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[A study of microdensitometric evaluation of opacity of maxillary sinuses in patients with nasal allergy].

The opacity of the maxillary sinuses on X-ray film in Waters' view in patients with nasal allergy was evaluated by a microdensitometer. The patients with nasal allergy were diagnosed with the positive results of the following; 1) eosinophilia in nasal secretion, 2) nasal provocation test, 3) intradermal skin test or radioallergosorbent test (RAST). The ratio of density of the maxillary sinuses and orbits was determined by a microdensitometer, and the ratio of the average degree of the opacity of the maxillary sinus to that of the ipsilateral orbit was designated as the M/O ratio. The normal range of the M/O ratio was set over the mean value -2 standard deviations in the normal group. The results are followings. 1) The abnormal shadows in the maxillary sinuses were found out to be 36.9% in patients with nasal allergy. 2) Patients under 15 years old had significantly higher incidence of abnormal shadows, especially in the bilateral sinuses compared with patients over 15 years old. 3) Polyps in the maxillary sinus were recognized in 5.0% of all the sinuses. 4) There were no significant differences for the incidence of abnormal shadow among the patients with nasal allergy caused by different antigens.

Absorptiometry, Photon↗

An evaluation of the allergic contact dermatitis potential of colloidal grain suspensions.

BACKGROUND: Colloidal grain suspensions have been used for decades as adjuncts in the treatment of atopic dermatitis, especially in the US. In Italy, many young children have been exposed to colloidal grains. Recently, it was suggested that these bath therapies may induce allergic contact dermatitis in some young atopic children. OBJECTIVE: To evaluate the allergic skin reactions to topical oat and rice colloidal grain suspensions of normal and atopic children with and without previous exposure to colloidal grain suspensions. METHODS: A double-blind, randomized patch study. Two concentrations of oat and rice colloidal grains (0.007% and 0.7%) were applied occlusively to the backs of 65 children living in Italy, ages 6 months to 2 years (43 were atopic and 22 were normal). RESULTS: There were neither immediate urticarial nor allergic reactions in any of the 65 study subjects, atopic or nonatopic; 5 of 43 (12%) atopic subjects developed irritant reactions to the test materials. Radioallergosorbent tests (RAST) tests were performed on 55 subjects. The negative RAST test results found in the nonatopic group correlated well with nonatopic status, but positive RAST tests were found in only 8 of 35 (23%) atopic dermatitis subjects. None of the sera from positive RAST scores corresponded to subjects with irritant patch reactions. CONCLUSIONS: The data indicate that topical colloidal grains can be used as an adjunct in the management of mild atopic dermatitis in children under 2 years of age. There was no evidence of sensitization to topical colloidal grains in the group studied.

Avena↗

Nasal allergen sensitivity and mucosal IgE antibodies.

Skin tests, nasal provocation tests, nasal smear tests, and serum-radioallergosorbent tests were performed on 17 patients with perennial allergic rhinitis, who had suffered nasal congestion without receiving any antiallergic treatment. After the above tests, tissue-radioallergosorbent tests (t-RAST) were conducted to determine IgE antibody levels in inferior turbinate mucosal samples taken peroperatively. The results obtained in this study suggest that the allergen sensitivity of the nasal mucosa correlates to some extent with the mucosal IgE antibody level, and that the t-RAST can provide us with objective data about nasal allergen sensitivity.

Humans↗

Allergens of Schistosoma mansoni. I. Comparison of the IgE response in human and experimental infections towards characterized allergens from adult worm products.

The reaction of adult worm products of Schistosoma mansoni with IgE antibodies in infected human and Fischer rat sera has been studied using the Prausnitz-Küstner test and the radioallergosorbent test. Incubation of worms in water released most of the soluble material reacting with both rat and human sera in the radioallergosorbent test. Sera from infected Fischer rats recognized a fraction with pI 4.9-5.2 separated by preparative isoelectric focusing throughout the time course of infection, whereas human sera reacted with material focusing between pI 4.4 and 6.0. A peak of allergenic activity with an apparent molecular weight between 70,000 and 150,000 was obtained by gel filtration. Human bilharzian sera also reacted with material in the molecular weight range 12,000-25,000. Allergenic material bound specifically to concanavalin A-Sepharose, Lens culinaris agglutinin-Ultrogel, and wheat germ agglutinin-Ultrogel, but substantial allergenic activity was also present in unbound fractions.

Allergens↗

IgE-mediated hypersensitivity and contact sensitivity to multiple environmental allergens in atopic dermatitis.

BACKGROUND AND DESIGN: Atopic dermatitis (AD) is a chronic eczematous skin disease that develops in a patient with atopic diathesis, which is characterized by an increased liability to produce IgE antibodies for environmental allergens mostly derived from other living organisms. Experimentally, eczematous skin lesions cannot be induced by immediate IgE-mediated reactions alone. They are produced by cell-mediated allergic contact reactions, and recently contact sensitivity to various environmental allergens has been demonstrated in patients with AD. However, the pathologic role of IgE-mediated skin hypersensitivity or that of delayed-type hypersensitivity to various environmental allergens in AD is not fully evaluated. They have been studied separately and against only specific allergens. Thus, we performed a combined testing procedure consisting of radioallergosorbent test, prick, and scarification patch tests for eight environmental allergens in 97 Japanese adult patients with AD; 48 of them had a history of atopic respiratory diseases (ARD), whereas the remaining 49 had no history of ARD (pure AD). RESULTS: Patients with AD, particularly those with ARD (AD+ARD), showed a higher incidence of positive radioallergosorbent test and prick test results as well as patch test results against multiple environmental allergens than healthy age-matched control subjects. Among them, we found a significantly high positive correlation between radioallergosorbent test scores and patch test reactions to two allergens, Japanese cedar, and Dermatophagoides farinae allergens in patients with AD. However, the patients with AD displayed a significantly lower incidence of positive patch test reactions to Candida albicans allergen than the healthy control subjects. Patients with AD with negative C albicans patch tests tended to have higher levels of total serum IgE including anti-C albicans IgE antibody. We found negative correlations between total serum IgE levels including specific antibodies and patch test reactions to C albicans allergen. CONCLUSIONS: Except for the dissociated reactivities to C albicans allergen consisting of decreased contact sensitivity and heightened IgE response, generally both IgE-mediated skin hypersensitivity and delayed-type hypersensitivity to various environmental allergens are pronounced in patients with AD. The combined use of these in vivo and in vitro tests is useful to estimate the immunological state of patients with AD.

Adolescent↗

Comparison between intracutaneous and prick tests in detecting sensitizations to common Mediterranean allergens.

The role of the intracutaneous test (IC) in clinical allergy routine was evaluated comparing its results with those from the prick test, the radioallergosorbent test (RAST), and the specific bronchial provocation test (BPT). The study was carried out making an a posteriori survey of 384 patients suffering from symptoms of perennial and seasonal rhinitis and/or bronchial asthma. They were tested with the most common allergens in the Mediterranean countries; 681 prick tests and 489 IC tests were compared with RAST and 69 with BPT. The IC tests showed disagreement with RAST and BPT more frequently than prick tests: this is attributable to a lesser degree of specificity of IC test performed with the usual concentrations, and depends on the nature of the allergens. On the other hand the prick test is no less sensitive than the IC test, being the occurrence of RAST positivity in patients with negative skin tests similar for the prick and IC tests. These results support the concept of the prick test as preferable with respect to the IC test because of its specificity and sensitivity.

Adolescent↗

Food sensitivity. Handling reactions to foods and food additives.

Food sensitivity is only one of several types of food-related reactions. Symptoms are not pathognomonic; hence, a broad differential diagnosis is often considered. Unless the anticipated reaction is systemic anaphylaxis, the role of any food suspected (by history, skin testing, and/or radioallergosorbent test) of causing the patient's symptoms should be verified by elimination-challenge testing. Dietary elimination is the most effective treatment, but its success depends on several factors.

Food Additives↗

Anaphylaxis from insect stings. Myths, controversy, and reality.

Some myths and controversies regarding allergy to insect stings have been resolved through research, and venom immunotherapy now has an important place in the prevention of life-threatening reactions to stings. Both children and adults who had cardiovascular and/or respiratory reactions to their most recent sting are candidates for this treatment, which should be discontinued at the end of 5 years (or sooner, if venom skin tests or radioallergosorbent tests are negative).

Adolescent↗

Fractionation and analysis of allergenicity of allergens from Prosopis juliflora pollen.

Prosopis juliflora pollen allergen extract was prepared, and its crude allergen extract was fractionated by Sephadex G-100 gel filtration. Six different fractions were obtained which was confirmed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Protein and carbohydrate content of each fraction were estimated. Fraction E (MW 20,000) showed a 25% carbohydrate concentration. The amino acid analysis indicated that this fraction was rich in glutamic acid and alanine. Antigenicity or allergenicity of fractionated allergens were checked by gel diffusion test, rocket immunoelectrophoresis, skin prick test, and radioallergosorbent test. All these test indicate that fraction E consisted mainly of allergenic molecules (MW 20,000) of P. juliflora pollen.

Allergens↗

Histamine release from human basophils by the insect allergen Chi t I.

Hemoglobins of the Diptera species Chironomus thummi thummi (Chi t I) are potent inhalant allergens. Chi t I-specific histamine release was measured by a new radioimmunoassay in whole human blood taken from 20 sensitized patients, 11 exposed nonsensitized probands, and 11 nonexposed controls. The sensitized patients, who all had positive skin tests and radioallergosorbent test results with Chi t I, showed a significantly higher histamine release than the two other groups. However, within the patient group, the percentage of released histamine did not correlate with the intensity of the skin test response or the concentration of Chi t I-specific IgE antibodies. Our results demonstrate that this method is a sensitive and specific in vitro test for evaluation of IgE-mediated sensitization.

Adult↗

Comparison of diagnostic tests for hymenoptera sting allergy.

The authors examined correlations among individual Hymenoptera venom skin tests, venom radioallergosorbent tests (RAST), venom-induced leukocyte histamine release (LHR) assays and individual Hymenoptera whole body extract (WBE) skin tests in 37 patients with histories of systemic reactions to Hymenoptera stings. Significant positive correlations were seen between the venom skin test results and results from either the venom RAST or the LHR assay for most venoms. There was a relatively high frequency of positive WBE skin tests in association with other negative tests. The ultimate diagnostic test for stinging insect sensitivity is a deliberate sting challenge; in lieu of such a sting the clinical history and the venom skin test appear to provide the best estimate of clinical Hymenoptera sting sensitivity.

Animals↗

Analysis of allergen-specific IgE responses in 341 allergic patients. Associations between allergens and between allergen groups and clinical diagnoses.

An allergic population of 341 patients was studied using 14 different allergen extracts in skin prick tests and radioallergosorbent tests (RAST) in an attempt to identify important allergen sources in the Sydney area and to examine relationships between these diagnostic methods and a number of clinical parameters. A computer based statistical analysis of the data revealed that: (a) male patients showed a significantly higher frequency of skin test reactivity to extracts of house dust and the house dust mite Dermatophagoides farinae; (b) the incidence of positive prick test reactions declined with age; (c) cross-reactive allergenic determinants were found in taxonomically-related extracts (e.g. between different house dust mites, pollens, and fungi); (d) a clear correlation emerged between relative potency using a histamine standard and RAST score which supports the continued use of histamine as a standard in skin prick testing; and (e) important associations between certain allergens and clinical diagnosis emerged (e.g. positive skin test reactions to house dust mites and epithelia but not pollens were associated with asthma).

Adolescent↗

Cloning and expression of a major allergen from Cupressus arizonica pollen, Cup a 3, a PR-5 protein expressed under polluted environment.

BACKGROUND: This paper describes the cloning and expression of the Cupressus arizonica pollen protein Cup a 3. In addition, we present its modulation under polluted environmental conditions. Species of the Cupressaceae family are important because of their high sensitization prevalence. METHODS: Cup a 3 cloning is based on the sequence of the homologous protein Jun a 3. Cup a 3 was expressed with good yield in the methylotropic yeast Pichia pastoris. RESULTS: Recombinant Cup a 3 (rCup a 3) contains 199 amino acids, 10 potential phosphorylation sites and no glycosylation sites. By immunoblot 63% of cypress allergic patients had specific immunoglobulin E antibodies against rCup a 3 (n = 104). This major allergen is homologous to members of the pathogenesis-related proteins (PR-5 group) and contributes to the overall allergenicity of C. arizonica pollen. Our results show that the increased expression of Cup a 3 is dependent on the pollution in the area where the pollen has been collected, being higher under polluted conditions. CONCLUSIONS: Cup a 3 is a PR-5 protein derived from C. arizonica pollen. The expression of the protein under polluted conditions has a direct incidence on the pollen allergenicity, as has been demonstrated by skin tests and Radioallergosorbent test inhibition.

Adult↗

Evaluation of a capsulated hydrophilic carrier polymer (the ImmunoCAP) for measurement of specific IgE antibodies.

The Pharmacia CAP System is a new assay for serum specific IgE, utilising a solid phase capable of binding more antigen than conventional systems. The CAP System has been evaluated in 69 consecutive patients referred to one allergy clinic in relation to skin prick test (SPT), radioallergosorbent test (Phadebas RAST) and specific allergy diagnosis for five inhalant allergens, D.pteronyssinus, timothy grass pollen, cat epithelium/dander, Cladosporium and Alternaria. Good correlation was obtained between RAST and CAP for all allergens, e.g. r = 0.974 for D.pteronyssinus and r = 0.964 for grass pollen. When sensitivity and specificity were examined for both CAP and RAST versus SPT, CAP was usually found to be of greater sensitivity than RAST, and of similar or slightly lower specificity. SPT gave more positive reactions than either in vitro test, but CAP gave more positives than RAST. Twenty-two of 336 (6.6%) tests were CAP positive/RAST negative, whereas a negative CAP with a positive RAST occurred in only 2/336 (0.6%) tests. Of patients with any test (SPT or RAST or CAP) for specific IgE positive, up to 20-30% did not have clinical allergy, confirming the importance of the history in interpreting these tests. Our results suggest that, for the allergens tested, the Pharmacia CAP System is more sensitive than the RAST, identifying more positive tests and approximating more closely to the SPT. It offers the additional advantages of speed and efficiency.

Adolescent↗

[A case of anaphylaxis caused by sunflower seed].

A 14 years old boy experienced an anaphylactic reaction of dyspnea, vomiting, urticaria and hypotension after he ate sunflower seeds. Specific IgE-mediated hypersensitivity to sunflower seen extract was demonstrated by skin tests and radioallergosorbent test (RAST). By immunoblotting test analysis (SDS-PAGE, Western blotting method), the allergenic activity of sunflower seem were shown to be in the MW range of 13.5 Kd.

Adolescent↗

[Assessment of the specific activity of commercial allergen preparations made of house dust in the bacteriosorption reaction: a comparison with the results of the radioallergosorbent inhibition test].

The activity of the commercial batches of house-dust (HD) allergens was compared in the inhibition of the radioallergosorbent test (RAST) and in the direct bacteriosorbent test (BST), detecting IgG to the antigens by adsorption on the complexes of whole staphylococcal cells containing protein A. BST was made with rabbit antiserum to HD allergen. This antiserum inhibited RAST by 76% and, therefore, contained antibodies to most of the allergenic determinants of HD. At the same time, no significant correlation between the activity of 15 batches of HD allergen was revealed in RAST inhibition and in BST with the above antiserum. Nevertheless, the exhaustion of the antiserum with a batch of HD allergen showing low activity in RAST inhibition, but high activity in BST made it possible to obtain BST results significantly correlating with the data resulting from RAST inhibition in two series of experiments.

Allergens↗

Histamine release from peripheral blood leucocytes in egg-allergic patients.

Twelve egg-allergic patients were selected on the basis of a clinical history of egg allergy and a positive skin-prick test (SPT) to whole egg. A study was then carried out on the ability of the patients' washed leucocytes to release histamine in the presence of whole egg, ovomucoid, ovalbumin and ovotransferrin. Histamine release (HR) from washed leucocytes was demonstrated in ten out of twelve patients, but only four out of ten released over 40% of their total histamine. Spontaneous HR ranged from 2.1-14.5% with a mean of 7.5%. There was good agreement between positive and negative HR, skin test and radioallergosorbent test (RAST) results. Concordance between the HR and skin test was found in 83%, HR and RAST in 71% and skin test and RAST in 78% of patients. However there was poor quantitative agreement between these three tests. When skin-prick tests and HR thresholds were compared, ovomucoid elicited the greatest skin test sensitivity in five out of six patients, whereas five of the same six were more sensitive to ovalbumin when judged by HR.

Adolescent↗