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PubMed1988

Foods and respiratory allergy.

Foods may induce respiratory symptoms by both reaginic and nonreaginic mechanisms. Asthma is one of the most common respiratory manifestations in children, and it is well known that many factors may provoke an attack. When considering the relationship between foods and asthma, we must keep in mind that food allergy may coexist with an inhalant allergy and that other nonallergens, such as pollutants, smoke, or additives, may modulate or modify bronchial reactivity and thus favor the food allergen action. In a study using clinical history, prick test, radioallergosorbent test, and double-blind food challenge, we demonstrated respiratory symptoms related to food allergy in 13 of 140 (9.2%) children with asthma. Asthma, in particular, was demonstrated in 8 of 140 (5.7%) patients. Food allergy respiratory symptoms are, in our experience, almost always associated with other clinical manifestations (e.g., cutaneous, gastrointestinal). The recognition of food-dependent IgE-mediated respiratory symptoms is essentially limited to those cases characterized by food allergy with asthmatic expression. It is possible, however, that in many cases foods may have a nonspecific role in the determination of asthma or in the preparation of bronchi for the possible consequent stimulus.

Asthma↗
PubMed2002

Chemical respiratory allergy: role of IgE antibody and relevance of route of exposure.

Chemicals are able to cause various forms of allergic disease in susceptible individuals. Among those of greatest importance in the context of occupational disease is chemical respiratory allergy, where allergic sensitization of the respiratory tract is associated with elicitation of rhinitis, asthma and/or other pulmonary symptoms following inhalation exposure to the inducing chemical allergen. Although for some chemical respiratory allergens (including the acid anhydrides) there exists a strong correlation between symptoms and the presence of specific IgE antibody, for other respiratory sensitizers (and notably the diisocyanates) such an association is variable or absent. These data have resulted in speculation about a universal mandatory role for specific IgE antibody in the induction and elicitation of respiratory allergy to chemicals and of the nature of alternative or complementary mechanisms of sensitization. There is debate also regarding the routes through which exposure to relevant chemical allergens may result in the acquisition of respiratory sensitization. Although inhalation exposure is probably the most common and most important route through which allergic sensitization of the respiratory tract is achieved, there is evidence also that respiratory sensitization to chemicals may be acquired also by dermal contact; observations that have important implications for occupational health management. The significance of IgE antibody and dermal exposure in the context of occupational respiratory allergy to chemicals is discussed.

Animals↗
PubMed1994

Skin reactivity and specific IgE antibody to two nonbiting midges in Korean respiratory allergy patients.

To evaluate the significance of chironomid as a respiratory allergen, we performed skin prick tests with Chironomus plumosus (CP) and Tokunagayusurika akamusi (TA) extracts on 475 respiratory allergy patients, and their specific IgE antibodies were detected by enzyme-linked immunosorbent assay (ELISA) in 106 positive reactors to skin prick test and 30 negative controls. Ninety-seven (20.4%) showed more than 2+ of allergen to histamine ratio to CP and 98 (20.6%) to TA on skin prick test. Seventy-one (73.2%) of 97 positive reactors had increased specific IgE to CP, and 34 (34.7%) of 98 positive reactors, to TA. CP-specific IgE was detected in 14 (14.4%) non-atopic asthmatics and 6 (6.2%) non-allergic rhinitis patients. TA-specific IgE was detected in 17 (17.4%) non-atopic asthmatics and 6 (6.1%) non-allergic rhinitis patients. No association was noted between skin reactivity to Dermatophagoides farinae and the prevalence of specific IgE to CP or TA (p > 0.05). The correlation between total IgE level and specific IgE level to CP and TA was poor (r = 0.07, 0.04). ELISA inhibition test suggested specificity of IgE binding and cross-allergenicity between CP and TA. It is suggested that CP and TA can induce IgE-mediated reaction in exposed patients and should be considered as important causative allergens in respiratory allergy patients in Korea.

Allergens↗
PubMed2004

Measurement of nasal IgE in an epidemiological study: assessment of its diagnostic value in respiratory allergy.

BACKGROUND: Specific questionnaire and skin prick test (SPT) are the most used methods in epidemiological studies on respiratory allergy. SPT, however, can be positive in many subjects without evidence of any allergic disease. Nasal IgE determination has been suggested by some authors as a valuable diagnostic method, which may overcome this lack of specificity. OBJECTIVE: The aim of this study was to evaluate sensitivity and specificity of nasal specific IgE for the seven most common inhalant allergens in order to verify its reliability as a screening test. METHODS: 126 children, involved in an epidemiological study on prevalence of respiratory allergic disease, were evaluated. All children were assessed with a specific questionnaire, SPT and nasal specific IgE. Nasal specific IgE were determined with a previously described method modified for screening purposes, in order to test seven allergens at the same time. When discordant results were obtained between questionnaire, SPT and nasal IgE, an allergen specific nasal challenge (ASNC) was performed and nasal tryptase was also determined before and after challenge. RESULTS: The questionnaire was positive for respiratory allergy in 28/126 children. SPT was positive in 21 of the 28 children, but also in 5/10 children with atopic dermatitis (AD), and in 12/88 children without allergic symptoms. Nasal IgE were positive in 22/28 and also in 2/10 with AD. Nasal challenge and tryptase confirmed the negativity of nasal IgE in 12/17 children with positive SPT but totally negative for allergic respiratory disease. Moreover nasal IgE was found to be positive to dermatophagoides in one of seven children with negative SPT despite a clinical history suggestive for mite respiratory allergy. In this patient and in 2 of the 5 children with AD the positive nasal IgE to mites was confirmed by a positive ASNC and tryptase. CONCLUSIONS: Nasal IgE have shown a specificity significantly higher than SPT (98% vs. 83%) and a good sensibility. This screening test may also be useful to detect the beginning of upper airways sensitization in patients with AD.

Allergens↗
PubMedDate not supplied

Respiratory allergy in Mexican patients with cystic fibrosis.

BACKGROUND: the purpose of this study was to investigate the presence of respiratory allergy in 30 Mexican patients bearing cystic fibrosis (CF). METHODS AND RESULTS: all patients completed a clinical history, had a physical examination, total serum IgE, nasal and blood eosinophils determinations and evaluation of skin prick tests for 36 allergens. In 26.6% of the patients included in the study was detected respiratory allergy diagnosed on clinical and laboratory analyses. Skin prick tests of 11 (36.6%) of the patients were positive to at least one allergen and Aspergillus fumigatus (A. fumigatus) was the most frequently observed allergen in 23% of the cases. CONCLUSIONS: we have demonstrated in this study that Mexican patients also present a coexistence of respiratory allergy in patients bearing CF.

Adult↗
PubMed1988

Value of a new screening test for respiratory allergy.

Phadiatop (Pharmacia) is a new in vitro screening test for respiratory allergy which detects in serum the presence of specific IgE to a mixture of common inhalant allergens; results are either positive or negative. Among 100 patients suffering from rhinitis and/or asthma, investigated with 15 skin prick tests (SPT) and RAST for frequent allergens, the Phadiatop was positive in 63: all 63 had at least one positive SPT and RAST (specificity: 100%). Conversely, ther were 67 patients who had a positive RAST for at least one allergen: among these 67 the total IgE concentration in serum was high (greater than 100 kU/l) in 43 (64%) and the Phadiatop was positive in 63 (94%). Phadiatop was negative in serum obtained from 10 cord bloods and 10 non-allergic subjects (disease-free, 15 negative SPT and RAST). Results of the radio-immunoassay originally proposed by the manufacturer were similar to those obtained with a modified enzymo assay using a fluorometric substrate. In the prediction of respiratory allergy, Phadiatop was found to be specific and more accurate than the determination of total IgE in serum.

Adolescent↗
PubMed1995

A two-centre study for the evaluation and validation of an animal model for the assessment of the potential of small molecular weight chemicals to cause respiratory allergy.

This study evaluated a single intradermal injection model in the guinea pig with subsequent inhalation challenge and serological analysis as a method to predict the potential of chemicals to induce respiratory allergy. Four known respiratory allergens (trimellitic anhydride, diphenyl methane diisocyanate, phthalic anhydride and toluene diisocyanate (TDI)) were screened by two industrial research laboratories using this protocol. Dinitrochlorobenzene, a potent contact allergen, was included as a negative control material. In both laboratories, the respiratory allergens, but not the contact allergen, induced high titre antigen-specific antibodies in treated animals. The inhalation challenge results were similar in both laboratories but were less conclusive in that exposure to free TDI failed to induce pulmonary responses, probably because it fails to penetrate to the deep lung in sufficient concentration. Although the assay shows promise as a means of identifying chemical respiratory sensitisers, its use as a routine screen for the prediction of the ability of materials to induce respiratory allergy in man is probably questionable.

Administration, Inhalation↗
PubMed1996

The immunology of respiratory allergies.

The main function of the respiratory tract is to provide a large surface area of thin epithelium for gas exchange. At the same time, this exposed surface and the conducting airways have to be defended against airborne irritants and infectious agents. The principal defence is the barrier formed by airway mucus and the mucociliary escalator. Agents which penetrate the initial defences may be destroyed by phagocytic cells, and may initiate an immune response. Respiratory allergy results when airborne allergens penetrate these defences and elicit and unhelpful immunological response. The nature of the airway immune response depends on the nature of the allergen, the antigen-processing pathway, and the microenvironment which dictates the phenotype of available T lymphocytes. Most allergens elicit IgE antibodies which then bind to mast cells and, when cross-linked, the mast cell releases inflammatory mediators which cause bronchospasm and mucus formation. Some chemical allergens appear able to trigger this pathway without involving IgE. In both cases, other inflammatory cells, especially eosinophils, are then recruited. These cells appear to be responsible for the epithelial damage and increased airways reactivity that characterise asthma. Similar histological patterns are found in atopic asthma, non-atopic asthma, occupational asthma due to low molecular weight chemicals and even in the reactive airways dysfunction syndrome (RADS)/irritant-induced asthma syndrome. Allergic airway inflammation and clinical asthma appear to be common histological and clinical consequences of a variety of specific and non-specific insults to the airways epithelium, airways mast cells and airways T lymphocytes.

Allergens↗
PubMed2000

[Epidemiology of respiratory allergies: current data].

Respiratory allergic diseases include seasonal allergic rhinitis or hay fever, perennial allergic rhinitis and allergic asthma. Prevalence of asthma is difficult to assess through epidemiological questionnaires. In France hay fever roughly affects 6% of children and 18% of teenagers and nasal allergies, more than one fourth of young adults. Prevalence of asthma is equal to 10 to 15% in teenagers and 7 to 9% in young adults. Risk factors include genetic as well as environmental factors. The role of the former have been exemplified in family studies, especially twin studies, and surveys of inbred populations. Environmental factors can be allergic or non-allergic. The influence of allergenic exposure on sensitization, occurrence and severity of respiratory allergic disease is well documented. The triggering influence of non-allergenic factors on established allergic diseases is also clear. In contrast, their implication in allergic sensitization and occurrence of allergic diseases need to be clarified.

Adult↗
PubMedDate not supplied

Skin prick test response to enzyme enolase of the baker's yeast (Saccharomyces cerevisiae) in diagnosis of respiratory allergy.

BACKGROUND: The aim of the study is to prove that Saccharomyces cerevisiae enolase, the major allergen of the baker's yeast, induces allergic immediate response in patients with inhalant allergy sensitized to Candida albicans extract. MATERIAL AND METHODS: The study was performed in three groups of patients: I. 20 atopic patients with respiratory allergy sensitized to Candida albicans and inhalant allergens (mite, feather, pollens) II. 30 patients with respiratory allergy, positive skin tests to inhalant allergens but negative skin tests to Candida albicans and other fungi; III. 20 nonatopic, healthy individuals. Skin prick test of purified enolase from Saccharomyces cerevisiae (bakers yeast) at concentration 1 and 10 mg/ml was performed in all groups. The results were documented planimetrically. RESULTS: 95% of patients sensitized to Candida albicans extract showed positive skin reactions to Saccharomyces cerevisiae enolase, 10% of patients of group II and none of the patients of the control group had positive skin responses to enolase. The mean wheal size (mm2) in skin prick test to Candida albicans, Saccharomyces cerevisiae enolase at concentration 10 mg/ml was x = 15.17 +/- 11.08, 15.76 +/- 19.67 and at concentration 1 mg/ml 10.02 +/- 10.49, respectively. CONCLUSIONS: 1. Saccharomyces cerevisiae enolase induces an immediate allergic reaction in skin in subjects with respiratory allergy and positive skin prick test results to Candida albicans and other fungi. 2. Enolase can be an important allergenic component of the Candida albicans extract.

Adult↗
PubMed2004

Analysis of new respiratory allergies in patients monosensitized to airborne allergens in the area north of Milan.

BACKGROUND: A recent study carried out in North of Milan, an area that was recently colonized both by birch and ragweed pollen, showed that subjects developing allergies to these "new" allergens were much older than those becoming allergic to "traditional" airborne allergens, which suggests that predisposition to develop respiratory allergies is probably allergen-specific, persists throughout life, and does not occur until the patient encounters the appropriate allergen for a sufficiently long period. OBJECTIVE: The present study aimed to test this hypothesis by following-up a large cohort of patients monosensitized to airborne allergens. METHODS: The prevalence and characteristics of new sensitizations to airborne allergens after >2 years of follow-up were retrospectively assessed in 726 patients monosensitized to grass, pellitory, mite, birch, ragweed, Alternaria, mugwort, or plantain living North of Milan. RESULTS: The overall prevalence of new sensitizations was 35% (256/726), with marked differences between the subgroups ranging from 11% in Alternaria-allergic subjects to 46% in grass-allergic subjects. Patients allergic to grass, birch, or pellitory pollen showed a significantly higher propensity to become sensitized to a second airborne allergen than subjects allergic to ragweed, Alternaria, and mite. Overall, the "new" allergens (birch and ragweed) caused 228/256 (89%) new sensitizations detected in the whole study group. Ragweed pollen induced 90% (38/42) of new sensitizations in birch pollen allergic patients, and birch pollen induced 80% (8/10) of new sensitizations in ragweed allergic patients. No difference in age at the first visit or in duration of the follow-up between patients developing and not developing new respiratory allergies was observed. CONCLUSION: This study shows that: 1) predisposition to develop respiratory allergies is allergen-specific and persists throughout life; 2) proneness to become allergic to certain airborne allergens might be associated with primary sensitization to specific airborne allergens; 3) in monosensitized adults, sensitization to another airborne allergen that has been always present in that particular geographical area is unlikely.

Adolescent↗
PubMed1988

[Limits of IgE serodiagnosis of occupational respiratory allergies].

In occupational respiratory diseases, it is important to establish the nature of the mechanism involved. The measurement of specific IgE is an excellent tool to prove a type I, IgE mediated, hypersensitivity. There are two distinct kinds of allergens: macromolecular allergens (storage mites, sea products...) which are technically and clinically similar to usual RAST; low molecular weight allergens (haptens such as isocyanates, formaldehyde...). In these cases, the RAST technology is different and the responsibility of specific IgE is less frequent, troubles being usually caused by irritative or toxic properties of these molecules.

Allergens↗
PubMed1994

Environment and development of respiratory allergy: I. Outdoors.

Respiratory allergic diseases appear to be increasing in most countries. In particular, asthma morbidity and mortality have been reported to be increasing despite the availability of effective asthma medications. It has been also observed that subjects living in urban and industrialized areas are more likely to have respiratory allergic symptoms than those living in rural areas. This increase has been linked to air pollution, rather than to a modification of the genome of the patient. The interplay of genetic and environmental factors in the development of allergic disorders remains a subject of investigation. In the outdoor environment, the most important air pollutants are sulphur dioxide, ozone and particulate matter, in particular diesel exhaust emissions. These pollutants, besides acting as irritants, increasing airways hyper-reactivity, are thought to be causal factors which act to modulate the immune response, with an adjuvant activity on immunoglobulin E (IgE) synthesis. In other words, atopic state can be upregulated by environmental influences, and some subjects develop atopic diseases in response to these environmental factors. Since airborne allergens and air pollutants are often both increased in the same areas, potentiation, either in the degree of acquired sensitization or in the degree of the response to allergens, should be considered as an important factor which might help to explain the increasing frequency of allergic respiratory disease. In the light of our present knowledge, it is evident that further investigation in human subjects, aimed at evaluating specific agents, and their concentration in the atmosphere, which can influence pulmonary function, is needed. These studies may help to explain the increasing problem of asthma morbidity and mortality.

Air Pollutants↗
PubMed2001

[Virus and respiratory allergy in children].

Links between viruses and respiratory allergy are not easy to understand in children. For example, the risk of atopy or asthma is increased after an infection with syncytial respiratory virus. In some studies, more the child suffers from viral infections, more the risk of atopy increases. On the other hand, other studies state that the development of allergy is reduced if a child enters day nursery before 12 months, and consequently if he is exposed early in life to viruses. Measles and hepatitis A viruses could also protect from allergy. In fact, viruses seem modulate the expression of a preexisting atopic status. Depending on their nature and their circumstances of occurrence, they could induce some sensitizations or inversely protect from atopy by facilitating the lymphocyte Th2 or Th1 response.

Air Pollution↗
PubMed1993

Respiratory allergy to the pollen of Mercurialis annua (Euphorbiaceae).

We have described ten cases of respiratory allergy to the pollen of Mercurialis annua in the area of Bordighera (Riviera dei Fiori) on the Italian Mediterranean coast. The incidence of sensitivity is only 0.9% in a population of 1081 patients with pollinosis. Since the Euphorbiaceae family (spurges) contains strongly sensitizing allergens (eg, seeds of Ricinus communis and latex of Hevea brasiliensis) our findings raise the possibility that respiratory allergy to the pollens of Mercurialis annua and other spurges has been underestimated throughout the world.

Adult↗
PubMed1995

Cytokines and adhesion molecules in respiratory allergy.

Cytokines and adhesion molecules play a central role in the inflammatory process of respiratory allergy. Cytokines like IL4 acts on IgE synthesis and expression of low affinity CD23 IgE receptors, IL-5 on eosinophil differentiation and activation and IL-2 on T cell activation and on the expression of CD25 IL-2 receptors. IL-2, IL-4 and IL-2 soluble receptor have been studied in pollen sensitive patients before, during and after pollen season. IL-2 serum levels initially increase and decrease at the end of allergen exposition. IL-4 serum level do not significantly changes during pollen season. Adhesion molecules are essential for recruitment and migration of inflammatory cells to tissues. CD45RO T memory cells expressing generally the adhesion molecule CD29 have also been studied in a group of pollen sensitive patients. During the peak of antigen exposition CD45RO/CD29 cells significantly decrease a turnover between CD45RA naive cells and memory cells being observed. The study of cytokines and adhesion molecules could add new data on the comprehension of inflammation in respiratory allergy.

Cell Adhesion Molecules↗
PubMed1991

IgE-mediated sensitization to English plantain pollen in seasonal respiratory allergy: identification and partial characterisation of its allergenic components.

Characterisation by SDS-PAGE immunoblotting of plantain pollen extract showed that components of 16,000-20,000 M(r) were frequently reactive with IgE antibody in the sera of subjects with seasonal respiratory allergy. Other, more weakly IgE-binding allergens were seen in the range of 40,000-60,000 M(r). HPLC followed by RAST inhibition demonstrated that components of approximately 17,000 M(r) were also responsible for much of the IgE-binding activity of the extract. These components appeared to have pI values between 4.5 and 5.2. RAST inhibition showed that there were no common IgE-binding epitopes in grass pollen and plantain pollen extracts, indicating that skin test responses should not necessarily be interpreted in terms of cross-reaction. 82 subjects with a clinical history of seasonal, respiratory allergy were screened in a skin prick test survey. 28% were skin test positive to plantain pollen extract. The frequency of positive skin test reactions to plantain pollen extract was greater than that to Betula (23%) and Artemisa (16%), both which are considered to be important allergens. In a larger survey positive RAST scores to plantain pollen were given by 34% of sera from subjects with respiratory allergy. Plantain pollen sensitivity should therefore be considered during diagnosis of seasonal allergy.

Allergens↗