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Biomedical subjects

W T Kniker

Publications and source records attributed to W T Kniker.

At least 19 recordsLinked to original sources
PubMed1993

Delayed type hypersensitivity in patients with rheumatoid arthritis.

Our study examines the relationship between in vivo delayed type hypersensitivity (DTH) and clinical and laboratory variables associated with rheumatoid arthritis (RA). Eleven patients with RA were examined. They were receiving no disease modifying drugs, immunosuppressive agents or corticosteroids. Skin tests were performed with the Multitest CMI system employing 7 antigens simultaneously. No patients were truly anergic, however, 3 of the 11 patients were hyporesponsive. No difference was noted between the total in vivo DTH responses of the patient and control populations. A significant correlation was observed between total DTH and the overall activity of the RA as measured by the erythrocyte sedimentation rate (ESR). However, there was no relationship between the total DTH scores and the degree of synovitis. There was no correlation between DTH and a variety of laboratory variables including the autologous mixed lymphocyte response, and the percentage of activated CD4+ or CD8+ T lymphocytes. These observations indicate that while anergy was uncommon in our population of patients with RA, decreased DTH responses were associated with greater disease activity as determined by the ESR.

Adult↗
PubMed1991

Metaproterenol (Alupent) metered dose inhaler in children 5-12 years of age.

This multiclinic study was performed to evaluate the safety and efficacy of metaproterenol sulfate (Alupent) metered dose inhaler in children with asthma ages 5 to 12 years. A total of 268 children completed this study according to the protocol, having received either metaproterenol or placebo for 30 consecutive days. Full spirometric testing was done pre- and postdose on Days 1 and 30 for a total duration of 6 hours on each day. The results showed that metaproterenol was consistently superior to placebo in all pulmonary function parameters measured on Days 1 and 30. This difference was statistically significant for peak values and areas under the curves for both FEV1 and FEF25-75%. There were no significant side effects noted. We conclude that metaproterenol metered dose inhaler is safe and effective in the treatment of asthma in children ages 5 to 12 years.

Administration, Inhalation↗
PubMed1986

An allergist's view of atopic dermatitis.

Based on the disagreements about the role of atopy in the condition known as atopic dermatitis, it is not surprising that there have been divergent views concerning the appropriate treatment of the disease. A large population of physicians, including most dermatologists and some allergists, believe that the fundamental approach to a successful outcome of the dermatitis is to control the itching and to improve the chronic dryness of the skin. Following a completely different approach are physicians, including many allergists, who are convinced that atopic dermatitis usually involves an imbalance of, or an abnormality in, the immunologic system. For this group, one of the main features of treatment is to remove or avoid offending allergens. Because of the demonstrated pathogenic role of food allergy in the majority of patients with eczema, any child with chronic moderate or severe disease that requires daily medications should be considered for allergic evaluation of this disorder. Further studies still need to be performed concerning the role of environmental and food allergens and the early- and late-phase reactions in atopic dermatitis.

Child↗
PubMed1986

Changes in non-specific immune responses induced by repeated delayed-type hypersensitivity skin testing with multiple antigens.

Delayed-type hypersensitivity (DTH) responses following in vivo multiple-antigen skin testing in healthy individuals have been well described as indicators of immune responsiveness. In contrast, little information is available about how repeated in vivo multiple antigen skin testing could effect major non-specific parameters of immune responses. In a prospective study of 22 healthy adult volunteers, DTH skin tests were performed 6 times at 4-week intervals over a 28-week course. Prior to each skin test, blood specimens were collected and evaluated by in vitro assays of non-specific parameters related to humoral and cell-mediated immune (CMI) responses. Sustained effects of repeated skin tests in the volunteers included decreased numbers of circulating polymorphonuclear leukocytes (PMNLs), increased serum IgM levels and decreased DTH responses in those individuals originally designated as high DTH responders. Increased lymphocyte transformation with PHA was transiently observed in the study group at 4-12 weeks into the study. In contrast, numbers of T, B and total lymphocytes, levels of IgG, IgA, and circulating immune complexes, and serum blocking activity did not change. This study suggests that few alterations in non-specific immune parameters may be expected to occur in normal, adult individuals as a result of repeated multiple-antigen skin tests.

Adolescent↗
PubMed1985

Cell-mediated immunity in schoolchildren assessed by multitest skin testing. Normal values and proposed scoring system for healthy children.

Measurement of cutaneous delayed-type hypersensitivity (DTH) to a battery of ubiquitous antigens is an accepted means of assessing cell-mediated immunity (CMI). The recently introduced Multitest CMI system consists of a plastic multiple puncture device that simultaneously applies seven standardized recall antigens in a reproducible manner. A representative population of 448 healthy US schoolchildren was tested to determine incidence and size of DTH responses to each of the seven antigens. All responded to one or more antigens, the number and size of reactions generally increasing with age. Incidence of positive DTH tests was highest for tetanus and diphtheria toxoids, intermediate for streptococcal, Candida, and Proteus antigens, and lowest for tuberculin and Trichophyton antigens. These normal values, related to age and sex, can be a foundation for immunologic evaluation and are the basis of a proposed scoring system that distinguishes between normal DTH reactivity and diminished responsiveness.

Adolescent↗
PubMed1985

Cell-mediated immunity assessed by Multitest CMI skin testing in infants and preschool children.

Two hundred twenty-one healthy children, from 6 months to 7 years of age, were tested for delayed-type hypersensitivity (DTH) by the Multitest CMI (cell-mediated immunity) (Merieux Institute, Miami). This device permits the simultaneous application of seven standardized recall antigens and a glycerol diluent control. Younger children were tested on the back and older children on the volar surface of the forearm. Only 6.8% of the children were anergic, and most of them (11/15) were female. The DTH responses were present for one or more antigens in 93% of the infants. The DTH responses increased tremendously during the second year of life and increased slowly thereafter. A relatively high incidence of positive reactions was found for three of the tested antigens--diphtheria toxoid (79%), tetanus toxoid (62%), and Proteus (57%), in children in the preschool years, and accounted for three fourths of all positive reactions. Much lower levels were found for Streptococcus (25%), Candida (16%), Trichophyton (5%), and tuberculin (4%). Measurement of DTH by the standardized Multitest CMI system seems to be a convenient and reliable tool for assessing CMI function in infants and small children. The tool permitted us to measure patterns of DTH responses from infancy onward in a healthy population and to develop index values in a normal reference population with which any tested preschool child can be compared.

Age Factors↗
PubMed1985

A controlled study of education for improving compliance with cromolyn sodium (Intal): the importance of physician-patient communication.

The effectiveness of an educational program to increase compliance with cromolyn sodium was assessed in 31 children and adolescents 6 to 17 years of age. Patients were randomly assigned to an education or noneducation group. A standard education program regarding asthma and asthma medications was provided to the education group during four monthly visits. At each visit, all patients were assessed in terms of knowledge of asthma and medications, asthma-related symptoms, and pulmonary function. Patients were also asked to self-rate their compliance. The education program increased the patients' knowledge of cromolyn, and appeared to result in increased cromolyn compliance. Post-hoc analyses, however, suggested that increased compliance did not correspond to improved medical status unless the quality of management (by physician and parents) of the child's asthma was taken into account. These results suggest that inadequate management of asthma in children may be a more serious problem than patient noncompliance.

Adolescent↗
PubMed1985

Cell mediated immunity in school children assessed by Multitest CMI skin testing II. Epidemiologic factors affecting immune responsiveness.

The Multitest CMI system was used to measure cutaneous delayed type hypersensitivity (DTH) to a standardized battery of seven recall antigens in 448 healthy school children in relation to sex, age, race, and socioeconomic groups. Blacks demonstrated highest overall DTH, hispanics were intermediate, and whites were lowest. There was a trend for males to be more reactive than females at certain ages in each race. Incidence of reduced DTH scores (relative to adult values) was somewhat increased in the youngest school children, chiefly whites. Incidence and size of DTH responses to certain antigens were consistently higher in the blacks and/or hispanics as compared with whites. Blacks lived almost exclusively in the "poorer" school district, hispanics were evenly divided in both districts, while whites were mostly from the "affluent" district. Level of DTH appeared to be greatest in children from relatively poor homes possibly reflecting more intense and frequent exposure to ubiquitous microorganisms.

Adolescent↗
PubMed1984

Multitest CMI for standardized measurement of delayed cutaneous hypersensitivity and cell-mediated immunity. Normal values and proposed scoring system for healthy adults in the U.S.A.

The Multitest CMI system, a disposable device that simultaneously applies seven standardized preloaded antigens and diluent control, is a major advance for measurement of delayed type hypersensitivity (DTH) in assessment of cell-mediated immunity (CMI). The system was tested in 402 healthy adults, aged 17 to 92 years, to determine normal values for incidence and size of DTH responses. Incidence of positive responses to individual antigens varied from 85% to 46%, with great variability related to age and sex. To better assess CMI, a two-part score based on 48-hour readings was employed. The mean number of positive antigens ranged between four and five, and the mean sum of their mm induration ranged between 18 and 25, with both scores increasing with advancing age. A statistical zone of reduced DTH scores (hypoergy) was identified. The Multitest CMI system appears to be a practical means of reproducibly assessing CMI in subjects with immunologic, metabolic, infectious, or neoplastic disorders. The scores in our population may serve as reference values to which results from any tested adult can be compared.

Adolescent↗
PubMed1982

Aggressive coseasonal immunotherapy in mountain cedar pollen allergy.

Ninety adults with "mountain cedar" pollen allergy were started on coseasonal immunotherapy regimens in December 1979. At season's end, there were 20 whose starting antigen dose was based on serial dilution end point titration (SDET), 1:2,500 or 1:12,500 weight by volume (w/v); 28 in a "traditional" group started at 1:62,500 w/v; and 28 who had been double-blind placebo control subjects. Injections twice weekly were pushed aggressively toward maintenance. The SDET group received 11 times more antigen than the traditional group; both showed a trend for fewer symptoms than the placebo group. As compared with the other groups, SDET subjects had substantially blunted total and specific IgE responses in season, lower specific IgE level at season's end and less shift of skin end point toward higher dilutions. The findings demonstrate that substantial immunologic effects are possible in the first months of aggressive coseasonal immunotherapy.

Adolescent↗
PubMed1981

Rinkel injection therapy: a multicenter controlled study.

The American Academy of Allergy sponsored a 2-yr "double blind" multicenter study of the effect of Rinkel injection therapy (RIT) compared with a histamine placebo in subjects with atopic rhinitis. Accumulated data included the symptom, medication, and physical examination scores and specific IgE antibody levels measured by the radioallergosorbent test (RAST). A total of 155 subjects (81 treated, 74 placebo) entered the project from six centers during their respective ragweed, grass, and mountain cedar pollen (from one center) seasons for a total of 11 pollen seasons. The total mean cumulative dose of extract was 18.6 PNU, which is much lower than recommended for standard immunotherapy. With one exception, none of the centers reported a consistent significant difference between the pollen extract-treated and placebo-treated groups in any of the weekly mean scores or the RAST before, during, and after the pollen seasons. For 4 wk after the height of the mountain cedar season the group treated with pollen extract showed a significant decrease in weekly mean symptom and medication scores as compared with the placebo group. The overall comparison of the mean seasonal scores for the entire study, however, showed no significant difference between the treated and placebo groups. We conclude the RIT is no more effective than a histamine placebo in influencing the weekly mean symptom, medication, and physical examination scores or IgE antibody levels.

Adolescent↗