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Biomedical subjects

R Patterson

Publications and source records attributed to R Patterson.

At least 379 records · Page 21Linked to original sources
PubMed1984

Varying presentations of allergic bronchopulmonary aspergillosis.

The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) may be difficult when the major criteria are not present or when the clinical, laboratory, and radiographic findings have been altered by prior corticosteroid therapy. However, the early diagnosis of ABPA is important because it may lead to the prevention of evolution to the corticosteroid-dependent asthma stage (stage IV) or fibrotic lung disease stage (stage V). The clinical histories of 3 ABPA patients are reviewed to demonstrate that these patients may appear in different stages of ABPA and with markedly varied presentations. The high index of suspicion required for diagnosis of ABPA deserves emphasis as does the importance of excluding a diagnosis of ABPA in all asthmatics with immediate skin reactivity to Aspergillus fumigatus.

Adult↗
PubMed1984

Allergic bronchopulmonary candidiasis.

A patient had an illness consistent with allergic bronchopulmonary candidiasis. She had asthma, fleeting pulmonary infiltrate, immediate skin reactivity and precipitating antibody against Candida albicans, elevated total serum IgE concentration, elevated IgE and IgG antibody activity against C albicans, and two positive sputum cultures for C albicans. Serial serologic studies showed a significant decrease of serum IgE levels and IgE antibody activity after corticosteroid treatment.

Antibodies, Fungal↗
PubMed1984

Hapten-modified basophils: a model of human immediate hypersensitivity that can be elicited by IgG antibody.

Trimellitic anhydride (TMA) was incubated with human leukocytes to produce leukocytes with trimellityl (TM) haptenic determinants. The basophils in these TM leukocytes released histamine when challenged with human serum containing IgG but no IgE antibodies against TM determinants. Controls of TMA-treated cells exposed to normal human sera or untreated cells exposed to anti-TM sera released no histamine. The most relevant site of TMA modification of the basophil was receptor-bound IgE. This was demonstrated by the marked reduction in histamine release if IgE was removed from the leukocytes before TMA treatment and challenge and also by activation of release from untreated cells by passive sensitization with TM-IgE before challenge. Affinity-purified IgG from an anti-TM serum released much more histamine from TMA-treated cells than did the IgG-poor effluent at similar protein concentrations. These observations suggest a new model of hypersensitivity resulting from human exposure to chemicals capable of combining with autologous proteins. In some individuals this could result in both an immune response to the new determinants without the production of significant quantities of IgE antibodies and hapten modification of receptor-bound IgE on mast cells and basophils. After sufficient antibody was produced, reexposure to the chemical with hapten modification of mast cells or basophils or both could result in mediator release and clinical symptoms. This mechanism may be relevant to immediate-type chemical hypersensitivity reactions in which IgE antibody has not been demonstrated.

Basophils↗
PubMed1984

Chymopapain allergy: case reports and identification of patients at risk for chymopapain anaphylaxis.

Chymopapain has been approved for intradiscal injection in the United States and is expected to be used in approximately 100,000 patients per year. The need to identify the population at risk for anaphylaxis is obvious. Both in vivo and in vitro methods are available for measurement of IgE against chymopapain. This is a report of two cases of chymopapain allergy. One case discusses a 25-year-old woman who had rhinitis, asthma, and urticaria associated with occupational health hazards who was rejected for chemonucleolysis. The other case describes a 59-year-old man who had a predictably severe anaphylactic reaction to chymopapain and responded to treatment with epinephrine. Both patients had IgE antibody against chymopapain.

Adult↗
PubMed1984

Traumatic posterior vitreous detachment: scanning electron microscopy of an experimental model in the monkey eye.

Traumatic posterior vitreous detachment was studied in a monkey model of posterior penetrating eye injury with retinal laceration and intravitreal blood. Posterior vitreous detachment can occur as a separation at the level of the internal limiting membrane, or as a cleavage within the vitreous. The foot processes of Mueller cells were found to be altered in eyes with detached vitreous. Epiretinal membranes were seen to proliferate through cracks in the internal limiting membrane. The internal limiting membrane beneath the epiretinal membrane appeared to be wrinkled, suggesting a contractile property of the epiretinal membrane. The plane of separation in posterior vitreous detachment may be of fundamental importance in the formation of epiretinal membranes and subsequent development of retinal detachment.

Animals↗
PubMed1984

Airway responses to sequential challenges with platelet-activating factor and leukotriene D4 in rhesus monkeys.

Leukotriene D4 and synthetic platelet-activating factor have been shown to qualitatively reproduce an antigen-induced airway response in rhesus monkeys at concentrations several hundred times less than histamine. In normal rhesus monkeys, challenges with concentrations of leukotriene D4 or platelet-activating factor, established as subthreshold doses (not producing a response), result in abnormal pulmonary function parameters when followed by a second challenge of a subthreshold dose. Results were similar with any sequence of leukotriene D4 and platelet-activating factor combination. This was not a result of additive effects of agonists, because previous experiments have shown that log or 0.5 log increases over the subthreshold dose are necessary for a response. Our results may suggest that these mediators that possess remarkable biologic activity might sensitize the lower airway for response to stimulation with the same or other mediators.

Aerosols↗
PubMed1984

Neutrophil chemotactic activity released in supernatants of human leukocytes challenged with antigens or anti-human IgE.

Neutrophil chemotactic activity was released into the supernatants of leukocytes from atopic individuals challenged with rabbit anti-human IgE, ragweed, or Aspergillus fumigatus antigen and from nonatopic individuals only on challenge with anti-IgE. Using a recently reported procedure for removing IgE from basophil receptors, it was possible to passively sensitize leukocytes from nonatopic individuals with plasma from atopic donors and to convert nonreleaser cells to cells releasing neutrophil chemotactic activity specifically. Histamine release measured in the same supernatants of immunologically challenged cells correlated with neutrophil chemotactic activity release, consistent with the interpretation that basophils and IgE mediation are involved in this phenomenon. The neutrophil chemotactic activity was not caused by histamine released from basophils. Activity persisted after incubation at 56 degrees C for 30 minutes. Chemokinetic activity was also present in the supernatants, because migration was not inhibited completely in the absence of a gradient.

Animals↗
PubMed1984

Four-year evaluation of workers exposed to trimellitic anhydride. A brief report.

In a four-year clinical, immunologic, and environmental study of trimellitic anhydride (TMA) exposure in a single plant, 20 workers exposed to TMA powder were evaluated in 1979 and a total of 32 workers were evaluated from 1979 to 1983. Two distinct groups emerged before and after workplace control improvements were made in 1979. Seventeen of the original 20 workers were available for longitudinal study through 1983. Annual clinical evaluations and serum radioimmunoassays for total antibody binding and specific IgE binding to 125I TM-HSA (human serum albumin) were performed on all 32 workers. In 1979, six workers had antibody against TM-HSA, three had the late respiratory systemic syndrome, and two had TMA-induced allergic rhinitis or allergic rhinitis and asthma. One worker had antibody against TM-HSA without illness. Fifteen additional workers were evaluated longitudinally after institution of several workplace control measures. Four of these 15 workers had TMA exposure prior to environmental improvement and joined the study in 1982. The remaining 11 workers joined the study in 1982 and had at least two years of TMA exposure in the modified workplace. None of these 11 workers developed a TMA-induced immunologic syndrome or significant total or specific IgE antibody binding to 125I TM-HSA.

Adult↗
PubMed1984

Corticosteroid-dependent asthma and schizophrenia.

Asthma may be difficult to manage in the patient with both schizophrenia and asthma. These patients may be noncompliant with medications or ambulatory appointments, abuse medical facilities, and require extra time and expense for their care. Some may be at increased risk of death through their noncompliance with medical regimens. The clinical course of nine patients with both schizophrenia and asthma is described. Therapeutic regimens that appeared to result in better control are reviewed.

Adolescent↗
PubMed1983

Audiometric monitoring of cis-platinum ototoxicity.

A prospective study was performed on 37 patients receiving 50 mg/m2 of cis-platinum every 3 to 4 weeks. These patients received a baseline audiogram evaluation and subsequent testing before each dose. Ototoxicity was noted to occur in 46% of the patients during therapy. Fourteen percent of this group showed a hearing loss in the speech frequency range. Four variables were analyzed to determine their correlative value for subsequent ototoxicity: (i) Pretreatment (baseline) audiograms, (ii) cumulative dose in milligrams, (iii) dosage in milligrams per square meter, and (iv) mean serum creatinine. Of these parameters, only a pretreatment abnormal audiogram was shown to have a prognostic value at a level of P = 0.095. Recommendations for audiometric monitoring of this high-risk group are discussed.

Adolescent↗
PubMed1983

Immediate-type reactions in patients with allergic bronchopulmonary aspergillosis.

Allergic features of 38 patients with allergic bronchopulmonary aspergillosis (ABPA) were reviewed. These features included skin reactivity to other inhalant antigens and to molds other than Aspergillus fumigatus (Af) plus clinical manifestations of rhinitis, conjunctivitis, asthma, eczema, urticaria, anaphylaxis, food allergy, and drug allergy. ABPA patients have a high degree of allergic reactivity in all these clinical features, in particular, clearly documented food allergy. These findings differ from those previously reported in ABPA patients in England, where it was noted that patients with ABPA whose asthma began after age 30 had few manifestations of other allergic diseases. By contrast, our patients in the same age group (onset of asthma after age 30) had the same multiple allergic manifestations as younger patients. These results show that ABPA patients are a subset of atopic individuals with a greater predisposition for the development of a wide spectrum of allergic diseases, despite the lack of manifestations of other major immunologic disease patterns.

Adolescent↗
PubMed1983

Immunologic and respiratory responses to airway challenges of dogs with toluene diisocyanate.

Dogs received biweekly or monthly aerosol immunization with single doses of toluene diisocyanate (TDI) that were cumulative doses analogous to human chronic exposure at 0.02 ppm. The three dogs developed systemic immune responses to TDI-dog serum albumin (DSA). The immune responses included IgG, IgA, and IgM antibody responses and development of lymphocyte reactivity. IgA titers approached IgG titers and both were persistent, whereas IgM titers were low and of short duration. IgE antibody titers demonstrated by endpoint cutaneous titration appeared but fluctuated and became negative in spite of continued aerosol exposure of TDI. Immediate-type airway responses occurred after TDI aerosolization. Some limited responses that showed only abnormalities of selected pulmonary function parameters were clearly not immunologically mediated because they occurred with initial exposure. Other immediate-type airway responses occurred that qualitatively simulated IgE-mediated, antigen-induced airway responses in dogs. There was a statistically significant correlation (p = 0.0268) between these latter airway responses and immediate-type skin reactivity. This study demonstrates that this dog model simulates the complexity of airway responses to TDI in man but may provide a laboratory system for evaluation of immunologic or other proposed mechanisms of TDI asthma.

Animals↗
PubMed1983

Hyperreactivity of mediator-releasing cells from patients with allergic bronchopulmonary aspergillosis as evidenced by basophil histamine release.

Histamine release was performed on 28 patients with allergic bronchopulmonary aspergillosis (ABPA) in various stages and on 14 patients with mold-sensitive asthma, by using Aspergillus antigens, other mold antigens, and anti-IgE. Total serum IgE, IgE and IgG antibodies to Aspergillus fumigatus (Af), and end point cutaneous titration for Af were determined for each patient. There was greater histamine release to Aspergillus mix (p = 0.0000) and anti-IgE (p = 0.047) in patients with ABPA than in patients with mold-sensitive asthma. Patients with stages IV and V ABPA had greater histamine release to Aspergillus mix than patients with stage I, II, or III ABPA (p = 0.0014). There was greater histamine release to other molds in ABPA patients than in mold-sensitive asthmatics. There was no correlation between histamine release to Aspergillus mix and total serum IgE, IgE or IgG antibodies to Af, ratio of IgE and IgG antibodies to Af to total IgE, or cutaneous end point titration for Af in ABPA patients or mold-sensitive asthmatics. Peripheral basophils from ABPA patients demonstrated marked hyperreactivity as evidenced by histamine release to Aspergillus antigens, other molds, and anti-IgE. This hyperreactivity is the first cellular difference recognized in ABPA patients when compared to mold-sensitive asthma patients. If this hyperreactivity is manifested by mediator release from other cells such as pulmonary mast cells, which would be in close contact with growing Af, a possible mechanism for pulmonary response in ABPA would be suggested.

Adolescent↗
PubMed1983

Polymerization of individual species of grass pollen allergens.

Six grass pollen allergens have been individually polymerized. We had previously polymerized mixed grass pollen allergens. However, since every patient does not react to every grass, we sought to polymerize individual grasses that could subsequently be mixed into a preparation based on a patient's skin reactivity. As demonstrated by Sepharose 4-B chromatography of individual grass monomers and polymers, all six grasses were polymerized. Polymerized grass preparations as compared with monomer preparations demonstrated a 10(3)- to 10(5)-fold reduction in allergenicity as determined by cutaneous end point titer. That grass polymer contains the great majority of clinically important allergenic determinants was demonstrated by the ability of polymer to inhibit 78% IgE binding against crude grass in a pool of untreated grass-sensitive patients. Its antigenic similarity to crude grasses is further shown by the ability of polymer to inhibit 85% of IgG binding against crude grass in a pool of patients treated with usual crude grass extracts.

Binding, Competitive↗