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PubMed1984

Characterization of the carbohydrate moiety in a partly purified allergen preparation from the mould Cladosporium herbarum and its possible importance for allergenic activity as tested by RAST-inhibition.

The monosaccharide composition of a partly purified Cladosporium herbarum allergen preparation was found to be mannose, galactose and glucose in the ratio 1:1:0.8. The carbohydrate part of the preparation was quantified to 55% of the dry weight material by means of methanolysis and gas liquid chromatography (GLC) of trimethylsilylated methyl glycosides. The protein content was found to be 25%, determined by the Lowry method. Methylation analysis and periodate oxidation indicated that the main part of the carbohydrate moiety consists of galactomannans and glucans. It is suggested that the galactomannan is a highly branched polymer with mannopyranose units, 1,2- and 1,6-linked in the main chain, having shorter chains of 1,6-linked galactofuranosyl units linked through position 3 of the 1,6-linked mannopyranose units. The glucan part is probably a mixture of several polymers consisting of 1,3-linked and 1,4-linked glucans. The radioallergosorbent test (RAST) inhibition showed a lower IgE binding capacity for periodate-treated mould preparations, in which sugars containing vicinal diols had been oxidized, suggesting that the carbohydrate moiety may be of importance in IgE binding reaction of allergens. Periodate oxidation did not seem to alter the amino acid composition of the protein.

Acetylglucosamine↗

PubMed1980

Food allergy in migraine. Study of dietary exclusion and RAST.

Two-thirds of severe migraineurs were allergic to certain foods, shown by dietary exclusion and subsequent challenge. Radioallergosorbent test confirmed the relevance of these foods. Oral sodium cromoglycate protected these patients from food challenges. The initial specific allergic reaction in the gut may result in increased mucosal permeability which allows food antigens, complexes, or mediators to be absorbed and cause symptoms.

Antigens↗

PubMed1987

Glycoprotein allergens in pollen of timothy. III. Immunochemical and biological properties of a basic glycoprotein.

Crossed immunoelectrophoresis (CIE) and tandem CIE indicated that a basic glycoprotein allergen isolated from pollen of timothy is immunochemically identical to the allergen formerly denoted as antigen 30. The glycoprotein gave one band in SDS-PAGE and agarose isoelectric focusing. After transfer to nitrocellulose by electroblotting or by capillary blotting, the allergen specifically bound IgE from persons allergic to timothy pollen. The single allergen inhibited about 15% of the IgE binding to radioallergosorbent test discs of whole timothy pollen extract. Sera from patients investigated also contained detectable amounts of IgG towards the allergen. In quantitative skin prick tests, the mean activity of 2 micrograms/ml purified allergen in 7 patients was equivalent to that of a timothy pollen extract containing 10,000 BU/ml (assayed relatively to histamine in skin prick test). The ability of the allergen to form a precipitate in rocket immunoelectrophoresis was lost when it was heated to 80 degrees C or incubated with 4 M guanidine hydrochloride.

Allergens↗

PubMed1990

Humoral immune response following extracorporeal immunoadsorption therapy of patients with hypercholesterolemia.

Low-density lipoprotein apheresis (LDL-apheresis) is an extracorporeal procedure that preferentially removes LDL cholesterol from the blood. One of the primary techniques for performing this procedure uses immunoadsorption columns containing monospecific polyclonal sheep antibodies to human LDL covalently coupled to a gel filtration medium. LDL-apheresis has generally been well-tolerated, with chills, fever, or flushing occurring rarely. The possibility of an immune reaction was investigated as a basis for these reactions observed in 12 of the 1312 procedures performed. Antibodies to sheep IgG developed in 12 of the 15 patients treated with LDL-apheresis as a result of the shedding of small quantities of the sheep immunoglobulin from the columns. A column acid-washing procedure minimized the quantity of shed antibody but did not prevent immunization of the patient. The clinical reactions were probably unrelated to shedding and immunization, as the reactions occurred even in patients who were not immunized to the sheep IgG. Immunization to ethylene oxide was not the cause, as determined by a radioallergosorbent test. The reactions were more likely related to the activation of complement, as indicated by the generation of C3a des Arg by the columns and an increase in C3a des Arg levels systemically.

Antibody Formation↗

PubMedDate not supplied

Anaphylaxis due to latex allergy.

An anaphylactic reaction to latex is reported in two patients. One occurred intraoperatively with exposure to the surgeon's latex gloves and the other during vaginal contact with a latex condom. Radioallergosorbent test (RAST) and scratch test with latex material identified the allergen. With the increasing use of latex gloves and condoms, one should be aware of the possibility of a severe immediate hypersensitivity reaction to latex products. Latex allergy should be considered when evaluating intraoperative and idiopathic anaphylaxis.

Adult↗

PubMed1992

Experience with RAST-based immunotherapy.

During its 80 year history, allergen immunotherapy has been used essentially as Noon and other early investigators described it. Immunotherapy is practiced mainly as an art based on uncontrolled clinical observations of individual patients treated in private practice. Dosing schedules and skin test interpretations are based primarily on the biases of the treating physicians. In an effort to improve the results obtained from immunotherapy, different approaches have evolved. Serial dilution skin endpoint titration (SET), practiced mostly by otolaryngologists, became popularized in the 1960s out of the need to optimize immunotherapy dosing regimens. SET can be viewed as a forward step in the direction of more aggressive yet safe initial immunotherapy doses. With the discovery of IgE in 1966 as the prime carrier of reaginic hypersensitivity in humans came the availability of a remarkable set of in vitro assays for the measurement of total and allergen-specific IgE reactivity. The radioallergosorbent test (RAST), which has been shown to correlate reliably with the major variants of the atopic state, was modified in 1977 in such a way as to enhance the sensitivity of the assay with minimal alteration of specificity. The modified RAST (MRT) has been carefully investigated and has shown reliable concordance with the major parameters of clinical allergy. Since its development only 14 years ago, the MRT has become a dependable adjunct for the determination of initial and in many cases final immunotherapy doses. An important contribution of RAST-based immunotherapy is that only patients with quantifiable serum titers of allergen-specific IgE qualify as candidates for immunotherapy. The fact that fewer allergens are used for treatment at higher initial doses and that potential reactors are identified before starting therapy are yet other advantages of RAST-based immunotherapy. The use of RAST as a method of allergen standardization only reinforces its value in patient management.

Allergens↗

PubMedDate not supplied

Diagnostic capabilities of penicillin-based structures as tools in the in vitro diagnosis of penicillin allergy.

Various penicillin-based structures attached to paper disks were used in the radioallergosorbent test (RAST) to measure concentrations of circulating specific IgE antibodies in sera from subjects suspected of having penicillin allergy. The structures used were penicilloyl, penicillanyl, penicoyl and penicanyl groups prepared from benzylpenicillin (PG), phenoxymethylpenicillin (PV), amoxicillin (AX) and 6-amino-penicillanic acid (6-APA). The efficacy of these structures was evaluated using serum samples from 53 subjects who, on clinical grounds, were considered to have had adverse reactions to penicillins. The results showed the presence of IgE antibodies specific to the penicillin side-chain in certain patients, whereas others had IgE antibodies specific to the penicilloyl or penicillin basic structure (penicillin nucleus), which led to clinical cross-reactions between penicillins. The results showed that the use of several penicillin-based structures in a new test system increased the positive rate observed to 54.7% from 37.7% utilizing penicilloyl G, penicilloyl V and amoxicilloyl Phadebas RAST. Thus, the prepared species improve the capabilities of the in vitro diagnosis of penicillin allergy.

Antibody Specificity↗

PubMed1996

[Case report of jellyfish injury].

We are presenting a 47-year-old woman who was stung by jellyfish while bathing in the sea of Thailand. Immediately after the injury she developed sharp pain and urticarial erythema of the skin of the knees accompanied by muscle cramps of the entire body. After a few days a toxic contact dermatitis with edematous swelling and ulcerations developed, which did not respond to topical antibiotics or corticosteroids. Three weeks later the patient presented with a disseminated urticarial eruption, which at first responded well to topical treatment and systemic corticosteroids. Over the next few weeks, however, a relapse of the eruption and the ulcerations occurred. Raised titres of IgG and IgM antibodies against different jellyfish from the Indian and Pacific Ocean were detected in the patient's serum by the enzyme-linked immunosorbent assay. Antibodies against bees (class 1) and wasps (class 4) were found by the radioallergosorbent test. The clinical features and the immunological findings led to the diagnosis of toxic and allergic contact dermatitis to jellyfish venom. First aid and secondary treatment of jellyfish injuries are suggested.

Adrenal Cortex Hormones↗

PubMed1990

[Allergy to ethylene oxide in dental patients].

IgE antibodies to human serum albumin-ethylene oxide conjugates were determined by radioallergosorbent test (RAST) in 50 patients who underwent multiple oral surgery during which Et-O sterilised material was used. Total serum IgE levels were also tested by enzyme immunoassay and possible sensitivity to common aeroallergens was investigates by the use of a newly introduced screening test (Phadiatop). IgE serum levels ranged between 12 and 98 IU/ml (normal values) and Phadiatop results were negative. We failed to demonstrate Et-O sensitisation between our patients, therefore we suggest that such a risk is minimal among dental patients.

Antigen-Antibody Complex↗

PubMed1990

Type I hypersensitivity to rubber.

Seven patients with type I hypersensitivity reactions to rubber are reported. Radioallergosorbent testing with crude latex antigen was positive in 6/7 patients. Five patients had coexisting spina bifida, and all had undergone surgery before the development of rubber allergy. Rubber allergy is a new phenomenon that should be in the differential diagnosis of idiopathic anaphylaxis and urticaria.

Adolescent↗

PubMed1997

An immediate (type I) hypersensitivity reaction during placement of a dental rubber dam.

A dental student developed swelling of the lips and peri-oral urticaria, immediately after placement of a dental rubber dam during a chairside demonstration of clinical dentistry. A provisional diagnosis of a Type I hypersensitivity reaction to natural rubber latex was made and an appointment organised for specialist investigations. The student reported an atopic history and allergy to peanuts. A Radioallergosorbent Test (RAST), to measure Ig-E antibodies to latex, was positive. The dental student was given advice concerning the avoidance of natural rubber latex. Dental staff must be aware of potentially serious reactions to natural rubber latex in the dental surgery.

Adult↗

PubMed1996

Latex allergy in pediatric emergency department personnel.

Allergy to natural latex proteins has been recently recognized as a dangerous entity among health care professionals. Cutaneous symptoms related to latex glove use vary from the redness and scaling of contact dermatitis to urticaria. In addition, anaphylactic reactions have been reported. We report the spectrum of reactions to latex glove use in 93 members of our emergency department (ED) staff during a one-month study period. In addition, we attempt to correlate these symptoms with serologic evidence of atopy and latex allergy. Eighty-four of these subjects underwent total serum immunoglobulin E and latex-specific radioallergosorbent test (RAST) testing. Fifty-four percent of subjects reported symptoms relating to latex glove use, categorized as either contact dermatitis (48.4%) or urticaria (5.4%). Of the urticaria group, two subjects reported additional symptoms related to latex glove use such as rhinitis, conjunctivitis, or sneezing. All three groups of subjects (asymptomatic, contact dermatitis, and urticaria) were alike with respect to age, sex, and race. The urticaria group reported a higher incidence of environmental allergies (chi 2, P = 0.02). Serum total immunoglobulin E levels and latex-specific RAST results did not differ among the three groups. The one subject with a positive latex-specific RAST reported urticarial and nasoocular symptoms when exposed to latex gloves. Seventeen percent of symptomatic subjects reported decreased use of latex gloves because of these symptoms. It was concluded that many members of our pediatric ED staff exhibit a sensitivity to latex antigens. Clinical symptoms, rather than serologic testing, must be used to identify latex-sensitive individuals in this setting. Recommendations are offered to assist in the identification and management of hospital personnel who exhibit allergy to latex-containing products.

Adult↗

PubMed1985

Antibodies in allergy and inflammation. Research tools and indicators of disease.

The identification of IgE and the development of the radioallergosorbent test was the initiation of a revolution in the allergy research field. Measurement of allergen specific IgE antibodies is today an integral part of the clinical investigation of patients with suspected allergic disease. However, in addition to a being a routine test for the clinical laboratory, Phadebas RAST has served as the model for a number of modified procedures and as the basis for a wide range of applications. The aim of this presentation is to review and communicate the experience for the benefit of researchers and clinicians working in the field of allergy.

Adult↗

PubMed1998

Effects of azelastine on the level of serum interleukin-4 and soluble CD23 antigen in the treatment of nasal allergy.

Research findings and various published studies point to interleukin 4 (IL-4) and CD23 antigen as instrumental in allergic reactions of allergy patients because these two substances are part of the main triggering mechanisms in cells producing IgE antibodies. In this study it was investigated whether the control of IL-4 and CD23 levels result in a decrease of the severity of allergic reactions. It is well known that azelastine hydrochloride (AZ, CAS 79307-93-0) suppresses symptoms of nasal allergy. The antiallergic activity of this drug includes the suppression of IgE antibody production, antigen-antibody reactions, liberation of mediators and mediator antagonism. One report states that the cytokines IL-2, IL-3, and IL-4 were suppressed by AZ in cultured cells. There have been no reports regarding cytokines in clinical treatment using AZ. Therefore, the effects of AZ treatment on IL-4, soluble CD23, and RAST (radioallergosorbent test) levels in the sera of allergic rhinitis patients were studied. The results show that the levels of IL-4 and soluble CD23 were significantly reduced by the administration of AZ over a 4-week period, especially in patients with "excellent" or "good" efficacy of therapy.

Adult↗

PubMed2001

Bronchial Chlamydia pneumoniae infection, markers of allergic inflammation and lung function in children.

A relationship between respiratory Chlamydia pneumoniae infection (RCPI) and bronchial asthma is under discussion. Our objective was to study the frequency of RCPI and whether it is associated with markers of asthma in children with recurrent or chronic bronchitis as well as pneumonia. One-hundred and forty-eight children who underwent bronchoscopy were enrolled; 42 children with additional respiratory infections were excluded. Therefore, 106 children were examined, regarding a RCPI, by polymerase chain reaction (PCR) of tracheobronchial aspirate, eosinophilic inflammation of respiratory mucosa (cytology, eosinophilic cationic protein [ECP]), total serum immunoglobulin E (IgE) and specific IgE for six important allergens, as well as lung function tests if possible. There was a RCPI in 55 of 106 children (51.9%); 25.4% of PCR positives (14/55) were weakly positive (double cut-off), which was more prevalent in the 2-5-year age-group and teenagers. Children with RCPI, inclusive of weak positives, showed a milder eosinophilia of nasal mucosa than children without RCPI (5.58% vs. 9.35%, p=0.039). Eosinophilia of > or =13% in nasal- and/or bronchial swab, as a marker for respiratory allergy, was less frequent in patients with RCPI too (7.3% vs. 21.6%, p=0.035). There were no differences in ECP. Total IgE was lower in PCR-positive children (101 vs. 179 IU/ml, p=0.032). Specific IgE with a radioallergosorbent test (RAST) of at least class 3 (as a marker for a relevant allergy), as well as any RAST above zero (to characterize early forms of allergy), were both less frequent in the RCPI group. In contrast, weak positives showed the highest rates of sensitization, surpassing RCPI negatives. In lung-function tests, vital capacity was lower in RCPI patients (87.5% vs. 95.3%, p=0.045); all parameters characterizing obstructive disturbance tended to be higher. Weak positives had both the greatest reduction of vital capacity (75.3%) and the most impaired obstructive parameters. All differences were accentuated in children of 11-18 years of age. Hence, our results indicate that in the children selected, a RCPI is common and not associated with allergic respiratory inflammation. Weak positives, however, differ, having the highest rate of allergic sensitization, reduction of lung volume, and obstructive disturbance. This group might be important in clinically observed asthma after pneumonia caused by C. pneumoniae. In these children, early diagnosis and treatment of a RCPI is recommended.

Adolescent↗

PubMed1987

The use of monoclonal antibodies raised against a human IgE myeloma paraprotein for the study of allergen extracts and sera from allergic patients.

Murine monoclonal antibodies have been produced against a single human IgE myeloma preparation. A single fusion yielded six different monoclonal antibodies which bound strongly to the immunogen. Two of these failed to react with 'normal' human IgE or with a second IgE paraprotein. The other four antibodies reacted with normal and myeloma-derived IgE and were found to be specific for antibodies of this class. Two of these antibodies were potent reagents for the detection of IgE by two site immunoradiometric assay, immunoblotting, and radioallergosorbent test. The other two antibodies were considerably less potent reagents when used in these assay systems. Our findings suggest that care should be taken in selection of suitable monoclonal antibodies for immunochemical study of allergens and sera from allergic patients.

Allergens↗

PubMed1986

An enzyme-linked immunosorbent assay for cow's milk protein-specific IgE using biotinylated antigen. Avoidance of interference by specific IgG.

Detection of specific IgE by the radioallergosorbent test (RAST) which uses labelled antibody can be hampered by the presence of antibodies other than IgE but with the same specificity and may limit usefulness of the RAST for diagnosis of IgE-mediated milk allergy in infancy when high titres of cow's milk protein-specific IgG antibodies are known to be present. This can be avoided by using a system employing labelled antigen, such as the enzyme-linked immunosorbent assay (ELISA) described here, where IgE in the test serum is immunoadsorbed to anti-human IgE coated to microtitre plates. Biotinylated antigen, in this case cow's milk proteins, binds to specific IgE and the reaction is revealed colorimetrically by adding horseradish peroxidase (HRP)-avidin conjugate.

Animals↗

PubMed1985

Seroepidemiological investigations of onchocerciasis in a hyperendemic area of West Africa.

Immunological study of individuals (aged 4 to 70 years) living in an area of Mali hyperendemic for onchocerciasis revealed an 83% prevalence of skin microfilariae (mf). Microfilariae counts from skin snips were highly age-dependent. Screening for concomitant helminth infections showed a low prevalence of hookworms and Mansonella (Dipetalonema) perstans, but neither schistosomiasis nor bancroftian filariasis. Immunological results revealed strong correlation between radioallergosorbent test (RAST) and skin test (5 and 50 ng adult O. volvulus extract), between RAST and total IgE, and between IFAT and ELISA. A negative correlation exists between mf counts and skin tests and between mf counts and RAST; the lowest median values were obtained in the group with high mf counts. Skin sensitizing antibodies were detected in most locally born children aged 4-5 years. Intradermal tests showed a high rate of sensitization to O. volvulus antigen in mf-negative children, whereas ELISA and IFAT values were significantly lower in these children than in mf-positive children. Increasing concentrations of circulating IgE antibodies were found in children aged 4-11 years by RAST, and, in individuals aged 12-19 years (age group for which mf counts sharply increase), skin testing revealed a state of anergy. In long lasting infections (adults greater than 20 years) skin reactivity was comparable to that of young children or was depressed. ELISA and IFAT achieved similar results in each age group.

Adolescent↗