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Rubber-specific IgE in children with spina bifida.

We attempted to determine the prevalence and clinical significance of rubber-specific IgE in a prospective case control study of 32 preoperative children with spina bifida, compared with 45 outpatient controls and 35 age-matched preoperative controls without spina bifida. A latex-specific radioallergosorbent test was positive in 11 of the 32 spina bifida patients (34%), compared with 1 (2%) and 4 (11%) of the respective controls (p less than 0.05). Within the spina bifida group 5 of 11 antibody-positive patients had a history of rubber-associated, intraoperative or otherwise idiopathic allergic episodes and 1 of 21 antibody-negative patients gave such a history (p = 0.012). Children with spina bifida have a significantly greater likelihood than controls of having IgE specific for rubber antigens. In addition, the presence of rubber-specific IgE is associated with a higher frequency of rubber-associated, intraoperative or idiopathic allergic reactions.

Adolescent↗

Longitudinal study of tolyl-reactive IgE antibodies in workers hypersensitive to TDI.

Three workers with TDI hypersensitivity were evaluated for IgE antibodies to TDI over a period of 13 months. A radioallergosorbent test (RAST) system was employed using p-toly(mono)isocyanate-human serum albumin antigen covalently bound to cyanogen bromide-activated paper discs. IgE antibody titers were consistently elevated in two individuals who experienced several bronchial hypersensitivity responses to TDI during the study period. The responses were either solely asthmatic or asthmatic accompanied by cutaneous hypersensitivity reactions. By contrast, antibody titers in a third subject who had not experienced any hyersensitivity reactions during the study period continually decreased, falling to insignificant levels after 12 months. In the absence of renewed TDI exposure, sensitive workers may have titers indistinguishable from those of workers exposed to TDI but without sensitivity to the chemical.

Adult↗

Type I allergy to foods in atopic dermatitis. Comparison between RAST-positive and RAST-negative cases.

Radioallergosorbent tests (RASTs) with five common foods were performed in 183 patients with atopic dermatitis. The results showed that about half of the patients had type I allergy to at least one of the five foodstuffs. The RAST results correlated roughly to the severity of dermatitis. In each group of patients with mild, moderate and severe atopic dermatitis, positive RAST reactions to common foods occurred predominantly in patients who had a personal or a family history of respiratory atopy. Positive RASTs were rare in patients with pure atopic dermatitis who had neither personal nor family history of respiratory atopy. It seems likely that type I food allergy occurs predominantly in those patients with atopic dermatitis who have a predisposition to respiratory atopy.

Adolescent↗

Allergic reactivity of Parthenium hysterophorus (Santa Maria feverfew) pollen: an unrecognized allergen.

Parthenium hysterophorus (PH), a member of the Asteraceae, is a ubiquitous weed found in great profusion in the United States Gulf coast area. A plant survey carried out in Texas Gulf coast demonstrated that around Corpus Christi, PH is the most prevalent weed. We have studied known ragweed-sensitive patients living in Austin and Corpus Christi, by radioallergosorbent test (RAST) analysis for PH and Ambrosia psilostachya (AP; western ragweed). Nine of ten patients from Austin were RAST-positive to PH and AP; 8 of the 10 patients had positive scores to both pollen extracts. All of the 8 patients from Corpus Christi were positive to both PH and AP. The Austin group showed a significant correlation between AP and PH RAST scores while no correlation between RAST values was seen in the Corpus Christi group. RAST inhibition analysis in this highly selected population did reveal patients that had true sensitivity to PH pollen alone or who were sensitive to both PH and AP pollen. This suggests that in areas where it is highly prevalent PH pollen is an overlooked cause of allergic disease.

Allergens↗

IgE-binding components of cultured human keratinocytes in atopic eczema/dermatitis syndrome and their crossreactivity with Malassezia furfur.

BACKGROUND: Atopic eczema/dermatitis syndrome (AEDS) patients display immunoglobulin E (IgE) reactivity to several antigens, e.g. saprophytic yeasts as Malassezia furfur. AEDS patients also show IgE autoreactivity towards cells of their own tissue including epidermis. PURPOSE OF THE STUDY: The aim of this study was to investigate the IgE autoreactivity of AEDS patients to cultured keratinocytes and to reveal potential crossreacting epitopes in cultured keratinocytes and M. furfur. MATERIAL AND METHODS: Serum samples of 27 AEDS patients were analyzed, of these 13 were M. furfur radioallergosorbent test (RAST) positive and 14 negative. Four urticaria, three psoriasis, and seven nonatopic patients were included as controls. The studies were performed by using IgE immunoblotting and immunoblotting inhibition methods. RESULTS: Ten IgE-binding protein bands were detected in cultured human keratinocytes by IgE immunoblotting using sera from adult AEDS patients. Anti-keratinocyte IgE antibodies were more associated with elevated S-IgE level than M. furfur RAST. Clear crossreactivity with M. furfur could not be shown. CONCLUSIONS: The possible pathomechanism of anti-keratinocyte IgE antibodies is not due to IgE epitope mimicry of saprophytic yeast and local tissue in AEDS skin.

Adult↗

Cross-Reactivity studies of gutta-percha, gutta-balata, and natural rubber latex (Hevea brasiliensis).

Gutta-percha and gutta-balata are derived from the Paliquium gutta and Mimusops globsa trees, respectively, that are in the same botanical family as the rubber tree Hevea brasiliensis. For this reason the potential for immunological cross-reactivity between the gutta-percha and gutta-balata used in endodontics and natural rubber latex (NRL) has been the subject of some controversy, because these products may be used in latex-allergic individuals. The objective of this study was to investigate the potential cross-reactivity between gutta-percha, gutta-balata, and NRL. Physiological extracts of seven commercially available gutta-percha products, raw gutta-percha, raw gutta-balata, and synthetic transpolyisoprene were each analyzed for cross-reactivity with NRL in a competitive radioallergosorbent test inhibition assay. No detectable cross-reactivity was observed with any of the raw or clinically used gutta-percha products. In contrast the raw gutta-balata released proteins that were cross-reactive with Hevea latex. We conclude that the absence of gutta-percha proteins that can react with Hevea latex-specific IgE antibody supports the minimal potential for commercially available gutta-percha to induce allergic symptoms in individuals sensitized to NRL. Because gutta-balata is sometimes added to commercial gutta-percha products caution should be exercised if products containing gutta-balata are used in endodontic care of latex-allergic individuals.

Adult↗

Allergens of horse epithelium. I. Physicochemical and immunochemical characterization of five different horse epithelium raw materials used for allergen extract preparation.

We investigated five horse epithelial allergen extracts prepared from different qualities of raw material by several biochemical and immunochemical methods. Horse serum albumin and horse serum were used to identify serum-related antigens. We found high similarities as well as marked differences between the extracts. There were strong differences in the protein contents, the protein patterns obtained by isoelectric focusing and sodium dodecyl sulfate polyacrylamide gel electrophoresis, the total allergenic activities obtained by radioallergosorbent test inhibition assays and the amounts and numbers of serum-related proteins. The patterns of dander-related allergens in crossed radioimmunoelectrophoresis were similar but showed partly strong differences in allergen concentrations. Allergen compositions determined by blotting methods showed only minor differences between the investigated epithelial extracts. It appears that some of the differences, e.g. the content of serum-related proteins, depend on the way the different raw materials are prepared. Because serum-related extract components are not considered as major allergens, their content should be low in horse epithelial allergen extracts. For this reason whole skin cannot be recommended as starting material for horse epithelium allergen extract preparation.

Allergens↗

Cross-reactivity between coconut and hazelnut proteins in a patient with coconut anaphylaxis.

BACKGROUND: The medical literature reports few cases of severe allergic reactions to coconut. We encountered a patient with anaphylaxis to coconut and oral symptoms to tree nuts. OBJECTIVE: To identify cross-reactive antibodies between coconut and other tree nuts. METHODS: We performed commercial radioallergosorbent tests to coconut and various tree nuts using the patient's serum. Skin prick testing was performed to fresh coconut and commercial extracts of coconut, almond, Brazil nut, cashew, pecan, walnut, and hazelnut. Proteins from fresh coconut, commercial coconut extract, and tree nuts were extracted. Immunoblot and inhibition assays were performed to evaluate for cross-reacting IgE antibodies between similar-sized allergens in coconut and hazelnut. RESULTS: Positive skin test results occurred to the coconut and multiple tree nut extracts. In vitro serum specific IgE was present for coconut, hazelnut, Brazil nut, and cashew. Immunoblots demonstrated IgE binding to 35- and 50-kDa protein bands in the coconut and hazelnut extracts. Inhibition assays using coconut demonstrated complete inhibition of hazelnut specific IgE, but inhibition assays using hazelnut showed only partial inhibition of coconut specific IgE. CONCLUSIONS: Our study demonstrates the presence of cross-reactive allergens between hazelnut (a tree nut) and coconut (a distantly related palm family member). Because there are many potentially cross-reactive allergens among the tree nuts, we recommend patients with coconut hypersensitivity be investigated for further tree nut allergies.

Adult↗

RAST inhibition: a collaborative study on its suitability and reproducibility for the assay of cocksfoot pollen extracts.

The suitability and reproducibility of the inhibition mode of the radioallergosorbent test (RAST) as a method for the assay of allergen extracts was examined in a collaborative study involving seven laboratories. Participants assayed five coded extracts of cocksfoot grass (Dactylis glomerata) pollen, including three batches from one manufacturer, both by a common method and by their local methods of RAST inhibition. For the versions of RAST inhibition employed in this study the estimates of relative potencies of the extracts were in agreement. Further, when laboratories used their local methods, the inter-laboratory variation in potency estimates was similar to that found when laboratories used the common method. It was concluded that RAST inhibition has a useful role in the assessment of the potencies of allergen extracts, and of the consistency of serial batches of extracts from individual manufacturers.

Allergens↗

Reverse enzyme immunoassay for the determination of Dermatophagoides pteronyssinus IgE antibodies.

Sera from patients with suspected mite sensitivity were assayed using both the radioallergosorbent test (RAST) and a reverse enzyme immunoassay for IgE antibodies (REIA). Of the 133 sera studied, the RAST gave positive results in 48 cases and the REIA in 59. Negative results for both assays were obtained in 72 of the sera. The immunoenzymatic assay described here, using micro-plates as solid phase, has proven to be IgE- and antigen-specific. The allergen conjugate has a prolonged shelf life and the method is easy to perform. The sensitivity of the REIA for Dermatophagoides pteronyssinus IgE antibodies is limited by the small amount of IgE bound by the well surface (less than 100 ng). However, we think that the method offers a reliable alternative for the diagnosis of D. pteronyssinus-allergic patients.

Animals↗

Standardization of rye-grass pollen (Lolium perenne) extract. An immunochemical and physicochemical assessment of six candidate international reference preparations.

Six candidate extracts of Lolium perenne (rye-grass) pollen have been studied in 6 laboratories using a variety of immunochemical and physicochemical techniques. Radioallergosorbent test inhibition, crossed immunoelectrophoresis, crossed radio-immunoelectrophoresis, sodium dodecyl sulphate-polyacrylamide gel electrophoresis combined with immunoblot, thin-layer isoelectric focusing and enzyme-linked immunosorbent assay inhibition were used to evaluate each of the coded extracts. The source materials were also studied for identity and possible contamination by light microscopy. On the basis of these data, the Rye-Grass Working Party recommended to the Steering Committee of the Allergen Standardization Subcommittee of the International Union of Immunological Societies that the extract coded C be chosen as the candidate international reference preparation.

Allergens↗

Indirect assessment of 4,4'-diphenylmethane diisocyanate (MDI) exposure by evaluation of specific humoral immune responses to MDI conjugated to human serum albumin.

BACKGROUND: A study of occupational asthma among workers exposed to 4,4'-Diphenylmethane Diisocyanate (MDI). OBJECTIVE: To demonstrate if serum concentrations of MDI-specific IgG or IgE are sensitive biological markers of disease or of MDI exposure. METHODS: The study group consisted of nine MDI-exposed workers and nine nonexposed workers. Air sampling for MDI and polymethylene polyphenyl isocyanate, occupational and medical histories, respiratory physical exams, pre- and postshift spirometry, and self-administered peak expiratory flow rates were performed. Serum specific IgE and IgG antibodies to an MDI-human serum albumin (HSA) conjugate were assayed by the radioallergosorbent test and the enzyme-linked immunosorbent assay, respectively, and compared to nine nonexposed laboratory controls. RESULTS: No definitive cases of occupational asthma were documented. The mean level of MDI-specific IgG was significantly greater among exposed workers compared to nonexposed workers and laboratory controls (p = 0.04). Mean levels of TDI and HDI-specific IgG were also increased. CONCLUSION: This study demonstrates that serum concentrations of MDI-specific IgG appear to be a moderately sensitive biological marker of MDI exposure, but not an indicator of occupational asthma. Workers with IgG antibodies specific for one diisocyanate-HSA conjugate exhibit cross-reactivity to antigens prepared with other diisocyanates.

Adult↗

Identification of casein as the major allergenic and antigenic protein of cow's milk.

The objective of this study was to analyze both the allergenicity and immunogenicity of cow's milk proteins. To this end, 80 milk-atopic patients were selected on the basis of the presence of cow's milk-specific IgE antibodies in serum and compatible clinical history. Fifteen patients allergic to other allergens and 10 nonatopic subjects were studied as controls. The specificity of serum IgG and IgE antibodies was determined by immunoblotting, employing both cow's milk and milk components, i.e., alpha- and beta-casein, beta-lactoglobulin, and alpha-lactalbumin separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The experiments showed that casein-specific IgE antibodies were present in all (80/80) sera examined; 10/80 showed reactivity to beta-lactoglobulin, and 5/80 showed reactivity to alpha-lactalbumin. None of the 25 negative control sera analyzed showed the presence of specific IgE antibodies against milk proteins. These results were similar to those corresponding to the detection, by the radioallergosorbent test, of IgE antibodies against the milk components coupled to paper disks. All sera from milk-atopic patients also showed IgE reactivity against a high-molecular-mass fraction that hardly enters the gel. This fraction, after separation by gel filtration and treatment with beta-mercaptoethanol and urea, was shown by SDS-PAGE analysis to be formed by casein monomers. All sera analyzed by immunoblotting reacted against the components corresponding to casein monomers. Inhibition of immunoblotting by adsorption with different milk components confirmed that those high-molecular-mass aggregates are formed by casein components. The results presented here strongly suggest that casein is the major allergenic component of cow's milk.

Adolescent↗

Glycoprotein allergens in pollen of timothy. V. Significance of the carbohydrate moiety for the immunological activity of a basic glycoprotein allergen.

When the allergen was oxidized with periodate the size of its precipitate in rocket immunoelectrophoresis (RIE) was reduced. Incubation of the allergen with various glycosidases did not significantly affect its precipitation in RIE. The binding of human IgE and IgG to allergen bound to nitrocellulose seemed not to be affected by incubation with alpha-L-fucosidase, beta-D-xylosidase, beta-D-galactosidase or periodate oxidation. Incubation with alpha-D-mannosidase reduced the binding of IgG to the allergen but not its binding of IgE. Periodate oxidation did not significantly affect the IgE binding of the allergen in radioallergosorbent test (RAST) inhibition. When RAST discs of the allergen were incubated with alpha-D-mannosidase, alpha-D-galactosidase, Arachis hypogaea lectin and concanavalin A, the IgE binding to the discs was slightly reduced. Pretreatment of the discs with the monoclonal antibody FMC-A9 against ryegrass pollen allergens and beta-D-xylosidase did not reduce their IgE binding. L-Arabinose, D-mannose, methyl-alpha-D-mannopyranoside, D-galactose, D-glucose or the monoclonal antibody FMC-A9 did not inhibit the binding of IgE to RAST discs of the allergen. After incubation of the allergen with pronase, it did not form a precipitate in RIE and its IgE-binding ability in RAST and RAST inhibition was almost completely lost.

Antigen-Antibody Reactions↗

IgE antibodies to house dust mite in patients with scabies.

Of 135 patients with scabies, forty-seven (35%) had a positive (Classes 1--4) radioallergosorbent test (RAST) to Dermatophagoides pteronyssinus (DP). Elevated serum IgE concentrations were found in sixty-one (45%) of the patients. Atopic disease was confirmed in twenty-eight (23%) of the 120 patients who completed a medical questionnaire satisfactorily. In a control group, well-matched for age and sex, of 201 employees at a local bank, only four (2%) had a positive RAST to DP, and eight (4%) had raised serum IgE levels. Atopic disease was confirmed in eighteen (9%) of them. These observations indicate that scabies infection stimulates the production of IgE antibodies, even in non-atopic individuals, and may suggest that IgE antibodies against the human pathogenic mite Sarcoptes scabiei cross-react with DP. Scabies infection in addition often seems to be associated with atopic disease.

Adolescent↗

Allergenic cross-reactivity between Callistemon citrinis and Melaleuca quinquenervia pollens.

Aqueous extracts of both Callistemon citrinis (bottlebrush) and Melaleuca quinquenervia (melaleuca) were analyzed for allergenic cross-reactivity. Inhibition analysis using the radioallergosorbent test (RAST) was performed on the ammonium bicarbonate extracts of bottlebrush (NH4B) and melaleuca (NH4M) pollens. RAST inhibition analysis demonstrated that the extracts contained allergenically cross-reactive components. Sephadex G-100 column chromatography of NH4B and NH4M extracts resulted in at least 4 distinct peaks for each extract analyzed. These fractions were designated NH4B1-NH4B4 and NH4M1-NH4M4. A modified dot-blot assay for detection of allergenic components was utilized to show that the first elution peaks of bottlebrush and melaleuca, NH4B1 and NH4M1, respectively, contained allergenic components. These allergenic components, NH4B1 and NH4M1, had estimated molecular weights of 50,000 and 35,000 daltons, respectively.

Animals↗

[Nasal allergies in Kushiro].

A clinical study of 107 patients with nasal allergies who were treated at Kushiro General Hospital between April 1998 and March 2000 was performed. Radioallergosorbent tests (RAST), X-rays, and nasal smears for the detection of eosinophilia were performed to obtain a diagnosis of nasal allergy. The patients (50 males, 57 females) ranged in age from 3 to 71 years. The RAST was positive for timothy in 22.4% of the patients, 14.0% for birch and 12.1% for mugwort. The most common pollinosis allergen in the Kushiro area was grass pollen. Other pollinosis allergens were birch pollen and mugwort pollen. We measured the daily count of dispersed birch pollen and timothy pollen in Kushiro and Sapporo. Birch pollen and timothy pollen was dispersed earlier in Kushiro than in Sapporo. Nasal allergies in the Kushiro area appear to be related to local characteristics, such as climate and geographical features.

Adolescent↗

An immunochemical method to measure atmospheric allergens.

Because particulate aeroallergens may exist in amorphous form as well as in pollen grains and fungal spores and because symptoms of allergic diseases presumably correlate with the total amount of allergen exposure, an immunochemical method of assay of aeroallergens would be useful. We report such a method based on (1) capture of airborne pollen, fungal spores, and amorphous particles 0.3 micrometer in diameter on fiberglass sheets with a high-volume air sampler; (2) elution of the sheets with buffered saline; and (3) analysis of eluate allergen content by radioallergosorbent test (RAST) inhibition assays. In preliminary indoor experiments we applied various quantities of short ragweed (SRW) pollen or dry Alternaria powder to the sheets while airflow was maintained at 1.19 m3/min. We compared techniques for extraction of allergen from the sheets, including homogenization, cutting and soaking, and descending elution of sheets. Although all three methods successfully extracted allergen from the sheets, an 8-hr descending elution procedure was optimal from the standpoint of yield and convenience. Eluates from filters exposed to as little as 4 mg of SRW pollen or Alternaria powder produced satisfactory RAST inhibition curves. When the sampler was operated outdoors continuously we could measure the atmospheric allergenic activity for both Alternaria and SRW from July to September. This allergenic activity was highly correlated with the traditional morphologic counts of airborne ragweed pollen and Alternaria spores.

Allergens↗