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At least 667 records · Page 37Linked to original sources
PubMed1999

[Allergy to hymenoptera venoms in children].

Incidence of hymenoptera venom allergy in children is about 0.4 to 0.8%. Clinical features usually range from urticaria to anaphylaxis. Fatal reactions can occur but with less frequency than in adults. Allergologic investigations must be performed in children with systemic or generalized reactions after hymenoptera stings, which may lead to venom immunotherapy. Venom immunotherapy is well reported, but protocols differ according to the authors: ultra-rush in 3 h, accelerated in 3 to 5 days and semi-rush in 2 to 8 weeks. Results are always excellent (90 to 100%). We report our experience with 91 children receiving venom immunotherapy. Clinical history and positivity of skin tests indicated immunotherapy. Clinical symptoms were anaphylaxis (15.3%), serious reaction (37.3%) strong reaction (34%), and mild reaction (7.6%). Changes in immunological parameters revealed wide individual variations, not differing from data in the literature, with no correlation with evolution of immunotherapy. Venom immunotherapy appeared with good tolerability in children, whatever the protocol used.

Adolescent↗
PubMed2006

Current developments in peanut allergy.

PURPOSE OF REVIEW: Peanut allergy is among the most serious, life-threatening food sensitivities, and recent studies indicate increasing prevalence, particularly among children. Our objective is to highlight recent advances in the immunology and treatment of peanut allergy. RECENT FINDINGS: Peanut sensitization may be both a Th1- and Th2-driven process, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) may play a role in regulating the response intensity. Preliminary work shows that the food matrix is important in the immune response to peanut and that purified peanut allergens may have little intrinsic stimulatory capacity. Studies characterizing peanut allergens have revealed Ara h 1 and Ara h 2 as the most potent allergens, but Ara h 3 may be more allergenic than previously thought. There appears to be a relationship between the diversity of IgE-binding patterns and the severity of clinical symptoms. Multiple novel approaches to treatment are being investigated, which include traditional Chinese medicine, various forms of modified immunotherapy and the use of adjuvants in modified immunotherapy. SUMMARY: By understanding the immunologic response to peanut and the roles of the major peanut allergens, it may be possible to predict those at risk for severe reactions, prevent peanut sensitization and effectively treat those already sensitized.

Allergens↗
PubMedDate not supplied

Adverse reactions associated with skin testing and immunotherapy.

Fatalities have been associated with allergen skin testing and immunotherapy. Therefore, physicians using such tests and therapy should be knowledgeable in their use and take proper precautions to decrease the risk of anaphylaxis. The American Academy of Allergy and Immunology recommends a 20-minute wait that can be extended for high risk patients following an injection, and that the physician in charge of administering immunotherapy should be familiar with and prepared to appropriately treat anaphylaxis. Future treatment with peptides rather than whole allergens may increase safety.

Anaphylaxis↗
PubMed2005

Immunoblot studies in allergic patients to hymenoptera venom before and during immunotherapy.

BACKGROUND: Hymenoptera venom immunotherapy (VIT) is immunologically effective in patients with systemic allergic reactions after hymenoptera stings. OBJECTIVE: To evaluate the effect of VIT on specific IgE and IgG4 immunoblotting bands in VIT-treated patients. MATERIAL AND METHODS: Specific IgE and IgG4 immunoblotting bands for hymenoptera venom were performed with ALABLOT in sera of 17 patients (8 allergic to honeybee venom, 8 to wasp and 1 to polistes venom) before and during successful VIT (1 and 3 years). Before immunotherapy, all patients had experienced moderate/severe systemic reactions to a hymenoptera sting, with positive skin tests and venom-specific IgE. During immunotherapy all patients suffered field stings, without any systemic reaction. RESULTS: Before VIT we detected several immunoglobulin-binding bands in different regions, with different individual patterns. After VIT, we observed in some patients (5/8 for honeybee venom, 6/8 for wasp and 1/1 for polistes) complete disappearance of some IgE-binding bands, mainly the 15 kDa region (honeybee) and 23 and 44 kDa regions (wasp and polistes). All patients showed decreased intensity of IgE-binding bands, most pronounced in regions 16, 44 and 52 kDa (honeybee); 44 and 35 kDa bands (wasp) and 23 kDa (polistes). Some patients showed de novo appearance of IgG4-binding bands (4/8 for honeybee and 8/8 for wasp venom), mainly in 52 kDa (honeybee) and in 23 and 44 kDa regions (wasp). All patients showed increased intensity of IgG4 bands that were already present before VIT, more pronounced in 52 and 44 kDa (honeybee) and in 44 and 35 kDa regions (wasp). CONCLUSIONS: During successful VIT there are changes in intensity and number of IgE and IgG4 binding bands, which could reflect the immunological improvement induced by VIT. These changes are more pronounced/frequent in wasp VIT, a fact that could explain the best results usually seen in these patients.

Adult↗
PubMedDate not supplied

Place of immunological examinations in extrinsic asthma.

The provocation test is - in spite of its drawbacks, especially the risk for the patient - the most reliable way to identify causative agents in extrinsic asthma. The immunological genesis of the obstruction provoked must be proved with adequate methods however. RAST (Radio-allergo-sorbent-test) and histamine liberation are valuable in vitro techniques for the identification of atopic sensitizations. Their disadvantages - the expensive equipment and the time-consuming procedure respectively - limit their widespread use. A carefully performed and evaluated prick test possesses a comparable specificity with acceptable risk. Less satisfying is the situation in nonimmediate asthma. Precipitations tests are at present most valuable. Main indications for immunological methods in extrinsic asthma are: - the identification of causative allergens and the kind of underlying immune reactions; - the control and - in the future - the individualization of hyposensitization procedure. The future use of allergen extracts containing a minimum of non-specific irritants is extremely important.

Asthma↗
PubMed2006

Sublingual immunotherapy in children modulates allergen-induced in vitro expression of cytokine mRNA in PBMC.

BACKGROUND: During subcutaneous immunotherapy (SCIT), there is a local mucosal shift from Th2 to Th1 type cytokine predominance and downregulation of interleukin (IL)-5 and eosinophilia. According to recent studies IL-10- and transforming growth factor (TGF)-beta-induced tolerance is another key phenomenon in SCIT. Few data to date is available on mechanisms and roles of these cytokines in sublingual immunotherapy (SLIT). SCOPE: This study was undertaken to analyse the allergen-induced in vitro mRNA expression of IL-4, IL-5, IL-10, TGF-beta and interferon (IFN)-gamma during SLIT in peripheral blood mononuclear cells (PBMC) of children with allergic rhinitis (AR). METHODS: Ten patients with AR undergoing pollen SLIT with a weekly dose of 200,000 SQ-U, 10 with a weekly dose of 24,000 SQ-U of glycerinated mixture of Betula verrucosa, Corylus avellana and Alnus glutinosa and 10 with placebo were included in the study. Peripheral blood mononuclear cell samples were collected and stimulated with pollen allergen extract prior to the treatment, after 1 and 2 years of the treatment. The cytokine mRNA expression was assessed using kinetic real time reverse transcription polymerase chain reaction (RT-PCR; TaqMan). RESULTS: The in vitro allergen-induced mRNA expression of IL-5 by PBMC in the placebo group at 1 (P = 0.0065) and 2 (P = 0.013) years of therapy were increased in comparison with the highest dose. The expression of IL-10 mRNA was increased in the highest dose group (P = 0.0016) and the lower dose group (P = 0.034) at 2 years of therapy when compared with placebo. The change in the expression of allergen-induced TGF-beta had an inversed correlation with the change of IL-5 (r = -0.38, P = 0.036) and positive correlation with the change of IL-10 (r = 0.58, P = 0.0019). CONCLUSIONS: Sublingual immunotherapy induced a dose-dependent systemic allergen-specific immunological response in children with AR. During high-dose SLIT, there was activation of regulatory cytokine IL-10 and an inhibitory effect on IL-5 expression increase that was associated with TGF-beta.

Administration, Sublingual↗
PubMedDate not supplied

Specific immunotherapy in pollinosis: I. Valuation of certain cytoimmunological indicators over the course of four years of immunotherapy in pollinosis.

The aim of this study was to identify, based on a wide range of cytoimmunological and immunological tests in combination with clinical valuations, the changes which occurred in pollinosis over the course of specific immunotherapy after the first, second, third and fourth years of treatment. Further tests were also conducted in order to demonstrate which of the indicators tested for correlated to a clinical improvement and might thus be helpful in determining the effectiveness of treatments for pollinosis. A group of 167 individuals, including subjects who had just completed their first, second, third and fourth year of desensitization treatments were tested. Levels of IgA, IgM, IgG, IgD, total and specific IgE, T-RFC, B-EAC, T-FcM-EN and T-FcG-BG lymphocyte counts, and concentrations of basal, total and specifically released blood histamine were all determined and noted. It was ascertained that the indicators best correlating to a clinical improvement over 4 years of desensitization in pollinosis were specific and total IgE, as well as the percentage of specifically released histamine present in the blood, with the level of basal histamine in the blood being constant during the entire course of the treatment. The remaining indicators which were tested did not undergo any characteristic changes over the course of 4 years of immunotherapy.

Adult↗
PubMedDate not supplied

[Allergy to Hymenoptera venom (author's transl)].

The venom injected with the sting of female Hymenoptera may be very dangerous to man. It contains toxic compounds similar to those of snake venom but these only affect men in case of numerous stings at the same time. In contrast, about 25% of the population may become sensitized to venom proteins (enzymes), the least common, but most serious, allergic reactions being anaphylactic shock, rarely fatal. Diagnosis rests upon questioning, skin tests with Hymenoptera venom and immunological investigations for specific IgE and IgG, the latter being considered as protective antibodies. First-aid treatment consists of adrenaline by inhalation and injection. The latest prophylactic treatment, which may protect 97% of the patients, is injections of Hymenoptera venom extracts.

Anaphylaxis↗
PubMedDate not supplied

Novel immunologic therapies.

Although current allergen immunotherapy is an effective method of treating allergic inflammation, it is time consuming and carries the risk of anaphylaxis. Novel therapies for treating allergic inflammation are of two general types. In one senario, a key factor in the allergic cascade is blocked. The other possibility is to modify current immunotherapy administration.

Anti-Inflammatory Agents↗
PubMed1979

Current concepts in asthma therapy.

Attacks of asthma can be precipitated in susceptible individuals by a variety of stimuli acting through immunological or non-immunological pathways. The pathological changes in the lung which characterize asthma include bronchoconstriction, mucosal oedema and tenacious secretions. A logical approach to therapy is outlined, based on intervention at successive sites along the trigger-to-target organ response pathway.

Acute Disease↗
PubMed2003

[Manifestations of rifampicin-induced hypersensitivity].

INTRODUCTION: The side effects of rifampicine due to an immunoallergic mechanism are rare and usually observed during discontinued treatment or administration of high doses. OBSERVATIONS: An immediate hypersensitivity reaction with anaphylactic manifestations and increase in IgE occurred in a 39 year-old man suffering from resistant tuberculosis. The reaction occurred within the first hour following a low dose of rifampicin administered in a desensitisation attempt, the outcome of which was favourable after administration of corticosteroids and antihistamines. A type II hypersensitivity reaction occurred in a 76 year-old male patient in the form of thrombopenia on D76 of a twice weekly treatment, diagnosed because of hemoptysis with normalisation of platelet level on withdrawal of rifampicin. An immune complex hypersensitivity reaction was responsible for hepato-renal failure on D68 of twice weekly treatment and required permanent withdrawal of rifampicin and dialysis, which led to subsequent improvement. COMMENTS: These clinical cases illustrate the variability of the hypersensitivity mechanisms observed with rifampicin, the difficulty in imputability tests and methods for immunological confirmation, the interest of continuous treatment which avoids a certain number of these accidents, and that of desensitisation during immediate hypersensitive reactions which permits the continuation this major anti-tuberculosis drug.

Acute Kidney Injury↗
PubMed1982

[Current aspects of bronchial asthma (author's transl)].

Immunologically mediated diseases of the lung and the bronchial system, in specially allergic bronchial asthma have reached increasing clinical significance. The importance of the immediate allergic reaction for pathogeneses, diagnosis and therapy is pointed out and discussed under the aspect of recent findings.

Antibody Formation↗
PubMed1994

[Current trends in the specific immunotherapy for allergic syndromes due to Dermatophagoides pteronyssinus].

House dust mites of the species Dermatophagoides pteronyssinus are among the most prevalent perennial allergens. Measurement of allergen exposure is so crucial to establish the natural history of the allergic reaction. The most common clinical manifestations induced by Dermatophagoides are perennial asthma and perennial rhinitis. Recently there are a number of studies indicating that a high degree of exposure to house dust mites may represent a risk factor for severe disease in patients with atopic dermatitis. The diagnosis was performed by in vivo and in vitro tests. Nowadays the treatments regard allergen eradication and specific immunotherapy. Mite specific immunotherapy is only effective under optimal conditions, including an appropriate selection of patients and the use of high-quality standardized extracts. The specific immunotherapy received by subcutaneous injection is the one mostly used until now and the results were really satisfactory, even if its evaluation has been made on clinical data or on bronchial challenges. Immunologic changes were found only when using same extracts. The incidence of systemic reactions during the immunotherapy was low. Recently local immunotherapy was used and it has been shown to be significant by safety, but further clinical investigations are needed to clarify the clinical efficacy in direct comparison with traditional parenteral immunotherapy.

Animals↗
PubMed1985

[Diabetes mellitus and immunology--a manifold interrelation].

The purpose of this article is to describe the manifold interrelations between diabetes mellitus and immunology. The survey starts with immune defects caused by insulin deficiency and expressed by reduced phagocytic functions of macrophages and decreased responsiveness of lymphocytes to mitogens. The following topic deals with immunologic side effects of insulin therapy due to species differences and impurities in former insulin preparations. Also in human insulin therapy small amounts of IgE and IgG antibodies are observed, although clinically insulin immunology in the future will be of minor importance for diabetic patients. Autoimmunity to islet antigens plays a major role in diabetes research. Some characteristics of islet cell antibodies are described and their impact on the pathogenesis of type I diabetes is discussed. Finally experimental islet transplantation and the attempts of immunoalteration of allogeneic islets are mentioned.

Desensitization, Immunologic↗
PubMed2006

Immunologic response to administration of standardized dog allergen extract at differing doses.

BACKGROUND: The immunologic response to immunotherapy with dog extract is not well characterized. OBJECTIVE: The purpose of this study was to examine the immunologic response to 3 doses of dog extract expressed as their Can f 1 content. METHODS: Cluster immunotherapy was administered to 28 patients with dog allergy who were randomly assigned to 1 of 4 treatment arms: placebo or acetone-precipitated extract containing 0.6 mug, 3.0 mug, or 15.0 mug Can f 1 per 0.5 mL maintenance dose. Studies included titrated skin prick tests, the late cutaneous response, titrated nasal challenge with dog extract, and serum allergen-specific IgE and IgG(4). Dog allergen-stimulated lymphocyte proliferation was performed with measurement of secreted cytokines by ELISA and of intracellular cytokines by flow cytometry. RESULTS: There was a significant dose-dependent response in suppression of titrated skin prick tests and suppression of the late cutaneous response. There was a significant increase from baseline in dog-specific IgG(4) in both the high-dose and low-dose groups and a dose-dependent suppression of secreted TNF-alpha and increase in secreted TGF-beta. There was a dose-dependent trend in suppression of secreted IL-4 with a significant decrease from baseline in the high-dose group. There were no significant changes in symptom scores; lymphocyte proliferation; secreted IFN-gamma, IL-10, or IL-5; or intracellular cytokine production. CONCLUSION: The dose-response in immunologic parameters after immunotherapy with dog extract is similar to that previously demonstrated with cat extract. CLINICAL IMPLICATIONS: The greatest and most consistent response is seen with a dose containing 15 mug Can f 1.

Allergens↗
PubMed2001

Classic specific immunotherapy and new perspectives in specific immunotherapy for food allergy.

Food allergy is a major cause of life-threatening hypersensitivity reactions. Food-induced anaphylaxis is the most common reason for someone to present to the emergency department for an anaphylactic reaction. The avoidance of the allergenic food is the only method of preventing further reactions that is currently available for sensitized patients. Strict avoidance of specific foods is the accepted treatment of food-induced allergic reactions but is often an unrealistic therapeutic option for food-induced hypersensitivity reactions for the many reasons previously described. Desirable therapeutic strategies for the treatment and prevention of food allergies must be safe, relatively inexpensive and easily administered. Recent advances in the understanding of the immunological mechanisms underlying allergic disease and better characterization of food allergens have greatly expanded the potential therapeutic options for future use. Several different forms of immunomodulatory therapies are currently under investigation: peptide immunotherapy, mutated protein immunotherapy, allergen DNA immunization, vaccination with immunostimulatory DNA sequences and anti-immunoglobulin E (Anti-IgE) therapy.

Desensitization, Immunologic↗
PubMed2003

Antigen resorption from the gastrointestinal tract. A historical perspective on the pathophysiological foundation of modern sublingual/oral immunotherapy.

Resorption of small particles and proteins through the mucous membranes of the intestines has been extensively studied for well over a 100 years and the arrival of sublingual/oral immunotherapy in clinical practice has renewed interest in this process. The first line of immune response to a potential allergen is at the site of contact with a mucous membrane and both inhaled and ingested allergens usually lead to some level of direct clinically appreciable manifestation on the mucous membrane. The initial process of antigen resorption has been relatively well understood for almost one century; however, the metabolic and/or immunological fate of large particles is the subject of more recent studies. We now recognize that resorption and hematogenous spread of biologically intact allergens from the gastrointestinal tract occur despite extensive predigestion of particles and proteins within the gastrointestinal lumen and this phenomenon provides the pathophysiological underpinning of modern sublingual/oral immunotherapy.

Administration, Oral↗