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Biomedical subjects

R G van Wijk

Publications and source records attributed to R G van Wijk.

11 recordsLinked to original sources

Intranasal cold dry air is superior to histamine challenge in determining the presence and degree of nasal hyperreactivity in nonallergic noninfectious perennial rhinitis.

The objective of the study was to compare cold dry air (CDA) and histamine in differentiating patients with nonallergic noninfectious perennial rhinitis (NANIPER) from control subjects. Nasal reactivity (nasal patency, mucus production, and sneezing) in 16 symptomatic nonsmoking patients with NANIPER and seven nonsmoking control subjects was measured with standardized CDA and histamine provocation series in a randomized crossover study. Intranasal CDA resulted in increased mucus production and nasal blockage in a dose-dependent manner in patients with NANIPER but not in control subjects. Sneezing did not occur. The reproducibility of CDA for patency and mucus production was good. Sensitivity for CDA was 87% compared with 100% for histamine. However, specificity was 71% for CDA and 0% for histamine. It is concluded that the new standardized intranasal CDA provocation method uses a recognizable natural nonspecific stimulus and seems to be more suitable than histamine for characterizing and assessing the presence and degree of nasal reactivity in NANIPER.

Adult↗

Selective effect of levocabastine on histamine receptor and histamine release from human leukocytes and guinea pig isolated tissue.

BACKGROUND: Levocabastine is a potent histamine H1 receptor antagonist used topically in the treatment of patients with allergic rhinitis. It has been suggested that antihistamines also have anti-inflammatory properties. OBJECTIVE: The present study was performed to investigate whether levocabastine, in addition to the anti-H1 receptor activity, has anti-inflammatory properties and thus is able to modulate the release of histamine and cytokines, such as interleukin 5 from human leukocytes and isolated tissues. METHODS: Leukocytes suspensions were prepared by dextran sedimentation of peripheral venous blood drawn from allergic and healthy volunteers. Leukocytes obtained from allergic volunteers were preincubated for 30 minutes with levocabastine (doses 10(-8) M to 10(-6) M) and thereafter incubated with allergen. Leukocytes obtained from healthy volunteers were incubated for zero to three hours with levocabastine (doses 10(-14) M to 10(-3) M). Histamine release was measured by an automated fluorometric method. Interleukin-5 release was measured by enzyme linked immunoassay. Contractile responses to histamine on guinea pig trachea and lung parenchyma as well as the release of histamine and interleukin-5 by the tissues were investigated in the absence or presence of levocabastine and/or the histamine H2 receptor antagonist cimetidine. RESULTS: Levocabastine did not influence allergen-induced histamine release from leukocytes obtained from allergic volunteers. High concentrations (10(-4)and 10(-3) M) of levocabastine, however, caused release of histamine from leukocytes obtained from healthy volunteers as well as guinea pig airway smooth muscle tissues. Pretreatment with levocabastine dose-dependently decreased the contractile response to histamine, showing an irreversible competitive mechanism. Interleukin 5 release from human leukocytes and by guinea pig airway smooth muscle was not detectable. CONCLUSIONS: These findings indicate that the H1 receptor blocker, levocabastine, has probably no anti-inflammatory properties, measured as histamine release, and that the histamine release from both human leukocytes and guinea pig trachea and lung parenchyma is significantly increased by the drug only at high concentrations.

Adult↗

Allergy to bumblebee venom. I. Occupational anaphylaxis to bumblebee venom: diagnosis and treatment.

We describe six patients with severe occasional anaphylaxis, caused by stings of bumblebees. Sensitization to bumblebee venom was confirmed by intracutaneous tests and RAST with purified bumblebee venom. Three patients changed their occupation and will probably not be stung by bumblebees in the future. The other patients started immunotherapy with newly purified bumblebee venom extract. After 1 year of treatment, no severe side-effects had occurred and clinical benefit in two patients could be demonstrated, as both skin sensitivity or serum IgE to bumblebee venom had decreased. Moreover, both patients were unresponsive to in-hospital sting challenge.

Adult↗

Drug-dependent exercise-induced anaphylaxis.

Exercise-induced anaphylaxis (EIA) is well known and may be food-dependent. We describe a patient with a history of anaphylaxis during exercise after taking nafylpropion acid (Naprosyne), a nonsteroidal anti-inflammatory drug. An exercise-challenge test after Naprosyne intake induced bronchoconstriction. The combination of history and challenge tests suggests that intolerance or allergy to drugs may present as EIA.

Adolescent↗

Cutaneous adverse reactions after intra-articular injection of triamcinolone acetonide.

A patient is described with a disseminated morbilliform and partially persistent urticarial dermatitis following intra-articular injections of triamcinolone acetonide. A delayed-type hypersensitivity to triamcinolone acetonide was observed after patch and intradermal testing. However, an immediate-type hypersensitivity to this drug was not observed. A delayed-type sensitization to betamethasone, dexamethasone and prednisolone, but not to hydrocortisone was also observed after patch testing. Intradermal tests with these representatives of corticosteroids were all negative. Although little is known yet about the relationship between immediate and delayed-type hypersensitivity and the side-effects of oral use of corticosteroids, the absence of positive skin tests to corticosteroids other than triamcinolone acetonide may indicate a safe use of these drugs orally or via injection.

Betamethasone↗

Isolated early response after nasal allergen challenge is sufficient to induce nasal hyperreactivity.

Ten rhinitic patients allergic to grass pollen were challenged with histamine intranasally 24 hours before and 24 hours after nasal provocation with grass pollen. Up to ten hours after allergen provocation nasal lavage fluid was obtained to characterize early and late phase reactions by measuring the levels of histamine and leukotrienes as indicators of mediator release, and albumin as a marker of increased vasopermeability. Ten minutes after allergen challenge with 10,000 BU grass pollen extract LTC4,D4, and albumin significantly increased from 62 to 576 pg/mL (P = .008) and from 15 to 81 micrograms/mL (P = .008), respectively, without significant changes after placebo challenge a week earlier. Although the patients showed increased responsiveness to histamine after allergen challenge compared with a placebo-challenged control group (P = .02), one patient only demonstrated a late phase nasal allergic reaction characterized by recurrence of clinical symptoms eight to ten hours after allergen challenge and recurrence of mediators in lavage fluid. It is concluded that an isolated early response after allergen challenge is sufficient to induce nasal hyperreactivity. A biochemically or clinically defined late phase allergic reaction does not necessarily accompany allergen-induced hyperreactivity.

Adolescent↗

Nasal provocation with histamine in allergic rhinitis patients: clinical significance and reproducibility.

In a selected group of rhinitis patients (n = 12) with an IgE-mediated allergy to house dust mites, the nasal response to insufflation of histamine chloride appeared to be related to symptom scores obtained from the patients. In contrast to the sum of the nasal airway resistances (NAR) induced by all doses of histamine, the total amount of secretion and total number of sneezes could be predicted from clinical scores. The reproducibility of the nasal provocation test was tested by comparison of the test results in two sessions with a 1-week interval. The correlation between both sessions was highest with respect to nasal secretion (r = 0.87; P less than 0.001) and the number of sneezes (r = 0.76; P = 0.004). The correlation coefficient was 0.71 (P = 0.01) when the nasal airway resistance was used in the assessment of nasal response. A good reproducibility of the nasal provocation test was also obtained using an end-point titration method and determining the concentration required to produce 0.5 ml secretion and/or five sneezes as the end-point (r = 0.76; P = 0.004). The concentration required to double nasal airway resistance yielded a correlation coefficient of 0.56 (P = 0.052). We conclude that the clinical significance of nasal provocation with histamine increases when, besides nasal airway resistance, the amount of secretion and the number of sneezes is used in the assessment of the nasal response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Irrelevant IgE binding to cellulose discs in RAST.

This study describes two sera that showed irrelevant IgE binding to all allergen-coated cellulose discs tested. This irrelevant IgE binding was not observed when allergen extracts were coupled to agarose beads. Such irrelevant IgE binding can be detected using human serum albumin-coated discs.

Adult↗

Seasonal variability in nasal sensitivity to house dust mite extract.

Nine patients with a house dust mite (HDM) allergy were monitored for one and a half year starting in Spring 1983 during immunotherapy with aqueous alum precipitated HDM extract. Evaluation included nasal provocation tests with HDM extract and histamine chloride. Nasal responsiveness was assessed by measurement of the nasal airway resistance, by counting the number of sneezes and measuring the amount of secretion. During the one and a half year hyposensitization a decrease in nasal sensitivity to HDM extract is found when measurements are compared at yearly intervals (Spring 1983-1984 and Autumn 1983-1984). However, nasal reactivity to HDM extract is elevated in autumn compared with spring (not significant in 1983, but significant in 1984). Changes in nasal sensitivity to histamine are not so obvious except for the interval between Spring 1983 and Autumn 1983. The fluctuations in nasal sensitivity could not be attributed to baseline variation in nasal resistance during the trial. We conclude that seasonal variation in sensitivity to HDM can influence the results of immunotherapy with HDM extract, and should be considered when evaluating such treatment.

Adolescent↗

Allergy to pistachio nuts.

Three patients with adverse food reactions due to pistachio and mango were studied. Specific IgE against these tropical stone fruits of the Anacardiaceae family could be demonstrated, indicating type I allergic reactions. Methods are described to detect these specific antibodies in a reproducible way.

Adult↗

Nasal hyperreactivity and its effect on early and late sequelae of nasal challenge with house-dust mite extract.

For a study on the relationship between nasal hyperreactivity to histamine and the nasal response to allergen, 14 rhinitis patients allergic to house-dust mites were challenged with histamine and 5 days later with a house-dust mite (HDM) extract. According to symptom scores, after allergen challenge two groups of patients were distinguished, i.e., isolated early and dual responders. The nasal response to histamine was significantly correlated with the amount of secretion (r = 0.71; p = 0.0039) and the number of sneezes (r = 0.78; p = 0.0016) induced by the HDM extract during the early reaction. The amount of allergen-induced secretion could be predicted from the response to histamine, skin reactivity to allergen, and blood eosinophils (multiple r = 0.90; p < 0.0001). Late-phase symptoms appearing between 3.5 and 9.5 hour after allergen challenge could be predicted from histamine responsiveness and skin reactivity (multiple r = 0.67; p = 0.004). Compared with early responders (LAR-) (n = 8), patients with early and late symptoms (LAR+) (n = 6) were characterized by a higher secretory responsiveness to histamine (p = 0.033), increased production of leukotrienes determined in nasal lavage fluid during the early response (p = 0.033), and elevated albumin levels occurring between 3.5 and 9.5 hours after challenge (p = 0.043). Late-phase symptoms were significantly correlated with albumin influx (r = 0.73; p = 0.001) and leukotrienes production (r = 0.60; p = 0.011) during the early reaction. In summary, nasal responsiveness to HDM extract was found to be closely associated with pre-existent nasal hyperreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗