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Biomedical subjects

T Reunala

Publications and source records attributed to T Reunala.

At least 19 recordsLinked to original sources

Characterization of latex antigens and allergens in surgical gloves and natural rubber by immunoelectrophoretic methods.

Allergy to natural rubber (latex) products is increasingly frequent among both medical personnel and lay subjects. Although individual antigens and allergens in latex products have not been fully characterized, they are believed to derive from the sap of the rubber tree. Rabbit IgG and human IgE antibodies against rubber proteins were used to characterize antigens and allergens in surgical latex gloves and natural rubber by crossed immunoelectrophoresis and its modifications. The results from crossed-line immunoelectrophoresis demonstrated that the surgical latex gloves had at least 10 antigens in common with natural rubber sap and ammoniated latex. In crossed radioimmunoelectrophoresis, at least six of the 10 protein antigens in the surgical glove extract and natural rubber were allergens since they bound IgE antibodies from the latex-allergic patients' sera. The surgical glove extract also demonstrated one allergen not found in natural rubber, suggesting that rubber proteins may be altered during glove manufacture.

Animals

Evidence for a structural abnormality of collagen VII in a patient with dystrophic epidermolysis bullosa inversa.

Recent studies indicate that in skin of patients with dystrophic epidermolysis bullosa (EB) inversa, anchoring fibrils have an abnormal ultrastructure, but the major protein of these fibrils, collagen VII, is expressed and detectable with antibodies at the dermo-epidermal junction. For molecular characterization of this rare EB phenotype, skin biopsies from a patient with dystrophic EB inversa were investigated with indirect immunofluorescence, immunoelectron microscopy, and immunoblotting. Ultrastructural analysis of clinically uninvolved skin showed sublamina densa splitting. In unblistered areas, focal groups of anchoring fibrils that appeared loosely polymerized and without a distinct crossbanding pattern were observed. Indirect immunofluorescence staining with antibodies to collagen VII exhibited a linear fluorescence at the dermo-epidermal junction and at the roof of a spontaneous blister. Immunoelectron microscopy demonstrated staining of the poorly assembled anchoring fibrils, but no significant reaction in areas where no fibrillar structures could be discerned. In contrast to normal control skin, immunoblotting showed immunoreactive collagen VII in both epidermal and dermal extracts. Moreover, the dermis-associated collagen VII appeared as a distinct doubleband that contained the tissue form of collagen VII (250-300 kD) and an additional band with a slightly smaller molecular weight. In epidermal extracts one band, of the size of the tissue form, was detected. The studies on the present patient suggest that a structural abnormality of collagen VII that prevents its aggregation to stable dimers or polymerization to distinct anchoring fibrils may contribute to the etiopathogenesis of dystrophic EB inversa.

Adult

Diagnostic value of skin and laboratory tests in cow's milk allergy/intolerance.

The applicability of a panel of five skin and laboratory tests in the diagnosis of cow's milk allergy/intolerance (CMAI) was investigated. The tests used were prick and patch tests, RAST, basophil histamine release test (BHRT) and lymphocyte proliferation test (LPT). Twenty-two atopic children who had experienced either immediate or delayed cutaneous symptoms upon challenge with cow's milk (CM), and 12 non-milk-allergic controls with atopic dermatitis (AD) were included in the study. RAST, prick test, BHRT and LPT to CM and patch test to alpha-casein were positive in the CMAI group and non-milk-allergic atopic controls as follows: 59% and 33%, 57% and 0%, 55% and 17%, 77% and 17%, 33% and 0%. RAST, prick test and BHRT were more often positive in children exhibiting immediate reactions, and patch test and LPT more often positive in those having delayed reactions to CM. The panel of five tests detected 21/22 children with CMAI and gave false-positive results in 5/12 of non-milk allergic controls. The sensitivity and specificity of the panel in the diagnosis of CMAI were 95% and 58%, respectively.

Adolescent

Increase of lymphocytes bearing the gamma/delta T cell receptor in the jejunum of patients with dermatitis herpetiformis.

The densities of T cells and of cells bearing the T cell receptors gamma/delta and alpha/delta and the surface antigens CD4 and CD8 in jejunal specimens from 21 patients with dermatitis herpetiformis were compared with those in specimens from 13 untreated adults with coeliac disease and 13 control subjects. In the lamina propria of the jejunum the median density of gamma/delta+ cells was significantly (p less than 0.001) greater in untreated patients with dermatitis herpetiformis than in control subjects (114 v 36 cells/mm2) and similar to that found in the patients with coeliac disease (115 cells/mm2). The difference in gamma/delta+ cell density between patients with dermatitis herpetiformis and control subjects was much greater in the surface epithelium of the jejunum: the median density for 14 untreated patients with dermatitis herpetiformis was 39 cells/mm, for seven patients with dermatitis herpetiformis on a gluten free diet 34 cells/mm, and for control subjects 2 cells/mm; the coeliac patients had the same density as the patients with dermatitis herpetiformis (45 cells/mm). The higher density of cells bearing the alpha/delta T cell receptor in the epithelium (median 77 cells/mm) of untreated patients with dermatitis herpetiformis was associated with a gluten containing diet; in specimens taken from patients with dermatitis herpetiformis on a gluten free diet the median density was similar to that in the control subjects (44 v 39 cells/mm). The increase in the number of lymphocytes bearing the T cell receptor gamma/delta, particularly in the epithelium of the jejunum, seems to be a constant marker for these closely related diseases, whereas the density of alpha/delta+ T cells is dependent on the diet.

Adolescent

Selective IgA deficiency and coeliac disease.

Twenty-five children and adults with concomitant coeliac disease and selective IgA deficiency are described. IgG-class reticulin antibodies were positive in 94%. The clinical course of coeliac disease did not differ from that of patients with normal serum IgA level. Patients with IgA deficiency also had other concomitant diseases, especially autoimmune diseases. Patients with selective IgA deficiency have at least a tenfold risk of coeliac disease compared with the population in general.

Adolescent

Immediate and delayed hypersensitivity reactions to birch pollen in patients with atopic dermatitis.

We investigated immediate and delayed hypersensitivity to birch pollen in 10 patients with atopic dermatitis (AD) who had experienced a worsening of their eczema during the birch pollen season. The patients were prick- and patch-tested and antigen-induced basophil histamine release and lymphocyte proliferation were measured. 9/10 birch pollen-allergic patients proved positive in the histamine release test and the results correlated with specific IgE levels measured by RAST. Birch pollen antigen induced lymphocyte proliferation in 6/10 patients, but a positive patch test result was obtained in only one case. Both peripheral blood monocytes and purified epidermal Langerhans' cells were able to present birch pollen antigen to T cells, although Langerhans' s cells seemed to function less efficiently in this respect.

Allergens

Alcohol and smoking: risk factors for infectious eczematoid dermatitis?

Risk factors for infectious eczematoid dermatitis (IED) were analyzed in a study of males aged 19-50 years. The subjects were 43 IED patients and 226 controls with other skin diseases from the dermatological outpatient clinics of three University Hospitals in Finland. The patients' lifestyles were assessed by a self-administered questionnaire pertaining to two specified periods: the period 12 months before the onset of the skin disease and the period 12 months before the examination date. Recalled mean alcohol intake before the onset of the skin disease was 39.2 g/day for the IED patients and 17.1 g/day for the controls (p = 0.04). The average number of cigarettes smoked daily was 17.7 for the IED patients and 10.4 for the control patients (p = 0.001). The IED patients significantly reduced their alcohol intake after the onset of the skin disease. In logistic regression analysis, IED associated with alcohol intake and smoking but not with coffee consumption, life events, age, marital status, or social group. The odds ratio for IED at an alcohol intake of 50 g/day as against no intake, was 1.7 (95% confidence interval 1.03-2.7), and the odds ratio at a tobacco consumption rate of 20 cigarettes/day as against no use of tobacco, was 2.1 (1.2-3.7). We conclude that alcohol intake and smoking appear to be risk factors for infectious eczematoid dermatitis among males.

Adult

Coeliac-type dental enamel defects in patients with dermatitis herpetiformis.

The teeth of 30 adult patients with dermatitis herpetiformis and 66 sex- and age-matched healthy controls were examined for dental enamel defects. Sixteen of the patients (53%) with dermatitis herpetiformis, opposed to only one (2%) of the healthy controls (p less than 0.001), were found to have coeliactype permanent-tooth enamel defects. The grades of these defects were milder than those described for severe coeliac disease. There was no correlation between the degree of enamel defects and jejunal villous atrophy. The present finding of frequent coeliactype dental enamel defects in adults with dermatitis herpetiformis suggests that these patients were already suffering from subclinical gluteninduced enteropathy in early childhood, at the time when the crowns of permanent teeth develop.

Adult

Cutaneous reactivity to mosquito bites: effect of cetirizine and development of anti-mosquito antibodies.

Cutaneous reactivity to mosquito bites was examined in 27 adult volunteers exposed to Aedes communis mosquitoes. Twenty-three subjects showed a combination of immediate wealing and delayed bite-papules, two subjects each experienced only immediate or delayed cutaneous reactions and two were non-responsive to the bites. The mean size of wealing and the mean score of pruritus was similar in 19 non-atopic and in eight atopic volunteers. These results confirm that normal subjects exhibit different stages of sensitization to mosquito bites. At the onset of the mosquito season, immunoblotting showed that four of 21 subjects (19%) had IgG-class antibodies to a recently described 21.5 kD Aedes communis mosquito antigen. After a 10-day exposure to a mean of 47 mosquito bites, these antibodies were found in 10 subjects (48%) who exhibited both strong and weak cutaneous bite-lesions. A placebo-controlled, double-blind study with cetirizine 10 mg was performed to examine the effect of this non-sedating antihistamine on mosquito bites. The bite lesions were measured and pruritus scored at 15 min, 60 min, 12 hr, and 24 hr. Cetirizine decreased significantly immediate wealing and pruritus (P less than 0.01), but had no effect on the delayed symptoms. This result supports the view that immediate mosquito-bite reactions are histamine-mediated.

Adolescent

Lymphocyte proliferation test as a diagnostic aid in chromium contact sensitivity.

We investigated the clinical applicability of the lymphocyte proliferation test (LPT) in chromium contact sensitivity. 6 out of 8 chromium-sensitive patients were positive in the LPT, whereas none of 8 non-chromium-sensitive controls responded in vitro to tri- or hexavalent chromium compounds. LPT thus appeared to offer an additional diagnostic tool in chromium sensitivity. We also studied cellular interactions in 4 of our chromium-sensitive patients. Sensitized T-lymphocytes could be activated to proliferate only in the presence of accessory cells, of which epidermal Langerhans cells (LC) appeared more efficient than blood adherent cells.

Adult

Surgical latex glove allergy: characterization of rubber protein allergens by immunoblotting.

Immunoblot analysis employing IgE antibodies derived from sera of 3 physicians and 2 nurses allergic to surgical latex gloves, disclosed 10 allergens in natural rubber sap. Nine of the 10 allergens were detected in ammoniated natural rubber latex, but only 4 allergens in a latex glove extract. The allergenic proteins had apparent molecular weights ranging from 14 to 70 kD. Allergens with molecular weights of 14 and 21 kD showed the most intense immunoblot reactions suggesting that these proteins could be the major allergens in the natural rubber. An 11-kD protein and a 26-kD protein were only seen in the glove extract, indicating that they could be modified rubber proteins formed during glove manufacture.

Adult

Alcohol intake: a risk factor for psoriasis in young and middle aged men?

OBJECTIVE: To clarify the nature of the association between alcohol intake and psoriasis. DESIGN: Case-control study of men aged 19-50 with onset of skin disease in 1976 or later. SETTING: Outpatient clinics of the departments of dermatology of the university central hospitals in Helsinki, Oulu, and Tampere from September 1987 to April 1989. SUBJECTS: 144 Patients with psoriasis and 285 unmatched controls with other skin diseases. MAIN OUTCOME MEASURES: Results of clinical examination and self administered questionnaire assessing lifestyle and alcohol intake during two specified periods--namely, 12 months before the onset of skin disease and 12 months before the date of examination. RESULTS: Recalled mean alcohol intake before the onset of skin diseases was 42.9 g/day among the patients with psoriasis and 21.0 g/day among the controls. In logistic regression analysis psoriasis was associated with alcohol intake but not with coffee consumption, smoking, age, marital state, or social group. The odds ratio for psoriasis at an alcohol intake of 100 g/day compared with no intake was 2.2 (95% confidence interval 1.3 to 3.9). The controls decreased their alcohol intake after the onset of the disease but the group with psoriasis did not. Analysis of serum enzyme values showed that gamma-glutamyltransferase activity was significantly correlated with alcohol intake (r = 0.35), the mean activity being 75.0 U/l among patients with psoriasis and 41.9 U/l among controls. CONCLUSIONS: Alcohol is a risk factor for psoriasis in young and middle aged men, and psoriasis may sustain drinking.

Adult