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PubMed1995

Ketoconazole in atopic dermatitis: therapeutic response is correlated with decrease in serum IgE.

The prevalence of specific IgE antibodies to the yeasts Pityrosporum orbiculare and Candida albicans was investigated in adult patients with atopic dermatitis (AD) or with seborrhoeic dermatitis and in healthy controls by means of the radioallergosorbent test (RAST). Of 63 AD patients, 28 (44%) had IgE antibodies to P. orbiculare and 21 (33%) to C. albicans. This is highly significant, since no antibodies were found in sera from other patients or controls. With the intention to treat, 20 patients with AD and a positive RAST to P. orbiculare were given ketoconazole 200 mg daily for 2 months and 200 mg twice weekly for further 3 months. The clinical scores improved during treatment with a reduction in the levels of specific IgE to P. orbiculare and total serum IgE. However, there were no correlations between clinical score and serum levels of P. orbiculare-specific IgE. C. albicans-specific IgE, on the other hand, correlated both with clinical score and with total serum IgE.

Adolescent↗
PubMed1993

Specific humoral response to cows' milk proteins and ovalbumin in children with atopic dermatitis.

Serum antibodies to four common food antigens, three cows' milk proteins (casein, alpha-lactalbumin and beta-lactoglobulin) and ovalbumin, were investigated in 21 children with atopic dermatitis (aged 3 months to 3 years) and in 15 age-matched healthy controls. Specific IgE was measured by radioallergosorbent test; an ELISA was developed to detect specific IgG, IgG subclasses and IgA. Specific IgE was found in 76% of patients, while antigen-directed IgG and IgA were present both in patients and healthy controls; IgG to ovalbumin and IgA to alpha-lactalbumin were significantly higher in children with atopic dermatitis. The analysis of the IgG subclass distribution showed different patterns of response, IgG1 and IgG4 being higher in patients (even though statistically significant only for ovalbumin), and IgG2 and IgG3 being lower in this group. The presence of food-specific IgE in the majority of atopic children and the different specific IgG subclass patterns observed in patients and controls may reflect an alteration in the immune response to dietary proteins in atopic dermatitis.

Animals↗
PubMed1999

[The skin prick test and nasal provocation test with individually prepared flour extracts in patients with bakers' rhinitis and asthma].

The reliability of skin prick tests (SPT) may be insufficient for the screening of occupational inhalant allergies. The influence of different flour extracts on the SPT in flour allergic subjects has not been compared previously. In this study, SPT reactions against two commercially available rye and wheat flour extracts and individually prepared extracts from flour samples were compared in 35 patients with known bakers' rhinitis. Flour sensitization was confirmed by a positive nasal provocation test (NPT) and/or serum-specific IgE. The sensitivity of NPT with a combination of rye and wheat flour extracts of individual flour samples was 94%. Wheat and/or rye flour specific IgE (RAST>/=2) was true positive in 86%. The sensitivity of the SPT was 94% for individual rye flour extracts compared to 38% and 59% for two commercially available rye flour extracts and 88% for individual wheat flour extract compared to 53% and 48% for commercially available wheat flour extracts. SPT and sIgE did not reveal a significant difference in prevalence between rye and wheat flour sensitization. Thirty healthy volunteers served as the control group. Three control subjects with histamine equivalent SPT reactions to grass pollen had a positive SPT reaction against individual flour extracts, whereas NPT with undiluted individual flour extracts was negative in all controls. SPT with individually prepared flour extracts appears to be sensitive for the demonstration of inhalant flour allergy. Our findings show that extracts of individual flour samples rather than commercially available extracts should be used for both SPT and NPT if flour allergy is suspected.

Adult↗
PubMed2007

Association of IL-10 level and IL-10 promoter SNPs with specific antibodies in penicillin-allergic patients.

OBJECTIVE: Our aim was to investigate the hypothesis that the sera interleukin-10 (IL-10) level and polymorphic nucleotides within the IL-10 gene promoters would link to specific IgE and IgG production and the expression of penicillin allergy. METHODS: One hundred and two patients and 86 healthy subjects were chosen for assay of serum IL-10 level by enzyme-linked immunosorbent assay (ELISA) and type -1082 G/A and -819 C/T alleles by sequence-specific primer polymerase chain reaction (SSP-PCR). Radioallergosorbent test (RAST) and ELISA were used to examine eight types of specific immunoglobulin-E (IgE) and IgG antibodies, respectively, which included four types of antibodies to major and minor antigenic determinants. RESULTS: Compared with control subjects and patients with negative-specific IgE, there were significantly lower levels of IL-10 in patients with positive-specific IgE (P < 0.05). Similarly, there were significantly lower levels of IL-10 in patients with positive-specific IgG compared with normal controls and allergic patients with negative-specific IgG (P < 0.05). The visible negative correlations existed between IL-10 and four types of specific IgE [benzylpenicilloyl (BPO), phenoxomethylpenicilloyl (PVO), benzylpenicillanyl (BPA), amoxicillanyl (AXA)], and patients with three or more positive-specific IgE had significantly lower IL-10 levels than normal controls (P < 0.01). There was a declining trend for IL-10 level in serum with the increase in types of positive-specific IgE. But there was no significant difference in serum IL-10 level between the positive skin-test group and the allergic-history group. Compared with controls and patients with negative antibodies, a significantly decreased frequency of the -1082 G allele was present in patients with positive antibodies (P < 0.01). The allele T and TT genotype at -819 C/T position had lower frequency in the negative-specific IgG group than that in the positive group and controls (P < 0.01). CONCLUSIONS: Positive specific IgE and IgG are associated with decreased IL-10 level in allergic reaction to penicillins. The distributions of genotype and frequency of allele at the -1082 G/A position may be associated with the production of both specific IgE and IgG antibodies.

Adolescent↗
PubMed2005

Latex sensitisation and allergy in children with myelomeningocele.

INTRODUCTION: Children with spina bifida (SB) have a high degree of exposure to latex products as a consequence of repeated surgical procedures, implantation of latex-containing materials and catheterisation. The consequence is a higher incidence of latex allergic reactions. OBJECTIVE: The aim of this study is to evaluate the prevalence of latex sensitisation and allergy in a population of children with myelomeningocele (MMC) and to assess the role of associated risk factors. RESULTS: Forty-eight percent of the patients (29 out of 60) showed a latex sensitisation with specific IgE >0.7 kU/l while 15% (9 out of 60) were allergic to latex (specific IgE >0.7 kU/l and clinical manifestations). The principal factor correlated with allergy to latex was specific serum IgE to latex (radioallergosorbent test [RAST]) values (p<0.01). Other factors were total serum IgE (paper radioimmunosorbent test [PRIST]) values, number of surgical procedures and familiarity with allergy. CONCLUSION: These results underline the importance of prophylactic measures to avoid the exposure, not only in the sanitary environment, through the institution of latex-safe routes, but also in daily life, to prevent potentially serious allergic reactions.

Adolescent↗
PubMed2006

Massive bloody stools in two neonates caused by cow's milk allergy.

Two neonatal cases of cow's milk allergy showing bilous vomiting and massive bloody stool are presented. In both cases, laboratory data on admission showed no eosinophilia. The immediate upper gastrointestinal series of both cases demonstrated no evidence of intestinal malrotation, but revealed a narrowing of the duodenum and upper jejunal loops and marked stasis of barium in one case, suggesting an edema with inflammation. Rectal mucosal punch biopsy of the other case showed eosinophilic infiltration in the lamina propria. These findings suggested an allergic origin, useful information for avoiding confusion with some diseases requiring emergency surgery. In both cases, bleeding resolved soon after elimination of cow's milk from the diet. Thereafter both cases showed a moderate to marked increase in peripheral eosinophilia, while serum radioallergosorbent tests for cow's milk protein were negative. Definitive diagnosis of allergic enterocolitis is difficult because there is neither specific laboratory data nor tests. Allergic enterocolitis can occur in the early neonatal period and should be considered in differential diagnosis of any newborn developing gastrointestinal bleeding.

Enterocolitis↗
PubMed1984

Focal renal cortical necrosis associated with zomepirac.

Anaphylactoid shock, disseminated intravascular coagulation, and anuric renal failure requiring dialysis occurred in a patient receiving zomepirac sodium for toothache. Although renal function showed gradual improvement after seven days of anuria, the recovery was slow and incomplete. Renal biopsy three weeks after the onset of renal failure revealed evidence of focal renal cortical necrosis. Association of zomepirac administration with renal cortical necrosis is not known to have been previously demonstrated. This observation adds another dimension to the previously reported renal complications of nonsteroidal anti-inflammatory agents, especially zomepirac. The proportions of lymphocyte subsets, as defined with monoclonal antibodies, and the proliferative response to mitogens were normal. The patient's lymphocytes showed no proliferative response to zomepirac. Serum complement components and immunoglobulin levels were within normal limits, and radioallergosorbent testing gave negative results. The mechanism of anaphylactoid reaction to zomepirac in this case, therefore, remains unclear.

Analgesics↗
PubMed1976

What can be measured with RAST?

A theoretical study of the basic principles involved in Radioallergosorbent test (RAST) showed that: 1) When a given serum is tested, the significance of the numerical value obtained with RAST depends upon the serum assayed and the allergosorbent preparation, in a rather unpredictable way. Three factors can be measured: a) The percentage of specific IgE antibodies among all allergen-specific antibodies; b) The specific IgE antibody level; c) The product of the specific IgE antibody level and its affinity constant. 2) Simple graphical techniques allow a straightforward determination of all these factors if four dilutions of each serum are assayed at the same time. The results are expressed in two constant parameters (arbitrary IgE unit and allergosorbent capacity). It is concluded that these theoretical calculations may give a fair account of a lack of correlation between specific IgE antibody levels (as assayed with RAST) and several clinical and biological parameters. Furthermore, they provide a simple procedure which makes such tedious manipulations as specific IgE antibody purification quite necessary.

Absorption↗
PubMed1983

A nylon ball solid-phase radioimmunoassay for specific antibodies in human sera. Application to measurement of IgG antibodies to pollen allergens.

The principle of the radioallergosorbent test (RAST) has been used to measure IgG antibodies to timothy grass pollen allergens in sera from desensitized allergic subjects. 125I-labeled goat anti-human IgG was used as detector protein. Non-specific binding was eliminated by use of a non-porous nylon ball an antigen carrier and by use of a special buffer with high ionic strength and pH, containing 1% bovine gamma globulin and 5% normal rabbit serum as 'balance proteins'. At dilution 1:80 non-specific binding was only 0.28% and the binding ratio for a high-liter serum was about 10. By inhibition experiments the assay was demonstrated to be specific for IgG antibodies to timothy grass pollen. The results obtained with this assay correlated statistically significantly with those found th a double -antibody method (rs equal 0.68, n equal 20, t equal 3.93, P less than 0.001). Serum dilution curves were parallel, indicating that the assay is in allergen excess. The within-assay coefficient of variation ranged from 3.9 to 7.6%; the between-assay coefficient of variation from 8.4 to 19.5%. The assay is very simple to perform, requiring no centrifugation. The allergen-coated balls are stable for at least 3 months. The assay should be applicable to measurement of IgG antibodies and IgG subclass antibodies to any protein antigen of interest.

Antibodies↗
PubMed1986

Specific IgE antibodies to reactive dye-albumin conjugates.

Hypersensitivity to reactive dye powders has been recognised for a number of years, although the extent of sensitisation amongst dye house operatives and the immunochemistry of the dye molecules has not been investigated. We have developed a radioallergosorbent test (RAST) to detect specific IgE to reactive dye-human serum albumin (HSA) conjugates. From a total of 19 dye-HSA conjugates, positive RASTs were found in six workers with allergic symptoms associated with dye exposure, while six asymptomatic case-matched controls were negative. Sera with raised total IgE (up to 4300 kU/l) from unexposed workers gave negative results except for two conjugates which gave a weak positive at 4300 kU/l and one which gave weak positives at all concentrations tested (750-4300 kU/l). RAST demonstrated that the antibody was specific for the complete dye-HSA conjugate. Substitution of bovine serum albumin (BSA) for HSA in the conjugate markedly reduced immunoreactivity and free hapten gave lower inhibition than the complete conjugate. Comparison of the dye-HSA RAST with a RAST using dyed discs showed that the latter did not correlate well with symptoms and was influenced by the total IgE concentration.

Coloring Agents↗
PubMed1975

The effect of cromolyn sodium powder as a treatment for ragweed pollinosis.

The effect of treating ragweed pollinosis with intranasal cromolyn sodium powder was evaluated in 26 patients in a double-blind clinical study. Thirteen matched patient pairs were treated by either nasal insufflation of cromolyn sodium powder, 20 mg three times daily, or by a placebo powder. Patients were monitored for severity of symptoms by means of daily symptom diaries collected weekly throughout the pollen season. Serum samples were obtained in July prior to the ragweed season and following the ragweed season during the first and fourth weeks of October for the determination of ragweed-specific IgE antibody levels by the radioallergosorbent test. A significant reduction in symptom severity was observed in the treated patients with high preseasonal levels of IgE antibody to ragweed. Initially the levels of IgE antibody to ragweed did not differ between the two groups. IgE antibody levels increased in both groups after pollen exposure, but the treated group showed a significantly greater rise in IgE antibody levels. The results suggest that treatment with cromolyn sodium enhanced IgE antibody response to pollen exposure and significantly reduced the severity of hay fever symptoms in patients with high preseasonal levels of IgE antibody to ragweed.

Administration, Intranasal↗
PubMed1975

Changes in the antigenic composition of the short ragweed plant during maturation.

Whole ragweed plants were collected before and during the ragweed pollination season and extracts of various portions of the plants were analyzed for antigen E (AgE) and for their inhibitory potency in the radioallergosorbent test (RAST). Ragweed stems and roots contained very low, if any, AgE. AgE was present in very small amounts in anthers prior to pollination season, increased with anther and pollen grain maturation, peaked with the appearance of significant airborne pollen grains in mid-August, and fell slowly through late September. Leaf AgE content also rose during mid- and late August, but brief rinsing reduced antigen E content by almost 50%. Significant RAST inhibitory activity was found only in anthers and the activity paralleled the content of AgE.

Absorption↗
PubMed1976

The cross-reactivity of IgE antibodies with pollen allergens. I. Analyses of various species of grass pollens.

Atopic patients with histories of grass pollen allergy often are sensitive to a variety of species of grasses. Using a serum pool from patients sensitive to June grass, we analyzed the reactivity of IgE antibodies to seven grasses by the radioallergosorbent test. Extracts were analyzed for their inhibitory activities with solid-phase allergens prepared from all of the grass pollen. Also samples of serum were exhaustively absorved with solid-phase allergens and the supernatants tested to determine the reactivity of the remaining IgE antibodies. Three patterns of reactivity were observed: (1) June, orchard, meadow fescue, and perennial rye grasses displayed similar reactivity in both inhibition and absorption studies; (2) sweet vernal and Bermuda grasses were considerably less reactive with the serum pool, indicating that they lacked antigenic determinants possessed by the other grasses; and (3) timothy grass possessed unique antigenic determinants. Knowledge of these patterns of cross-allergenicity is of importance for diagnosis and treatment of sensitive patients as well as for in vitro standardization of extracts.

Absorption↗
PubMed1976

The cross-reactivity of IgE antibodies with pollen allergens. II. Analyses of various species of ragweed and other fall weed pollens.

Although the antigenic composition of short ragweed pollen has been extensively investigated, very few studies have analyzed the allergenic cross-reactivity among various types of ragweed pollens. Using a serum pool from patients sensitive to short ragweed, we studied the cross-reactivity of IgE antibodies to six ragweeds by the radioallergosorbent test. Extracts were analyzed for their inhibitory activities with solid-phase allergens prepared from all of the ragweed pollens. Also, samples of serum were absorbed with the various solid-phase allergens and the reactivity of the remaining IgE antibodies was determined. Two patterns of reactivity were observed. Short, giant, western, and false ragweeds displayed comparable reactivity in both inhibition and absorption experiments. Slender and southern ragweed were considerably less active, indicating that they lacked allergenic groupings possessed by the other species. These same patterns of cross-reactivity were found using ragweed pollens from four commercial sources. Knowledge of these patterns of cross-allergenicity is of importance for diagnosis and treatment of sensitive patients as well as for in vitro standardization of extracts.

Absorption↗