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PubMed1994

[The value of immunotherapy in treatment of IgE-induced allergic diseases].

Until today, immunotherapy is the only causal treatment of IgE-mediated allergic disease. Its efficacy has been demonstrated in controlled studies for rhinitis and bronchial asthma due to various pollens, house-dust mite and animal dander as well as for systemic allergic reactions following hymenoptera stings. This treatment is especially successful in younger patients with seasonal allergy of rather short duration and with sensitization only to few allergens. In order to avoid allergic side effects of this treatment, measures of precautions must be strictly observed. A close cooperation between patient, family practitioner and allergist is important for the success of this treatment.

Allergens↗

PubMed1995

Four species of house dust mites recovered from houses of patients with allergic respiratory diseases.

Arthropods and their products are wide spread and considered one of the common allergens affecting man. Allergy to arthropod antigens is the major cause of respiratory allergy as rhinitis and bronchial asthma. The range of reaction depends on several factors which include the type and source of the material, the rate of intensity, the duration of exposure, the human immune response and history of prior exposure. Successful management of allergic disease depends on proper identification of the causative allergen and reduce exposure to this allergen. Generally speaking, the house dust is not a simple substance but an accumulation of living and non living parts as mites, pollens, molds, dander and decaying insects. In the present study, four species of mites were isolated from the dust collected from the houses of patients with allergic respiratory diseases. The species were Dermatophagoides pteronyssinus, D. farinae, Ornithonyssus bacoti and Haemogamassus pontiger. The two species of Dermatophagoides. were the predominant mites which are known to produce the most potent allergies. Studying the serum immunoglobulins level showed that the IgE had a highly significant concentration among respiratory allergic patients (28) with (5) or without (23) atopic dermatitis. It was concluded that house dust mites, that cause inhalant allergens, are one of the main aetiological factors of allergic respiratory diseases, with or without atopic dermatitis.

Allergens↗

PubMed1994

[Origin of allergens in the cat].

Danders and animal products have long been recognized as major allergens. One of the most common animals responsible for allergy is cat. Fel d I the major allergen has been detected in fur and a number of authors have claimed that saliva is the principal source of this major allergen and that pelt is contaminated as a result of licking during grooming. We could demonstrate that one of the major sources of Fel d I present on the skin are sebaceous glands and that the production of Fel d I is under hormonal control at least in male cats. Castration decreases significantly the level of Fel d I on the skin and the injection of testosterone reverses the phenomenon. These data lead to continue the work about the regulation of this protein and the knowledge of its biological function.

Allergens↗

PubMed1994

Allergies and skin testing: a Nairobi experience.

A prospective study of 72 consecutive patients with symptoms of allergy is presented. Patients aged 20-39 years formed the bulk of the study population (55.6%). Most patients had allergic rhinitis (48.6%); bronchial asthma and atopic dermatitis occurred in 29 patients (40.3%) each. Drug allergies were found in 22 patients (30.6%), urticaria in 15 (20.8%), food allergies in 13 (18.1%), contact dermatitis in 10 (13.9%) and allergic conjuctivitis in 6 patients (8.3%). In many cases more than one allergic condition appeared simultaneously. Skin and prick tests and skin patch tests were done on 46 (63.9%) and 65 (90.3%) patients respectively. Soaps were most frequently implicated in positive reactions (75.0%); D. pteronyssinus, drugs, animal dander and foods gave positive reactions in 40.3%, 30.6%, 19.4% and 18.1% respectively. The need to have a high index of suspicion towards allergic conditions, especially extrinsic bronchial asthma, is stressed.

Adolescent↗

PubMed1994

[Immunoregulatory role of gamma delta T cell receptor in atopic asthma--association with the IgE response to molds antigen].

To evaluate the role of gamma delta T cells in atopic asthma, we examined the relationship among atopy bronchial asthma, and genetic polymorphism of the gamma chain of T cell receptors (TCR) in families through atopic asthmatic probands. We recruited 5 families (69 subjects). Total serum IgE levels were estimated by a radioimmunosorbent test (IgE RIST). Skin prick tests were done with inhaled allergens consisting of house dust, grass and tree pollens, common molds, and animal danders. Antigen-specific IgE levels in response to these allergens were also measured by multiple antigen simultaneous test (IgE MAST). The atopic phenotype was determined by the presence of a positive skin test, an elevated antigen specific IgE value, an elevated total IgE level, or some combination of these. Although linkage of atopy or bronchial asthma to the gene encoding the gamma chain of TCR was excluded, the lod score between this gene and molds-specific IgE responses was 0.42 at the recombination fraction of 0.1. In an association study, a 19 kb allele of the gamma chain of the TCR gene was found more frequently in asthmatic subjects than in non-asthmatic subjects (p = 0.068). Also, molds-specific IgE responses were significantly associated with this allele (p = 0.018). These findings suggest that molds-specific IgE responses underlying atopic asthma are partly regulated by the gene encoding the gamma chain of the TCR.

Adolescent↗

PubMed1994

Comparison between skin testing and in vitro testing for diagnosis of allergen in asthmatic children.

BACKGROUND: This study was designed to compare the skin testing and in vitro testing for the diagnosis of most common inhalant allergens in asthmatic children. METHODS: Sixty-two asthmatic children positive to most common allergens in the area of skin tests and multiple allergosorbent chemiluminescent assay (MAST-CLA) were subjected to another Pharmacia CAP test (CAP). RESULTS: The agreement between the results of MAST-CLA and CAP was variable. The correlation coefficient for CAP with MAST-CLA was significant for five allergens except candida, dog dander and Willow pollen when the diagnostic levels of MAST-CLA and CAP were compared with skin test reactions. For all the allergens tested, MAST-CLA showed a sensitivity of 51%, a specificity of 84% and an efficiency of 73%, compared with 57%, 80% and 74%, respectively, in the CAP analysis. CONCLUSIONS: MAST-CLA and CAP can be used as a screening test to measure allergen IgE level. Both MAST-CLA and CAP were comparable in their ability to diagnose of allergy to tested allergens.

Adolescent↗

PubMedDate not supplied

Do latex allergens potentiate other skin tests?

We report the case of a 33 year old atopic female patient, who worked for the last 4 years as a cleaner in the surgical area of a hospital. One year after starting the work in this area, the patient noticed upper respiratory symptoms and soon later dyspnea immediately after entering the operating room. Other allergic symptoms were perennial rhinoconjunctivitis and urticaria after contact with peaches. Common skin prick tests were positive for Dermatophagoides pteronyssinus. Fifteen min later a skin prick test with latex was done with a strong positive result after 10 min. At the same time, several allergens (cat dander, grass and olive pollens) showed positive results. The patient experienced a fall in the FEV1 that returned to basal levels after two inhalations of a bronchodilator. New skin tests to common allergens performed one week later were only positive to mites.

Adult↗

PubMed1975

Antigenic and allergenic constituents of Dermatophagoides pteronyssinus extract.

The antigenic analysis of Dermatophagoides pteronyssinus extract was performed by using antiserum obtained in rabbits by immunization with mite extract in Freund's adjuvant. Immunodiffusion and immunoelectrophoretic analysis revealed the presence of many constituents, most of which were common to human dander, house dust and Dermatophagoides farinae extracts. By fractionation of the mite extract on Sephadex G-75 and DEAE-Sephadex it was shown that the highest allergenic activity was related to a family of heat-stable molecules weighing about 30,000. The antigenic analysis of chromatographic most active fraction revealed the presence of three heat-stable constituents, one of which is not shared by nutrient medium, or by D. farinae extract. The fractionation of D. pteronyssinus extract by preparative isoelectrophocusing on sucrose gradient (pH range 3-10) showed that the two fractions (pH 3.5 and pH 5.0) containing the major allergenic activity (measured by the RAST-inhibition capacity) were also able to induce a significant in vitro activation of lymphocytes from allergic patients. When the anti-mite rabbit gammaglobulins were fixed to an immunosorbent and incubated with a house dust extract, it was constantly possible to induce a strong decrease or a complete loss of allergenicity of the dust extract in man. This is in favour of an allergenic identity between dust and mite.

Allergens↗

PubMed1994

Home environmental risk factors in urban minority asthmatic children.

Urban minority families with children with asthma often live in homes with allergen and irritant exposures harmful to these children. We enrolled 392 African-American asthmatic children, male and female, aged 5 to 12, from 42 schools in Washington, DC and Baltimore, MD. The project is designed to test the effectiveness of school-based asthma education interventions, community-based asthma health workers' programs, and the combination on these children. Baseline telephone interviews were carried out with the primary home care-givers for demographic data and for environmental home exposures that exacerbated asthma. Exposures stated to cause wheezing in the children were cigarette smoke in 72%, dust in 53%, cats in 34%, dogs in 27%, and roach exposure in 15%. Fifty-six percent of children live with cigarette smoke exposure, 73% of which is from mothers. This was a highly symptomatic group with 44% reporting two or more days per week of restricted activity and 62% reporting two or more episodes of night symptoms per week. Those with mattress covers on beds had significantly fewer emergency department visits in the past 6 months than those without covers. Over one-third of parents reported children taking two bronchodilators without anti-inflammatory agents. Less than 20% were reported using anti-inflammatory medications. Decreasing asthma severity in this population entails the prevention and control of known risk factors in the home environment. Emphasis must be placed on cigarette smoking cessation programs, covering mattresses, and dust and animal dander control. Primary care physicians require education on the role of anti-inflammatory medications.

Adolescent↗

PubMed1994

[Allergic reactions of the respiratory tract].

Allergic rhinoconjunctivitis and allergic asthma bronchiale are immunologically mediated diseases of the respiratory tract. Dependent on the allergen, they occur seasonally or perennially. Allergens can cause a specific reaction of the immune system, mediated by IgE-antibodies in individuals with a genetic predisposition. Different mediators are released from mast cells, and complex immunopathological mechanisms lead to inflammatory changes of the mucosa. A significant increase of allergies has been observed in the last decades. Indoor and outdoor allergens can be differentiated. Mites and animal dander are the most important indoor allergens. The pollens of birch, alder, hazel, different grasses and mugwort are the most important outdoor allergens. For diagnostic purposes skin tests, laboratory analyses and provocation tests are used. The best therapy is elimination of the offending allergen. As pharmacological agents histamine-receptor antagonists, topical corticosteroids and topical cromoglycate are currently used. Immune therapy is the most specific form of treatment.

Allergens↗

PubMed1993

Immunotherapy for respiratory allergic diseases: indications, efficacy and monitoring.

The author reports a detailed analysis of the indications for Specific Immuno-Therapy (SIT) in allergic rhinitis and asthma. After pointing out the requirements for a correct clinical trial, the efficacy of SIT towards various allergenic agents is examined (pollen, mites, cat and dog danders, moulds). Clinical monitoring--by means of clinical diaries, symptom score, drug consumption, skin tests, challenge tests--and immunological monitoring--by means of measuring of IgE and IgG serum antibodies, mediator and cytokine release, lymphocyte study, etc.--are then discussed. Immunological and clinical parameters to evaluate the efficacy of SIT are compared: clinical parameters being the most effective means of evaluation of clinical improvement.

Allergens↗

PubMed1993

[Ficus benjamina, a perennial inhalation allergen of increasing importance].

12 patients are described with perennial allergic rhinoconjunctivitis or asthma, 3 had additionally urticarial eruptions and one edema of the eyelids. In all of them sensitization to Ficus benjamina was identified by skin prick tests, in 7 cases by the additional presence of specific IgE in vitro, and in 2 it was verified by a conjunctival provocation test. 10 patients were atopic with sensitization to other respiratory allergens such as pollen, house dust mite or animal dander. 2 patients, however, with a massive exposure to Ficus benjamina at home, were non-atopic with monovalent sensitization to this plant. Ficus benjamina is a tropical tree of the genus Ficus which belongs to the Moraceae family. The allergen is located in the plant sap, the so called latex, which after evaporation binds to dust particles on the leaf surface. Upon contact they are emanated from the leaves, thus imitating allergy to house dust components. Since Ficus benjamina is a very popular decorative plant, an increasing number of sensitized individuals is to be expected. The identification of a preventable respiratory allergen is of considerable importance for the patients.

Adolescent↗

PubMed1993

[Evaluation of immediate hypersensitivity and environmental factors by intracutaneous skin tests and specific IgE antibodies in allergic children. Part 1. The annual change of immediate hypersensitivity measured by intracutaneous skin tests and radioallergosorbent test].

To evaluate the relation between immediate hypersensitivity and environmental factors, a total of 2,187 allergic children were given the intracutaneous skin tests (IC test) and specific IgE antibodies (RAST) at Kudanzaka Hospital over a period of 21 years (1967-1987). The incidence of positive IC test to house dust (HD) and Japanese cedar pollen (sugi) increased, and that to molds increased transiently in the period 1965-1975. There was no sex difference in the incidence. Asthmatic children with allergic rhinitis scored higher both in IC test and RAST than those with asthma only. The more severely asthmatic children had a higher incidence of positive IC test to HD, molds, sugi, ragweed, cat dander, silk and buckwheat (sobagara). The recent rise of in the number of allergic diseases was partly proved by higher positive IC tests to HD and sugi. The number of positive test to HD mites also increased because twice as many non-wooden houses as wooden houses, have been built since 1969, and there were 3 times as many, high-rise building in 1975 as in 1965. Pollution and the increasing area of sugi forests were also responsible for increased allergic problems.

Animals↗

PubMed1993

[Evaluation of the Magic Lite SQ specific IgE kit].

The new IgE specific antibody assay kit (Magic Lite SQ) was evaluated by comparing its results with those obtained by the Phadebas RAST and the skin prick tests. Sera from allergic children were used in the tests. The correlation coefficients between the Magic Lite SQ and the Phadebas RAST were as follows: 0.87 for D.p., 0.89 for D.f., 0.87 for HD1, 0.55 for HD2, 0.76 for orchard grass, 0.93 for cat dander, 0.78 for Alternaria, 0.88 for egg white, 0.75 for egg york, 0.81 for milk, 0.75 for say bean, and 0.60 for shrimp. The concordance rate of the two methods was high, except on the case of HD2. The sensitivity and specificity of Magic Lite SQ to the skin prick test was high, except on the case of HD2 and orchard grass. Dilution tests using samples from D.f. positive patients showed a good linearity and excellent quantitativeness. When mite allergen was added to D.f. positive pool serum, mite specific IgE antibody yielded an excellent inhibition curve of up to a maximum of 96%. Since the Magic Lite SQ requires only a small sample of serum and can completed the test in a short time, it is a useful and specific IgE antibody assay kit.

Child↗

PubMedDate not supplied

Eosinophil and neutrophil chemiluminescence in patients with atopic asthma and in healthy subjects.

The 10 patients with atopic asthma and 6 healthy subjects were selected for the study. Each person underwent prick testing to common allergens (extracts of house dust, grass, trees, animal danders, feathers and mould). In addition blood was drawn for the specific IgE antibodies to D. pteronyssinus and total serum IgE levels. Neutrophil and eosinophil chemiluminescence induced by PMA and FMLP was measured in both groups. Eosinophils obtained from patients with atopic asthma stimulated with PMA and FMLP generated significantly greater free radicals than obtained from normal subjects. There was no observed significant difference of neutrophil chemiluminescence activated by PMA and FMLP and of the percentage of hypodense eosinophils in the peripheral blood between subjects with asthma and healthy ones.

Adult↗

PubMed1993

[Hyposensitization treatment of allergic diseases].

Hyposensitization or allergenic immunotherapy has been used extensively for 80 years as a specific treatment of IgE-mediated allergic diseases. Highly effective is venom immunotherapy for patients with systemic reactions after hymenoptera stings and positive diagnostic tests for venom-specific IgE. The clinical efficacy of immunotherapy in hay fever has also been convincingly documented. 20 to 30% of patients with allergic rhinitis pollen develop asthma at a later stage of the disease. Some studies have shown a significant efficacy of immunotherapy in reducing the further development of rhinitis into asthma. The clinical efficacy of immunotherapy in allergic asthma to house-dust mites, animal danders or moulds has been questioned; however, a number of controlled studies published during the last decade shows a clear tendency towards a beneficial effect, especially in children. Recent data show a reduction in mediator release induced by immunotherapy and an inhibition of the late-phase reaction following skin and bronchial challenge tests. Immunotherapy and pharmacotherapy should be integrated components of the treatment strategy of allergic diseases in order to gain the optimal result for the allergic patient.

Desensitization, Immunologic↗

PubMed1993

The state of childhood asthma in young adulthood.

We investigated whether patients with childhood asthma had improved when reaching adulthood. We also evaluated factors which might influence the course of the disease. The study included a group of 108 asthmatics, diagnosed and monitored throughout childhood at the out-patients clinics of Oulu University Central Hospital. At the age of 20-24 yrs of age they were evaluated for the clinical state of their disease, ventilatory lung function and hyperreactivity of the airways. In the interval 30 (28%) had become totally free of symptoms, whilst 24 (22%) continued to have symptoms weekly, or more often. A quarter of the patients continued to use prophylactic medication, half still suffered from allergic rhinitis, and one third had atopic dermatitis. Skin prick tests showed at least one positive result in 86% of the patients, most often to animal danders. Ventilatory lung function tests showed forced vital capacity (FVC) to be within normal limits, but forced expiratory volume in one second (FEV1)/FVC values less than -2 SD predicted were found in 18%. Forty eight percent of the asthmatics reacted to methacholine at a dose of 0.8 mg or lower, and the degree of airway reactivity showed a significant correlation with the current attack rate. The compliance to treatment of asthma was not adequate, as one third smoked and 81% lacked proper check-ups. Concomitant atopic dermatitis, severe early disease and impaired ventilatory lung function at school age, were observed to be significant risk factors for a severe asthma outcome as a young adult.

Adult↗

PubMed1995

Controlled comparison of two fluorometholone formulations in the antigen challenge model of allergic conjunctivitis.

We compared the safety and efficacy of MethaSite, a gel-forming suspension (0.1% fluorometholone), to a commercially available 0.1% fluorometholone ointment, FML S.O.P., using an antigen challenge model. Subjects with known allergic histories were exposed to increasing concentrations of cat dander, ragweed, or grass at visits 1 and 2. Allergic responses of conjunctival injection, chemosis, and subjective itching were quantified on a scale from zero to 3; the sum of these ratings constituted the total allergic score. At visit 3, 105 subjects with total scores of > or = 5 received a drop of MethaSite in one eye and a 0.5 inch ribbon of FML ointment in the other eye. Three and 6 hours postdose, the eyes were challenged with the antigen concentration that provoked significant allergic response at visit 2. We determined safety by evaluating changes in visual acuity, intraocular pressure, and biomicroscopy that occurred between visits 1 and 3. Eyes treated with MethaSite and FML responded similarly to the antigen challenges. Both groups demonstrated suppression of allergic response 3 and 6 hours postdose through equivalent and significant reductions in total allergy scores and individual ratings of injection, chemosis, and itching. In this population, MethaSite was equivalent to FML ointment in safety and efficacy.

Adult↗