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Increased serum levels of eosinophil cationic protein and eosinophil-derived neurotoxin (protein X) in vernal keratoconjunctivitis.

PURPOSE: To evaluate whether the eosinophil preformed mediators, eosinophil cationic protein X, and eosinophil-derived neurotoxin/eosinophil protein X (EDN/EPX) are detectable in serum and can be used as markers of eosinophilic inflammation. METHODS: A competitive radioimmunoassay was used to detect serum levels of eosinophil cationic protein and EDN/EPX in 31 patients with vernal keratoconjunctivitis (VKC) and in 15 healthy controls. RESULTS: Mean serum levels of both eosinophil cationic protein and EDN/EPX were significantly higher in patients with VKC than in controls. There was a good correlation between serum levels of eosinophil cationic protein and EDN/EPX. No significant difference in mean serum eosinophil cationic protein levels was observed between patients with positive radioallergosorbent test (RAST) results and those with negative RAST results who have VKC, whereas mean EDN/EPX and total immunoglobulin E serum levels were significantly higher in patients with positive RAST results than in those with negative RAST results who have VKC. Serum eosinophil cationic protein, but not EDN/EPX, levels were significantly related to total immunoglobulin E levels. CONCLUSION: The authors' data indicate that serum levels of eosinophil cationic protein and EDN/EPX are useful markers of eosinophilic ocular inflammation in VKC.

Adolescent↗

Serological methods in the diagnosis and management of human allergic disease.

The diagnosis and management of human allergic disease is aided by serological measurements involving the quantitation of total human serum IgE, allergen-specific IgE and allergen-specific IgG. Initially, a brief overview of immediate hypersensitivity reactions will be presented with a focus on the role of "reaginic" allergen-specific IgE antibody. The principles and design of immunoassay methods employed in the measurement of total serum IgE and allergen-specific human IgE will then be examined with a discussion of the pros and cons of different radioallergosorbent test (RAST) reporting schemes. Next, Hymenoptera venom will be used as a model allergen system for exploring the clinical utility, principles and design of immunoassays used to quantitate allergen-specific IgG antibody in human serum. Examples of the utility of specific IgG measurements will be provided with recent clinical data. Finally, an overview will be presented on more research-based techniques used in the study of human allergic responses such as cross-immunoelectrophoresis and immunoassays for leukotrienes, prostaglandins, platelet Factor 4 and cyclic AMP.

Allergens↗

Cross-reactivity of IgE antibodies with allergens in birch pollen, fruits and vegetables.

Allergens extracted from apple, carrot, celery tuber and orange were coupled to radioallergosorbent test (RAST) discs. These and commercial birch, mugwort and timothy pollen discs were used to study sera from 90 patients for the presence of IgE antibodies which react with the allergens in question. Individual sera frequently gave positive results with several discs - in particular with birch pollen, apple, carrot and celery tuber discs. If IgE antibodies to birch pollen or apple allergens were detected, there was a 90% chance of antibodies being found also to the second one of these two source materials. Skin tests and patient histories indicated similar clustering of allergies. RAST inhibition experiments showed that the clustering phenomenon was due to cross-reactivity. All immunological determinants in fruits and vegetables appeared to be present also in birch pollen, but all birch pollen determinants were not present in fruits and vegetables. 45 children with atopic dermatitis were studied to establish whether a positive orange RAST would correlate with a history of atopic dermatitis aggravated by orange. The results were negative.

Adolescent↗

Immunoglobulin E antibodies to ingested cereal flour components: studies with sera from subjects with asthma and eczema.

The specificity of immunoglobulin E for different cereal grain proteins was investigated using sera from twenty paediatric patients with asthma and/or eczema. Close correlations were observed between radioallergosorbent test values for grain extracts of wheat, rye and barley, and, to a lesser extent, oats. Of the different wheat four fractions tested, the globulins and glutenins consistently bound higher levels of IgE than the gliadins and albumins. This is in contrast both with bakers' asthma (an allergy to inhaled flour where the albumins are important allergens) and with coeliac disease (in which gliadin is the most toxic fraction). Partial digestion of the flour proteins largely removed their ability to bind IgE. An analytical technique of identifying allergens after gel isoelectric focusing demonstrated that many different flour proteins were involved.

Adolescent↗

Leishmania (Viannia) panamensis-specific IgE and IgA antibodies in relation to expression of human tegumentary leishmaniasis.

Leishmania (Viannia) panamensis-specific IgE and IgA antibodies were quantified in patients with parasitologically confirmed American tegumentary leishmaniasis using a radioallergosorbent test (RAST) and an enzyme-linked immunosorbent assay (ELISA), respectively. The RAST values, presented as the mean +/- SEM percentage of total isotope added, were significantly elevated in patients having disease evolution greater than 12 months (3.14 +/- 0.91), as compared with those with an evolution time of 12 or fewer months (1.66 +/- 0.15) (P = 0.017). A separate group of patients, those with eosinophils in the biopsy specimen of their lesion, also had elevated mean RAST values (2.55 +/- 0.58) when compared with patients who did not demonstrate these cells in their biopsy specimens (1.32 +/- 0.24) (P = 0.038). Leishmania-specific IgA levels, presented as the mean +/- SEM optical density, were significantly higher for patients with mucocutaneous disease (0.40 +/- 0.03) than for patients with cutaneous disease (0.28 +/- 0.023) (P = 0.0063). Inhibition testing with homologous and heterologous antigens confirmed the specificity of these assays, and were used to assess cross-reactivity among L. (Viannia) subspecies and other kineto-plastic hemoparasites. Results demonstrate that patients with more severe forms of American tegumentary leishmaniasis, defined either as increased duration of disease or invasion of the mucosa, have elevated levels of Leishmania-specific IgE and IgA antibodies, respectively.

Adolescent↗

Patients with Meniére's disease possess IgE reacting with herpes family viruses.

OBJECTIVE: To determine if patients with Meniere's disease possess serum IgE specific for herpes simplex virus (HSV) type 1, HSV type 2, Epstein-Barr virus, and/or cytomegalovirus. DESIGN: A modified radioallergosorbent test method was employed wherein each serum sample was processed with recombinant protein A to remove competing non-IgE antibodies, and HSV-1, HSV-2, cytomegalovirus, and Epstein-Barr viral proteins were used as potential antigens. PATIENTS: Ten patients with long-standing active Meniere's disease were tested. Ten age- and gender-matched patients with allergic rhinitis but without Meniere's disease served as control subjects. RESULTS: IgE specific for HSV-1, HSV-2, Epstein-Barr virus, and/or cytomegalovirus was found in the serum sample of nine of 10 patients with Meniere's disease but only in four of 10 control serum samples. Of the positive subjects tested, seven patients with Meniere's disease were positive for IgE for at least three viruses compared with only two control subjects. CONCLUSIONS: (1) Most patients with Meniere's disease possess virus-specific IgE in their serum samples; (2) four viruses of the herpes family are capable of inducing such IgE-mediated sensitization; and (3) latent virus-specific, IgE-mediated inflammation may be an important factor in the initiation and/or sustenance of Meniere's disease.

Case-Control Studies↗

Importance of IgG4 determination in in vitro immunotherapy follow-up of inhalant allergens.

Choosing the right parameters to recommend immunotherapy in allergologic diagnosis is very important. Therefore, other parameters which are independent of the improvement of clinical manifestations and which indicate the evolution of asthma are very useful. Although a decrease in skin reactions was observed in 20% to 25% of patients in previous studies, since the in vitro techniques appeared, their evolution has been observed. Total and antigen-specific IgE evolution, as well as histamine release from basophils, in immunotherapy were followed as we had presented in previous studies. In this work, we studied 151 patients with asthma and rhinosinusitis, 70 of whom were sensitive to Lolium perenne and 81 to Dermatophagoides pteronyssinus. The parameters mentioned above were used, and the patients underwent immunotherapy at three different concentrations depending on the degree of sensitization. The standard concentration was used in the first group; those patients with very high values in radioallergosorbent test (RAST) and histamine release test (HRT) were given the concentration 1:2; and lastly, the largest group of patients, who presented the highest sensitization both in vivo and in vitro, were given the concentration 1:10. As a complement to the mentioned in vitro techniques, the antigen-specific IgG4 determination (blocking antibody) was also evaluated. As we observed in previous studies, skin test, total IgE, antigen-specific IgE and HRTs showed no significant modifications in any of the three groups, in spite of the very positive clinical evolution over the 6 years. Regarding IgG4 follow-up in pollinic patients, a very significant increase was observed, reaching its highest value after 6 years, at standard concentration and with an increase of 49.4%. In conclusion, we think that antigen-specific IgG4 is the only easily available and suitable parameter existing for immunotherapy follow-up.

Adult↗

Allergenic cross-reactivity of cytochromes c of Kentucky bluegrass and perennial ryegrass pollens.

The allergenic cross-reactivity of cytochromes c isolated from Kentucky bluegrass (KBG) and ryegrass (RG) pollens was demonstrated by the finding that both cytochromes elicited PCA reactions of comparable titers in rats sensitized with murine reaginic antiserum to either KBG or RG cytochrome c. However, allergenic differences were revealed at limiting doses of the cytochromes c; under these conditions RG cytochrome c elicited PCA reactions only with the homologous reaginic serum, whereas KBG cytochrome c elicited PCA reactions with both murine reaginic sera. Moreover, in experiments involving inhibition of PCA, RG cytochrome c failed to neutralize some of the IgE antibodies of the antiserum to KBG cytochrome c, whereas KBG cytochrome c neutralized all IgE antibodies of both murine reaginic antisera. From these results it may be concluded that: (1) the two cytochromes c share common allergenic determinants, and (2) the KBG cytochrome c possesses additional allergenic determinant(s) not present on RG cytochrome c. The radioallergosorbent test, utilizing KBG cytochrome c discs and a pool of sera of individuals allergic to KBG, was inhibited to the extent of 87 or 41% by the addition of 10 micrograms of KBG or RG cytochrome c, respectively. By contrast both cytochromes c at 10 micrograms were equally effective in the inhibition (92%) of the binding of the IgE antibodies in this serum pool to RG cytochrome c allergosorbent discs. These experiments confirmed that the two cytochromes share common allergenic determinants.

Amino Acids↗

Bronchial asthma induced by rice.

A 43-year-old patient with rice-induced bronchial asthma was first admitted to our hospital for developing bronchial asthma induced by mite and house dust. At that time, there was no sign of allergic response to rice. Two years later, he was readmitted in an emergency state, with a severe attack of bronchial asthma. This time, however, the result of immunoglobulin E (IgE)-radioallergosorbent test (RAST) for rice was positive, with those to mite and house dust were unexpectedly negative. The causative factors and pathological mechanisms of various kinds of food allergies still remain unknown. The patient is now followed up in an ambulatory setting, and has been eating hypoallergenic rice with no bronchial asthma-induced attack. The present case, being an adult patient with severe grain-induced bronchial asthma previously allergic to mite and house dust, seems to be rather rare in the literature.

Adult↗

[The use of monoclonal antibodies with human IgE for determining the level of allergen-specific IgE].

The possibility of using monoclonal antibodies to human IgE, obtained in our laboratory, with the aim to determine allergen-specific IgE in the radioallergosorbent test (RAST), the enzyme immunoassay and the radioimmunoassay has been studied. The results obtained with the use of the standard RAST system (manufactured by Pharmacia, Sweden) and different variants of assay based on the use of our antibodies, labeled with 125I or conjugated with peroxidase, and timothy pollen allergen (obtained from the Stavropol Research Institute for Vaccines and Sera) have been compared. The best results have been obtained with anti-IgE antibodies 11-2, but for working out our assay systems it is necessary to develop our own standards and control limits.

Allergens↗

Detection of Chlorella-specific IgE in mould-sensitized children.

The content of IgE, specific to the unicellular green alga Chlorella sp., was analysed in sera from 46 atopic children sensitized to moulds, using radioallergosorbent test (RAST), immunoblotting and crossed immunoelectrophoresis/crossed radioimmunoelectrophoresis (CIE/CRIE). Chlorella-specific IgE was found in 23/46 sera by RAST, in 28/41 sera by immunoblotting and in 6/30 sera by CIE/CRIE. The Chlorella components most frequently binding IgE as analysed by gradient gel electrophoresis and immunoblotting were of molecular weights of approximately 13, 17, 19, 26 and 49 kD. Twenty-nine precipitating antigens, including seven IgE-binding precipitates were detected by CIE/CRIE. The study shows that low concentrations of specific IgE are formed to the green alga Chlorella in sera from atopic individuals sensitized to moulds.

Adolescent↗

High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea.

STUDY OBJECTIVE: To determine whether allergic sensitization occurs frequently in children with habitual snoring and whether allergy predicts the occurrence of obstructive sleep apnea syndrome (OSAS) in snoring children. DESIGN: Prospective study of 39 children with habitual snoring who were referred for polysomnography. SETTING: Pediatric pulmonary sleep disorders clinic in a tertiary referral center. MEASUREMENTS: Subjects underwent a complete history and physical examination. To assess for the presence of allergic sensitization, a multiantigen radioallergosorbent test (RAST) was performed on serum samples. Subjects then underwent nocturnal polysomnography to determine the presence and severity of OSAS. RESULTS: Fourteen subjects (36%) demonstrated sensitivity to allergens; this is higher than expected for the general pediatric population. The frequency of OSAS was increased in subjects with positive RAST results compared to those with negative RAST results (57% vs 40%; chi 2 = 9.11; p < 0.01). CONCLUSION: Allergy is frequently present in pediatric patients with habitual snoring. Furthermore, the presence of allergy is associated with an increased risk of OSAS in this population.

Child↗

IgE-type antibodies to Ascaris antigens in man.

IgE antibodies to Ascaris antigens were detected by radioallergosorbent test (RAST) in the serum obtained from a person experimentally sensitized with Ascaris suum antigens prepared from the body fluid of worms. This serum passively sensitized human skin in vitro and histamine release from the sensitized skin was observed by challenge with antigens. The allergenicity of A. suum antigens was present over a very broad spectrum of molecular size. The present results suggest that specific IgE antibodies to Ascaris antigens might be in Ascaris-infected patients and allergic symptoms which belong to type 1 reaction might be mediated by IgE in these patients.

Antibody Formation↗

Basidiospore extracts: evidence for common antigenic/allergenic determinants.

Spore extracts, prepared from Armillariella tabescens, Pleurotus ostreatus, Coprinus quadrifidus, Amanita muscaria, Ganoderma lucidum, Psilocybe cubensis, Pisolithus tinctorius, Scleroderma sp. and Calvatia cyathiformis, were examined for antigenic/allergenic relationships by Ouchterlony and radioallergosorbent testing (RAST) inhibition, respectively. Ouchterlony, using hyperimmunized rabbit sera, demonstrated a high degree of cross-antigenicity among the extracts tested; however, some unique antigens were also present. RAST inhibition, evaluated by comparing extract concentrations which inhibited the RAST by 50% (IC-50), varied with the allergen tested. P. cubensis was the most potent inhibitor (IC-50 ranged from 0.034 mg/ml for A. tabescens RAST to 0.29 mg/ml for G. lucidum RAST). P. tinctorius was the least potent inhibitor, failing to reach IC-50 at 10 mg/ml for any basidiospore extract. Evaluation of slopes and intercepts of the dose-response lines demonstrated qualitative and quantitative differences among allergens in these extracts. These results indicate the presence of shared allergenic epitopes, and suggest that representative extract panels could be developed for future use in diagnosis and treatment of basidiospore-sensitive individuals.

Allergens↗

Immune response to Blomia kulagini and Dermatophagoides pteronyssinus in Sweden and Brazil.

The immune responses to the non-pyroglyphid mite Blomia kulagini and the pyroglyphid mite Dermatophagoides pteronyssinus were compared in 440 Swedish farmers and 34 allergic subjects from Brazil using the radioallergosorbent test (RAST). Both B. kulagini and D. pteronyssinus were shown to be a common cause of sensitization, particularly in Brazil. The highest RAST scores were found against D. pteronyssinus in sera from both countries. Allergenic cross-reactivity between the two mites was studied by the RAST inhibition technique. Both B. kulagini and D. pteronyssinus possess their own unique allergens as well as allergens in common. Thus, besides mites belonging to the Dermatophagoides genus, other pyroglyphid and non-pyroglyphid mites in different countries should be taken into consideration before starting hyposensitization treatments.

Adolescent↗

IgE-mediated allergic reactions to potatoes.

We investigated sera of 12 patients with IgE-mediated hypersensitivity reactions to potato, using different in vitro methods. Radioallergosorbent test classes 2-4 (7.6-46.5% binding) were measured with potato allergen disks. Immunoblot detected allergen bands with an isoelectric point range of approximately 4.5-5.2 and mainly in a molecular weight range between 16.00 and 30.00 kD. But also at molecular weights of 43.00 and 65.00 kD allergen bands (IgE specificities) could be detected. Histamine release assay performed with isolated fractions of the potato extract showed a great individual variation and positive results of fractions of molecular weights between 10.00 and 80.00 kD. From our data we conclude that raw potato is a 'multiallergenic' vegetable.

Adolescent↗

Comparison of vespid venoms collected by electrostimulation and by venom sac extraction.

Venoms of three vespid species, yellow jacket, bald-faced hornet, and yellow hornet, obtained by either electrostimulation of venom sac extraction were compared with regard to their enzymatic activity, antigenicity, and allergenicity. Phospholipase a, phospholipase B, and hyaluronidase enzymatic activities were present in all six preparations. The activity of venom sac extracts lay in the range found in different batches of venoms obtained by electrostimulation for each species. Analysis of sera from vespid-sensitive patients in the radioallergosorbent test (RAST) with discs coupled with either venom sac extracts or venoms obtained by electrostimulation showed a good correlation of the results within all three species (r = 0.95). In RAST inhibition the potency of venom sac extracts and venom obtained by electrostimulation was similar for each species. Analysis of rabbit antisera to the six preparations revealed similar patterns in immunoelectrophoresis and identity reactions between the major antigens within each species. Tissue protein contamination was detected in all venom sac extracts but not in venoms obtained by electrostimulation.

Animals↗

Analysis of allergenic components of Bermuda grass pollen by monoclonal antibodies.

A panel of 16 monoclonal antibodies (MoAbs) directed against Bermuda grass (Cynodon dactylon) pollen (BGP) were generated for identification and purification of the major allergenic components of the eliciting antigen (Ag). Radioimmunoprecipitation (RIP) analysis revealed that there were at least eight antigenic components with molecular weights (MW) ranging from 12 kilodalton (12 kDa) to 200 kDa. Each of these components has distinct biochemical characteristics based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and isoelectric focusing (IEF). Among them, Cyn d Bd67K and Cyn d Bd58K were basic proteins, Cyn d Bd35K consisted of at least four isomeric components with isoelectric points ranging from 6.2 to 7.2. The other antigens (Cyn d Bd68K, 48K, 38K, Cyn d Bd200K, Cyn d Bd46K, Cyn d Bd25K and Cyn d Bd12K) were all acidic proteins. The IgE binding capacity of all these antigens was determined with sera from 11 BGP-allergics by using a modified radioallergosorbent test. All but one of the antigens (Cyn d Bd200K) were found to react with human IgE from sera of BGP-allergic patients. Among those human IgE-binding molecules, Cyn d Bd35K reacted with allergic sera most frequently (10 of 11), followed by Cyn d Bd58K (8 of 11) and Cyn d Bd46K (7 of 11) respectively. Our results suggest that Cyn d Bd35K, Cyn d Bd58K, and Cyn d Bd46K are major allergens of BGP, and the MoAbs we obtained should be valuable tools for further purification of these allergens.

Allergens↗