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Biomedical subjects

S Quirce

Publications and source records attributed to S Quirce.

At least 37 records · Page 2Linked to original sources
PubMed1998

Inhalant allergy to egg yolk and egg white proteins.

BACKGROUND: Several egg white and egg yolk and avian proteins have been described as a cause of inhalant allergy. Sometimes inhalational type I hypersensitivity to these proteins is associated with food allergy to egg. OBJECTIVE: We studied two patients who experienced respiratory and food allergic symptoms upon exposure to egg or avian antigens through the inhalative or digestive routes. Clinical and immunological studies were carried out in order to identify individual allergens from these sources that could be responsible for crossreactivity reactions. RESULTS: Patient 1 showed IgE sensitization to egg yolk livetins, feathers, and chicken serum. Specific bronchial challenge with chicken albumin and livetin extracts elicited a positive early asthmatic response and an increase in serum eosinophil cationic protein. Immunoblot and CAP-inhibition studies in this patient supported that chicken albumin (alpha-livetin) was the crossreactive antigen present in egg yolk and chicken serum and feathers. Patient 2 showed sensitization to egg white, ovomucoid and lysozyme. However, SDS-PAGE and immunoblot studies demonstrated contaminating lysozyme in the ovomucoid extract and identified lysozyme as the main allergen causing egg sensitization in this patient. Conjunctival challenge test confirmed allergy to lysozyme. CONCLUSION: Egg yolk and egg white proteins may act not only as ingested allergens but also as aeroallergens. Immunological studies using highly purified preparations of egg proteins are useful for the accurate diagnosis of allergic reactions to egg proteins and to identify individual allergens that may be responsible for crossreactivity reactions.

Adult↗
PubMed1998

Hypersensitivity pneumonitis due to an ultrasonic humidifier.

We describe a woman with hypersensitivity pneumonitis that was related to using a home ultrasonic humidifier. A micronodular infiltrate was seen in her chest radiograph. The inhalation challenge test was performed with the humidifier, and she exhibited a positive response. The cultures of the humidifier water grew Candida albicans, Rhodotorula spp., and Aspergillus spp. The test for precipitating antibodies against the humidifier water gave a positive response, and specific IgG, IgM, and IgA antibodies against extracts of A. fumigatus, C. albicans, and Rhodotorula spp. were demonstrated in the patient's serum by ELISA. A strong, dose-dependent inhibition of Rhodotorula IgG-ELISA by humidifier water was observed, suggesting that Rhodotorula might be the cause of hypersensitivity pneumonitis in this patient.

Adult↗
PubMed1998

Eosinophilic lung disease associated with Candida albicans allergy.

A significant number of cases of chronic eosinophilic pneumonia remain idiopathic in spite of a comprehensive search of associated causes. This study reports a patient with a classical clinical presentation of chronic eosinophilic pneumonia and peripheral blood eosinophilia in whom selective sensitization to Candida albicans was demonstrated. This yeast was present in the bronchoalveolar lavage culture and specific serum immunoglobulin (Ig)E and IgG against C. albicans were found in the patient's serum. Levels of these specific immunoglobulins diminished with corticosteroid treatment and increased coinciding with a new outbreak of symptoms after lowering the dosage of corticosteroids. To the author's knowledge, this is the first case described of chronic eosinophilic pneumonia associated with sensitization to C. albicans. Evaluation of allergy to C. albicans should be performed in chronic eosinophilic pneumonia before labelling cases as idiopathic.

Adult↗
PubMed1997

Laboratory and clinical evaluation of a portable computerized peak flow meter.

A mini-Wright based peak flow meter (VMX Mini-Log), which stores the readings together with the time and date of each measurement, has recently been marketed but has not yet been evaluated. The accuracy, reproducibility, and interdevice variability of this instrument were investigated using a pneumotachograph connected in series as a standard. Flows from 100 to 700 L/min were generated by an explosive decompression chamber. The performance of this instrument was also tested in 20 normal subjects and in 20 patients with airflow obstruction. The accuracy of the instrument was expressed as the percentage of error, and reproducibility and interdevice variability were assessed using the coefficient of variation. In the laboratory evaluation, all devices recorded flow rates that were within +/-10% of the pneumotachograph readings at flows between 200 and 600 L/min. At the extreme flow rates of 100 and 700 L/min, the mean error was higher than 10%. The reproducibility of the VMX was within +/-5% at all the flows tested. The interdevice variability was less than 5% at flow rates between 200 and 700 L/min. When tested on normal subjects with PEF between 400 and 700 L/min, the VMX performed well. In patients with airflow obstruction, four devices had greater than 10% error. The largest error was observed in those patients with PEF below 200 L/min. The VMX Mini-Log peak flow meter is accurate and precise in the flow range between 200 and 600 L/min. Its performance, however, may be affected in subjects with airflow obstruction and PEF below 200 L/min.

Adolescent↗
PubMed1996

In vitro T-lymphocyte response and house dust mite-induced bronchoconstriction.

BACKGROUND: There is considerable evidence that T cells may play an important role in asthma. The purpose of this study was to determine whether the responsiveness of T lymphocytes to mite allergen stimulation in vitro is a determinant of bronchial response to house dust mite (HDM) allergen challenge in subjects who are allergic to HDM. METHODS: Peripheral blood was taken from seven healthy nonatopic subjects and 23 subjects with positive skin test reactions to HDM. Of the subjects in the latter group, 16 had an asthmatic reaction on inhalation challenge with HDM extract (HDM-responders), whereas the remaining seven had a negative reaction (HDM allergic). The proportion of subsets of T lymphocytes and their activation and the amount of IL-2, IL-4, IL-5, and interferon-gamma released in the supernatants with and without stimulation with the HDM extract were determined. RESULTS: Without stimulation, the proportions of subsets of T lymphocytes and their activation were similar between groups. When stimulated with the HDM allergen, the proportion of CD4+CD25+ cells from HDM responders was significantly higher than those in the control group. Comparison within groups of cell cultures with and without stimulation with the mite allergen showed that the proportion of CD4+, CD4+CD25+, CD4+/CD8+, and CD3+HLADR+ cells were significantly increased in HDM responders with stimulation; there was a trend for CD4+CD25+ cells to be increased in the HDM-allergic subjects; no increase in any T-lymphocyte subsets was found in the control subjects. The release of IL-5 was significantly greater in HDM responsers than in the other two groups. The severity of the immediate asthmatic reaction was significantly associated with the degree of nonallergic bronchial hyperresponsiveness and the amount of IL-5 released but not with the level of specific IgE to the mite allergen or subsets of T lymphocytes with and without stimulation. CONCLUSION: The findings suggest that responsiveness of T lymphocytes to allergen challenge in vitro may play a role in determining the bronchial response to the allergen in vivo.

Animals↗
PubMed1996

Diversity of allergens causing occupational asthma among cereal workers as demonstrated by exposure procedures.

BACKGROUND: Occupational asthma among cereal workers is frequently due to cereals but other allergens can also be responsible. OBJECTIVE: We evaluated the allergens causing occupational asthma in the patients who had been diagnosed in our Department during the last 5 years. Specific bronchial reactivity to the implicated allergens was assessed and compared by standardized bronchial challenge. METHODS: Twenty-one patients (12 bakers, three millers and six farmers) were studied. We carried out in vivo tests (skin and challenge tests) and in vitro tests (specific IgE measurement) with cereals, enzymes, soyabean, storage mites and egg. A definitive diagnosis was established by means of specific bronchial provocation tests (BPT), except in three patients in whom it could not be carried out due to the severity of their asthma. In these cases the causative agent had to be determined by means of conjunctival challenge. RESULTS: Cereals were the main sensitizers among bakers (75%) and farmers (66%). Bakers were also sensitive to alpha-amylase (41%) and soyabean (25%), and farmers, to soyabean (33%) and storage mites (33%). Occupational asthma was due to cereals, soyabean and storage mites among millers. CONCLUSIONS: Besides cereals, other allergens such as enzymes, leguminous, egg and storage mites can be the causative agents of occupational asthma among cereal workers. Sensitization to different allergens in the different jobs is very likely due to differences in exposure.

Adult↗
PubMed1995

Pickled onion-induced asthma: a model of sulfite-sensitive asthma?

BACKGROUND: Asthma elicited by sulfite ingestion has been mainly described in steroid-dependent and in non-atopic asthmatics. We have studied a group of 18 young extrinsic asthmatics who presented with asthma attacks immediately after eating pickled onions. OBJECTIVE: The aim of this study is to ascertain if these asthma attacks are elicited by sulfites contained in pickled onions and the influence of the dose and pH of onions. METHODS: The bronchial hyperreactivity of the patients was assessed by a methacholine challenge test. Oral challenge tests were performed with sodium metabisulfite (MSB) diluted in lemon juice at pH 4.2 and at pH 3.3 (only in patients who did not react with pH 4.2). Two types of pickled onions, Spanish and Dutch pickled onions, were used for oral challenge in seven of the patients. The Monier-Williams method was used to measure the SO2 concentration in pickled onions. RESULTS: The oral provocation test with MBS, pH 4.2, elicited a positive response in six patients (33.3%) and the test at pH 3.3 was positive in three out of 12. No significant difference in PD20 values was found between these groups. Three of the seven patients challenged with Spanish pickled onions had a positive reaction but had no reaction with Dutch pickled onions. The SO2 concentration in Spanish pickled onions varied between 765 and 1182 ppm while in Dutch pickled onions were 200 ppm; this exceeded the permitted level (100 ppm). SO2 release in Spanish pickled onion samples was nearly 2.5 times higher when the pH of the sample decreased from 4.2 to 3.3. CONCLUSION: High levels of SO2 in Spanish pickled onions, and their low pH (3.3) would be the responsible factors of the asthmatic outbreaks after ingestion of Spanish pickled onions by these patients.

Adolescent↗
PubMed1995

Peak expiratory flow monitoring is not a reliable method for establishing the diagnosis of occupational asthma.

This is a study of the reliability of peak expiratory flow (PEF) monitoring using a portable computerized peak flow meter, the VMX Mini-log, in 17 subjects referred for suspected occupational asthma. Subjects were requested to monitor their PEF six times daily using the VMX Mini-Log for 2 wk at work and at least 10 d away from work. They were unaware that their readings were stored by the flow meter in addition to the digital readout. Four subjects (22%) were unable to complete the monitoring. The results recorded by the subjects were compared with the results recorded by the VMX. Of those who completed the monitoring, only 55.3% of the records were completely accurate in terms of the value and the timing of the measurements, 23.3% were inaccurate either in terms of the recorded value or of the timing of the measurement, and the remainder were fabricated results (not recorded by the Mini-Log). Our results suggest that PEF monitoring using ordinary peak flow meters for assessment of work-relatedness of asthma has limitations and is not reliable.

Adult↗