received venom immunotherapy (VIT). RAST titers decreased similarly in the VIT and untreated groups. There were 55 testings resulting in 40 recurrent large local reactions occurring in equal incidence in treated and untreated patients. One systemic reaction occurred in an untreated patient. In reviewing 118 patients with sting anaphylaxis, a previous large local reaction occurred in five. These results suggest that after repeat stings, patients with large local reactions tend to have subsequent large local reactions, regardless of the presence of venom-specific IgE or immunotherapy. There is small risk of anaphylaxis. Determination of serum venom-specific IgE by RAST or skin tests does not aid in treatment or in predicting prognosis. Thus skin tests are not necessary in patients who have had large local reactions, and venom immunotherapy is not indicated.

Desensitization, Immunologic↗

PubMed1984

Studies of coexisting honeybee and vespid-venom sensitivity.

Honeybee and vespid venom-specific IgE were measured by RAST in randomly selected sera of 87 patients who had had anaphylactic reactions after insect stings. Overall there was a poor correlation between the titers of honeybee venom and yellow jacket or hornet venom-specific IgE. Sera from nine patients with high titers of both honeybee venom and yellow jacket venom-specific IgE were selected for RAST-inhibition studies, with these two venoms as coupling and inhibiting antigens. Three patterns of IgE-antibody specificity were detected. Four patients had unique antibody activity with no cross-reactivity between the yellow jacket and honeybee venom-specific IgE. This is probably the most common pattern in patients with dual sensitivity. Three patients reacted to a major allergen in yellow jacket venom cross-reacting with a minor allergen in honeybee venom. Their RAST-inhibition patterns demonstrated that the yellow jacket-venom RAST was inhibited by yellow jacket venom only and the honeybee-venom RAST was inhibited by both yellow jacket venom and honeybee venom. Two patients had the opposite pattern with honeybee-venom RAST inhibited by honeybee venom only and the yellow jacket RAST inhibited by both honeybee venom and yellow jacket venom. These latter patients reacted to a major allergen in honeybee venom that was cross-reacting with a minor allergen in yellow jacket venom. Studies with rabbit antisera raised to vespid and honeybee venoms demonstrated major antigens that were unique to each family that did not cross-react and several minor cross-reacting antigens.

Adolescent↗

PubMed1984

Use of dialyzed venoms in the radioallergosorbent test.

Optimal concentrations of honeybee, hornet and yellow jacket venoms were used in the radioallergosorbent test (RAST) before and after dialysis. RAST titers in the majority of sera from insect-allergic patients increased significantly with the dialyzed yellow jacket and hornet venom-coupled discs. Of 26 sera which had negative RASTs with crude venom, 20 became positive with dialyzed venom. No change in RAST results was found with crude and dialyzed honeybee venom. The low molecular weight component in the vespid venoms removed by dialysis had no specific activity in RAST inhibition experiments, suggesting nonspecific blocking of binding sites. These results indicate the importance of the appropriate antigen preparation coupled to discs in the RAST.

Allergens↗

PubMed1983

Allergy to honeybee body components: distinction from bee venom sensitivity.

Two patients with inhalant allergy to whole bee body components are described, documented by positive skin tests to whole bee body extract and the presence of serum bee body-specific IgE. Both had evidence of mild sensitivity to bee venom. RAST inhibition studies indicated that the IgE antibodies directed at whole bee body components and bee venom were distinct. These observations suggest that venom allergy from insect stings and bee body inhalant allergy are caused by different antigens.

Adult↗

PubMed1983

Local intranasal immunotherapy for grass-allergic rhinitis.

In a double-blind controlled study, local intranasal immunotherapy was evaluated for the treatment of grass pollenosis. On the basis of serum grass-specific IgE levels, 50 grass-allergic patients were randomly divided into three groups and treated with either an aqueous solution of mixed-grass extract, a formaldehyde-modified mixed-grass extract (allergoid), or a histamine solution (placebo). Intranasal solutions were administered in gradually increasing doses over a preseasonal 10 wk period, adverse local reactions from the aqueous grass extract were frequent during treatment. Few adverse reactions occurred from the allergoid or histamine solutions. During the pollen season, patients receiving both grass extracts had much lower symptom/medication scores than patients receiving placebo. The severity of eye symptoms was the same in all groups. After treatment, serum grass-specific IgE rose in patients receiving aqueous and allergoid extract; no change was noted in patients receiving placebo therapy. Grass nasal secretory-specific IgA titers in each group did not change during the study. The results of this study suggest that local intranasal immunotherapy with either aqueous or allergoid grass extracts is clinically effective for the treatment of grass pollenosis. Adverse reactions associated with the aqueous extract may limit its usefulness. No correlation was present between the secretory immune response and clinical benefit.

Administration, Intranasal↗

PubMed1983

Anaphylaxis after Hymenoptera stings in three patients with urticaria pigmentosa.

Three patients with urticaria pigmentosa are reported who developed symptoms of anaphylaxis after Hymenoptera stings. Serum IgE antibodies to various Hymenoptera venoms could not be detected in any of the patients. Skin tests were completely negative in one patient, and borderline reactions with honeybee and yellow jacket venom, respectively, were found in the other two. Peripheral blood leukocytes of these latter two patients did not release significant amounts of histamine after exposure to the respective venoms. In patients with mastocytosis, anaphylaxis after insect stings may not be IgE-mediated but due to mediator release by the pharmacologic action of histamine liberators normally present in Hymenoptera venoms.

Adult↗

PubMed1983

Modified rapid venom desensitization.

The clinical and immunologic response to a modified rapid (r) regimen of venom immunotherapy was evaluated and compared to a traditional (t) therapeutic regimen. Nineteen patients in the r group received a starting dose of 0.01 microgram and reached a maintenance dose of 50 micrograms in 7 weeks. Twelve patients in the t group received an average of twenty-one injections on a weekly basis, reaching the same maintenance dose. The age and sex distribution and pre-treatment venom-specific IgE titres (RAST) of both groups were comparable. There were thirteen local reactions to venom therapy in both groups and no systemic reactions. Following therapy, most patients developed a rising titre of serum venom-specific IgG (V-IgG). Serum venom-specific IgE (V-IgE) changes were similar in the two groups; over half of the patients had a falling titre when on maintenance dose. Twelve patients were re-stung after reaching maintenance dose. Only one developed a mild systemic reaction, an individual who failed to show a V-IgG response with rapid therapy. Five of nine patients did not have an anamnestic V-IgE response. This rapid method of venom immunotherapy appears to be safe, clinically effective, and comparable to traditional dosing without additional adverse reaction.

Adolescent↗

PubMed1983

Effect of prolonged venom immunotherapy on serum venom-specific IgE and IgG.

Serum venom-specific IgE and IgG were monitored in twenty-three patients receiving venom immunotherapy for more than 3 years. Two response patterns of IgE antibody were found. Following initiation of therapy, seven patients had a rise in serum venom-specific IgE, peaking at one year, then decreasing. Sixteen patients had a persistent fall in IgE antibody titres following initiation of therapy. At the end of 3 years, levels of serum venom-specific IgE in both groups were comparable. The presence of atopy may have influenced the rising IgE antibody response. Serum venom-specific IgG either rose or remained elevated if the pretreatment titres were high. After several years of therapy, there was generally a decrease in serum venom-specific IgG.

Adolescent↗

PubMed1983

Local nasal immunotherapy for ragweed-allergic rhinitis. III. A second year of treatment.

In 1979, pre-seasonal local nasal immunotherapy (LNIT) was found to be an effective treatment for ragweed hay fever. In 1980, this study was continued to evaluate the clinical and immunologic responses of a second year of LNIT. Patients received either pre-seasonal treatment with an unmodified ragweed extract (RW) or a polymerized ragweed extract (PRW), or no treatment. The results of the second year of treatment were the same as the first year. Adverse reactions were significantly higher in the RW-treated group than in the PRW-treated group (P less than 0.001). Symptom/medication scores (SMS) in the RW-treated group were significantly lower than in the control group (P less than 0.005). Although SMS in the PRW-treated group were lower than in the control group, this difference was not significant. The immunologic response was evaluated by measurements of serum (S) RW-specific IgE and IgG and nasal secretory (NS) RW-specific IgE, IgG, and IgA. After treatment, serum IgE titres and secretory IgA titres rose in the RW-treated patients. Nasal secretory-IgG and NS-IgA titres increased with PRW treatment. The only immunologic response observed in the control group was a rise in S-IgE titres after the ragweed season. There was no substantial difference in immunologic measurements observed in the 1979 and 1980 seasons, except that the pre-treatment NS-IgE level was higher in 1980 (P less than 0.02). No significant correlations were found between antibody response and SMS. This study supports the efficacy of LNIT but does not support the protective role for NS-ragweed-specific IgA or IgG.

Adult↗

PubMed1982

Comparison of the allergenicity and antigenicity of Polistes venom and other vespid venoms.

The crossantigenicity of Polistes venom with other vespid venoms was examined with rabbit and human antisera. Venom preparations from various Polistes species were obtained by electrical stimulation of individual insects and venom sac dissection. Rabbit antibodies were raised to the venom (P. apachus) and venom sac extract (P. exclamans). Human antisera were obtained from patients allergic to Polistes and other vespid venoms. The venom appeared to be more potent than the venom sac preparations in reactions with rabbit IgG and human IgE antibodies. Among the Polistes species, P. exclamans, P. instablis, and P. apachus venoms showed several lines of precipitation with rabbit antisera, and P. annularis and P. fuscatus venoms only one line, suggesting quantitative or qualitative antigenic differences. In RAST analysis, most sera reacted equally to all Polistes species but occasional exceptions were noted, again suggesting differences in venom allergens. P. exclamans-coupled discs gave the most consistent results. In gel diffusion experiments, there was no crossreactivity between Polistes and yellow jacket venoms and only limited crossreactivity between Polistes and hornet venoms. Patients sensitive to Polistes venom showed varying degrees of reactivity to yellow jacket and hornet venoms in RAST analysis. Patients sensitive to other vespid venoms also showed varying degrees os sensitivity to Polistes venom. Polistes venom appears to contain a genus-unique antigen (allergen). In addition, there appear to be some crossreacting antigens in Polistes and other vespid venoms but to a much lesser degree than found previously in the analysis of the relationship of yellow jacket and hornet venoms.

Allergens↗

PubMed1982

Comparison of the allergenicity and antigenicity of yellow jacket and hornet venoms.

The immunologic properties of yellow jacket and hornet venoms were compared by measuring their reaction with rabbit antisera and human IgE and IgG antibodies. Anti-hornet venom rabbit serum showed precipitin bands unique to hornet venom and several bands crossreacting with yellow jacket venom. Anti-yellow jacket venom rabbit serum reacted with yellow jacket venom but failed to react with the hornet venoms. Most sera from patients who had had allergic reactions after vespid stings reacted with yellow jacket and hornet venoms in RAST analysis. A few sera reacted with only one of the venoms. RAST inhibition studies confirmed the crossreactivity of these IgE antibodies. The IgG antibody response of 14 patients was measured after yellow jacket venom immunotherapy. All had rising titers of yellow jacket venom-specific IgG. There was also an increase in the IgG antibody response measured with hornet venom in the majority of patients. The rise was significant with yellow hornet venom (p less than 0.02) but failed to reach significance with bald-faced hornet venom (p greater than 0.05). In IgG radioimmunoassay inhibition studies using yellow jacket venom-coupled discs, yellow jacket venom was considerably more potent than hornet venom. These studies indicate major crossreactivity between yellow jacket and hornet venoms. In this group of patients, yellow jacket venom appeared to be the primary allergen.

Allergens↗