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PubMed1989

Occupational allergic rhinitis reaction to psyllium.

We report studies that document a specific rhinitic reaction that developed as a result of occupational exposure to a psyllium-based powdered laxative. This nurse had a nonatopic family history, personal evidence of atopy (skin test reactions to pollen, cat dander, and house dust), and a significant elevation of antipsyllium IgE. Measurements of nasal and lower airway resistance documented only nasal obstruction to brief inhalational challenge to the laxative. Symptomatic relief was achieved with prior treatment with cromolyn. We suggest that nasal airway challenge can document and assess treatment for occupational rhinitis.

Airway Resistance↗

PubMed2001

Endogenous function and biological significance of aeroallergens: an update.

Significant advances have been made in delineating the structure and function of the clinically important aeroallergens. Most have now been characterized at the molecular level, and their endogenous function determined. In the period of review, however, several novel allergens have been identified. They include the house dust mite lipophorins and gelsolins, and the birch isoflavone reductase. In addition, the functions of previously described allergens have now been established or inferred on the basis of homology studies. For example, cat Fel d 1 and the grass pollen group 1 allergens possess proteolytic activity and the thaumatin-like plant and pollen allergens possess endo-beta1,3-glucanase activity. Similarly, the lipocalin allergens may possess endonuclease activity, and the mite group 2 allergens may bind cholesterol. The three-dimensional structure of the horse dander lipocalin Equ c 1 and the honey bee Api m 2 allergens have also been determined during the review period. Finally, in this period, a variety of novel or improved immunotherapeutic allergen reagents designed to redirect the host immune response from a T-helper-2 to a T-helper-1 cell phenotype have been described, in particular, allergen and immunostimulatory CpG motif conjugates.

Allergens↗

PubMed1995

cDNA cloning and protein analysis of a bovine dermal allergen with homology to psoriasin.

Immunoscreening of a cDNA library from bovine skin led to isolation of clones coding for an allergen named BDA11. Sequence analysis of the clones revealed that they can encode a protein of 11.6 kDa with a predicted pI of 5.19. Allergenicity of BDA11 was verified by the IgE reactivity in cattle-allergic patients' sera with the recombinant protein produced in Escherichia coli. A biochemically purified native allergen of 11 kDa from bovine dander was identified as BDA11 by peptide sequencing. Homology comparisons showed that BDA11 had a 63.4% amino acid identity with human psoriasin. Psoriasin is a calcium-binding protein expressed in keratinocytes, and it is strongly up-regulated in psoriatic skin. BDA11 also had segments homologous with calcium-binding proteins from three other species.

Allergens↗

PubMedDate not supplied

Evaluating the needs of children with asthma in home care: the vital role of nurses as caregivers and educators.

To date, few evaluations have examined issues specific to children's asthma management in their homes. This study examined the characteristics, risk factors, and needs of children with asthma, and the impact of home health nurses on improving parents'/family caregivers' knowledge about asthma triggers and management. The medical records of children, </=19 years, residing in New York City, who were admitted to home care with asthma in 1999 (n = 1,007) were reviewed retrospectively to collect a wide range of data. The majority of children with asthma in home care were </=5 years, male, racial/ethnic minorities, and hospital referred. Approximately one in four children with asthma suffered from additional comorbidities. Home environmental triggers included dust/dust mites, animal dander, mold, perfumes/detergents, and cigarette smoke. Notable psychosocial triggers were family tensions, physical activity, anxiety/stress, and friends/peer pressure. Most parents/family caregivers had inadequate knowledge about recognition of asthma attacks and its triggers and management. Discharge assessments suggested that home health nurses can help improve caregivers' knowledge about asthma management. Children with asthma in home care have diverse needs, receive few nurse home visits, and have parents/family caregivers in need of more intensive education on asthma symptom recognition and management.

Asthma↗

PubMed2006

The course of eczema in children aged 5-7 years and its relation to atopy: differences between boys and girls.

BACKGROUND: The role of atopy in the pathophysiology of eczema is still under debate. The concept and analyses of the nonatopic and atopic subtypes of eczema have gained increasing interest in recent studies. The course of these subtypes and differences between boys and girls have not been investigated so far. OBJECTIVES: To examine the course of nonatopic and atopic eczema in preschool children from Germany with regard to sex. METHODS: Repeated cross-sectional studies were performed in 5-7-year-old preschool children from Germany between 1994 and 2000. Individuals with eczema were identified by a dermatological examination. In addition to a questionnaire, skin prick tests and analyses of serum IgE antibodies against seven and five environmental allergens, respectively, were performed. Atopy was defined by sensitization to at least one of five common aeroallergens (birch, grass and mugwort pollen, house dust mites, cat dander). In part of the study population investigations of spare time behaviour and skin function were carried out (including stratum corneum hydration and skin surface pH). RESULTS: A total of 2693 girls and 2783 boys underwent a full dermatological examination of the skin and determination of sensitization. Among the girls, 8.7% demonstrated eczema clinically at the day of investigation in contrast to 6.1% of the boys. In girls, early onset eczema (< 2 years of age) was strongly related to atopy at age 5-7 years [odds ratio (OR) 3.7; 95% confidence interval (CI) 2.7-5.1], whereas late-onset eczema (> or = 2 years of age) was not (OR 1.0; 95% CI 0.7-1.5). Boys were more often atopic at the age of 5-7 years than girls (28.3% vs. 20.6%), and early and late-onset eczema were related to atopy without such a difference (OR 2.8, 95% CI 2.0-4.0; OR 1.9, 95% CI 1.3-2.8, respectively). The excess of current eczema in 5-7-year-old girls compared with boys was related to the nonatopic type. The higher susceptibility of girls in that age group to develop eczema was reflected by the skin physiological examination: even girls without eczema had significantly higher skin surface pH and lower stratum corneum hydration than boys. Additionally, questionnaire data revealed that girls more often than boys predominantly played indoors, which was associated with more eczema. CONCLUSIONS: Atopy and eczema develop differently in boys and girls. Boys are more often atopic, whereas girls suffer significantly more often from eczema without relation to atopy. The nonatopic type of eczema in preschool girls is noticed predominantly after their second birthday. Genetic and lifestyle factors may contribute to this difference.

Age of Onset↗

PubMed1975

In vitro diagnosis of atopic allergy. The occurrence and clustering of positive RAST results as a function of age and total IgE concentration.

Specific IgE antibodies were determined on a routine basis in patient sera using the radioallergosorbent test (RAST) with a panel of ten common allergens. Total IgE was also assayed. Of all positive RAST reactions observed, 74% were against the following allergens: horse and cat epithelium, birch and timothy pollen, and house dust. Clustering (occurrence together with significantly elevated frequencies) accompanied both positive reactions to some animal danders and food allergens. Children in all age groups had significantly more positive food RAST results than adults, and this explains the clustering among food allergen results. Children aged 0-4 years had few positive pollen results. Among those with at least one positive RAST result, the mean number of positive results was 3.3, a figure which did not vary with age. In the present patient population 37% had a total IgE above the upper reference (normal) limit, and of these 95% had at least one positive RAST result. A normal or low IgE value was found to be less informative.

Adolescent↗

PubMed1978

Relationship between nasal and conjunctival tests in patients with allergic rhinitis.

Simultaneous conjunctival and nasal provcation tests, a total of 174 test pairs, were carried out in fifty patients with allergic rhinitis, using serially diluted antigen solutions of birch, Timothy grass and mugwort pollen, as well as cat and dog dander. The nasal mucosa was found to be more sensitive than the conjunctival mucosa in ninety-six test pairs (55%). This differs from earlier reports. Nasal reaction only was observed in twenty-nine instances (17%). Posterior rhinomanometry was also used to evaluate test reactions, but was found to yield little additional information. In 43% of nasal provocation tests, which according to other criteria were positive, the rhinomanometric results were negative. Despite a fairly good correlation between the results obtained by nasal and conjunctival challenge, the results point to organ specificity in type I reactions. Provocation tests, if indicated in a thorough allergy evaluation, should be performed in the shock organ. The provocation methods and interpretation of reactions of this study differ from those of earlier reports. Comparison of results is difficult and standardization of methods is needed.

Adolescent↗

PubMed1978

Relationship between the results of bronchial, nasal and conjunctival provocation tests in patients with asthma.

Skin tests and bronchial, nasal and conjunctival provocation tests with pollen and animal dander allergens were performed in thirty patients with atopic asthma. In vivo test results were compared only when the same batch of allergen had been used. A nasal reaction was mostly elicied at a lower concentration of allergen than was needed to elicit a bronchial reaction (P less than 0.01). Positive nasal reactions were often obtained when the corresponding bronchial tests were negative. The conjunctiva reacted to lower concentrations than the bronchi in a third of the instances of testing, with most of these being tests with mugwort allergen (P less than 0.05). A positive skin test in cases with a negative bronchial challenge test was often accompained by a positive nasal test and in some cases by a positive conjunctival test. It is concluded that nasal or conjunctival provocation tests do not replace bronchial challenge tests. In an asthmatic patient who gives no reaction to bronchial challenge with a particular allergen, a positive skin test may reflect a nasal allergy.

Adolescent↗

PubMed1980

Predictable clinical disorders related to serum and saliva Ig-levels and the number of circulating T cells in asthmatic chidren.

An examination was made of 221 children with bronchial asthma, who were divided into six groups according to serum and saliva Ig levels and the number of circulating T cells. Absence or small amounts of IgA and low or low-normal numbers of T cells were associated with (1) atopic dermatitis, (2) hypersensitivity to house dust mite and animal danders, (3) previous hospital admissions due to respiratory tract infections with pathogenic bacteria and (4) a high family incidence of allergic diseases. In a group of patients with IgA deficiency and elevated serum and saliva IgM, respiratory tract infections were not common, and furthermore, in another group of IgA-deficient patients with normal numbers of circulating T cells, atopic dermatitis was rare. In the latter patients, allergic rhinitis occurred very frequently, and in that respect they resembled a group of patients with combined high IgM/high IgE levels. Another group of asthmatic children with normal Ig levels represented an intermediate type of patient with regard to hypersensitivity to different allergens and family incidence of allergy on the one hand, and the occurrence of atopic dermatitis and allergic rhinitis on the other. Investigations on Ig levels and circulating T cells in asthmatic children may provide important clues into disease classification and mechanisms of such patients.

Asthma↗

PubMed1980

Double-blind crossover trial comparing beclomethasone dipropionate and sodium cromoglycate in perennial allergic rhinitis.

A double-blind crossover trial comparing the clinical efficacy of intranasal beclomethasone dipropionate and intranasal sodium cromoglycate was carried out in fourteen patients with perennial rhinitis due to animal danders. Intranasal beclomethasone dipropionate was significantly more effective than intranasal sodium cromoglycate in relieving nasal obstruction, nasal discharge and sneezing. Eleven patients reported preference for beclomethasone dipropionate and three had no preference for either drug.

Adolescent↗

PubMed1980

The atopic syndrome: in vitro immunological characteristics of clinically defined subgroups of atopic subjects.

Total IgE, selected specific IgE antibody levels, C2 and yeast opsonization were measured in four clinically defined subgroups of atopic patients who had previously been HLA-typed. Each group was characterized by a distinctive mean total IgE level and profile of specific IgE responses. All groups gave comparable levels of IgE antibodies to Timothy grass pollen but in patients initially presenting with infantile eczema and who subsequently developed asthma and/or hay fever, IgE antibodies to bovine milk proteins, egg ovalbumin and cat dander were frequently observed whereas in patients initially presenting with hay fever later in life these antibodies were usually absent. Computer assisted analysis failed to show any association between IgE antibody responses and (a) the HLA phenotypes A1,B8 and A3,B7 (b) C2 levels and (c) the yeast opsonization index.

Adult↗

PubMed1981

The incidence and causative factors of atopic asthma and rhinitis in an Orkney farming community.

Fifty farming families on the mainland (the largest island) or Orkney were surveyed to assess the amount of allergic respiratory disease and the principal causative factor. This account deals with only type I allergy and demonstrates a prevalence of asthma and rhinitis of 17.3% and of extrinsic asthma and rhinitis, in which definite allergic causes can be identified, of 12.7%. In addition it is shown that over one-fifth of the farming community are 'atopic' in that they demonstrate positive prick tests to one or more allergens. Less than 50% of those with allergic respiratory disease have attended the doctor with their complaint, a fact which calls in question the validity of epidemiological studies of allergic disease based on hospital and clinic attendances. Sex distribution confirms the finding that males suffer from asthma more frequently than females, however more females than males give positive skin tests without exhibiting symptoms of allergy. Pollens, animal danders and fungi all have a part to play in the aetiology of asthma and rhinitis among Orkney farmers, although the incidence of grass pollenosis is well below average. The two commonest allergens are hay dust and Dermatophagoides pteronyssinus which are found frequently to affect the same subject.

Adolescent↗

PubMed1981

Prevention of asthma.

Infants born of allergic mothers but normal fathers, who had eczema and who were fed cows' milk, had a significantly greater incidence of asthma (P less than 0.001) than infants with a similar history but who were breast-fed. An analysis of all breast-fed infants in the study showed that they were less likely to develop asthma than those who were bottle-fed (P less than 0.06). There was a lower incidence of allergy in infants born of families with allergic mothers and normal fathers, than in families in which both parents were allergic (P less than 0.02). In skin tests of both breast or bottle-fed babies, the two most common allergens eliciting reactions were egg and cat dander.

Animals↗

PubMed1982

Allergen-specific IgE and IgG4 antibody levels in sera and the capacity of these sera to sensitize basophil leucocytes in vitro.

Leucocytes from normal non-allergic donors were passively sensitized with sixty-five atopic sera that contained IgE directed against house dust mite (HDM) or guinea-pig dander (GPD). In no serum was there any IgE with an abnormal basophil anaphylactic-sensitizing activity. In sera from patients hypersensitive to GPD, both GPD-specific IgE and IgG4 were measured. A significant correlation was found between the GPD-IgE RAST and the basophil-sensitizing capacity of GPD-positive sera, but no correlation was found between this sensitizing capacity and the GPD-IgG4 RAST. Leucocytes were passively sensitized with serum mixtures that contained the same amounts of total and HDM-specific IgE; these mixtures differed as to sensitizing activity. It is unclear whether this variation is due to differences in IgE or to influences of other factors in serum.

Allergens↗

PubMed1982

Improvement of the radioallergosorbent test (RAST) sensitivity by using an antibody specific for the determinant D epsilon 2.

A technical modification was introduced by the manufacturer (Pharmacia) of a commercially available RAST, with the use of an anti-IgE antibody specific for the domain epsilon 2 of the IgE molecule. Results of the previous and of the new RAST were compared in 100 patients suffering from bronchial asthma or chronic rhinitis. When the same serum was assayed by both techniques, the new RAST technique disclosed a higher positivity in 26% of the comparisons. The new RAST improved the overall correlation between RAST and skin-tests by 6%: individually by 12% for house dust, 8% for Dermatophagoides pteronyssinus and 15% for animal danders. However, the level of correlation was decreased by 8% for the moulds. In patients with a total IgE concentration larger than 100 PRIST units, the new RAST allowed the demonstration of specific IgE in a number of cases twice as large as the previous technique. Thus, the modification of the RAST provides a more sensitive test, the results of which better correlate with those of other diagnostic methods.

Adolescent↗

PubMed1985

Allergy to guinea pigs: II Identification of specific allergens in guinea pig dust by crossed radio-immunoelectrophoresis and investigation of the possible origin.

An extract of dust from the air-vent filters of a room housing guinea pigs was analysed by quantitative immunoelectrophoretic procedures and compared with extracts of various materials derived from guinea pigs. Crossed radio-immunoelectrophoresis (CRIE) of the dust, performed with sera from twenty asthmatic patients who were positive by skin testing and RAST to guinea pig extracts, identified fourteen IgE-binding constituents. Although responses varied, most sera reacted with four particular allergens, antigens 2, 3, 10 and Sl. The numbers of allergens recognized by individual patients correlated with the RAST score, but not with total serum IgE. All seventeen dust constituents detected by crossed immunoelectrophoresis (and all four major allergens), were also present in extracts of guinea pig dander, fur, saliva and urine; several of these components were absent in an epithelial extract, and there were even less in preparations of shaved pelt, serum or faeces. None of the dust extract antigens were detected in materials used in animal husbandry, dust samples from rooms without guinea pigs, or a D. pteronyssinus extract. These findings suggest that inhalant allergens may be derived predominantly from material shed from the guinea pig coat after contamination with saliva, and possibly to a lesser extent, urine.

Allergens↗

PubMed1985

Storage mite allergy is common in a farming population.

The prevalence of storage mite allergy was investigated in an epidemiological study of respiratory symptoms in farmers on Gotland, an island in the Baltic Sea. A questionnaire concerning work-related and chronic symptoms from the airways and eyes was completed by 2578 farmers. A sample of 440 farmers subsequently underwent examination comprising skin-prick tests (animal danders, pollens, moulds and house dust mite), blood sampling for RAST against four storage mites (Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae and Glycyphagus domesticus) and total IgE analyses. Immediate onset hypersensitivity reactions in the airways and eyes were very common among active farmers on Gotland, the prevalence being as high as 40.0%. The prevalence of atopic allergy was 15.6%. Allergy to storage mites was diagnosed, from the case history and a positive RAST to at least one of the four storage mites, in fifty-two of 440 studied farmers (12%), corresponding to a calculated prevalence of storage mite allergy in the whole farming population of Gotland of 6.2%. The corresponding prevalence among farmers with hypersensitivity symptoms was 15.4% and among those with possibly IgE-mediated symptoms it was as high as 37.8%. The present study clearly demonstrates a high prevalence of allergy to storage mites among farmers with respiratory symptoms.

Adolescent↗

PubMed1988

Immune response of the atopic woman and foetus: effects of high- and low-dose food allergen intake during late pregnancy.

The influence of the mother's consumption of cows' milk and hens' egg on the immune response (IgE, IgG) in the mother and foetus was studied in 165 pregnant women with atopical respiratory disease with an allergy to pollen and/or animal dander. The women were randomly allocated to four diets ranging from a diet free from hens' egg and cows' milk to a diet containing intake of one egg and one litre of milk daily during the third trimester. No significant differences in cord blood IgE levels were noted in spite of differences in maternal diet, and no specific IgE antibodies to ovalbumin, ovomucoid and betalatoglobulin were found in the cord blood. The mother's IgG antibody concentrations to ovalbumin, ovomucoid and betalactoglobulin were influenced by her diet, but cord blood IgG antibody levels to the selected food allergens were unaffected. The data presented on the IgE and IgG antibody levels to ovalbumin, ovomucoid and betalactoglobulin in cord blood suggest that changes in maternal diet during the last trimester of pregnancy in order to prevent atopic sensitization in utero are less likely to affect the foetus than previously supposed.

Adult↗