ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01787.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01788.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryLimiting factors in the understanding, clinical management, and prevention of occupationally related allergic disease should be identified, since these dictate the tasks that need to be undertaken and/or important research questions that warrant an answer. Through an adaptation of the Delphi technique, a working group of the Special Interest Group on Occupational Allergy of the British Society of Allergy and Clinical Immunology addressed these issues. The consensus categorized and ranked the limiting factors and tasks needed in relation to epidemiology and natural history, mechanisms, clinical diagnosis, statute and education, and the workplace environment. This report should help focus the debate regarding which issues are perceived to be most relevant and timely for research and good practice in the field of occupational allergy.

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01789.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryA standardized in‐house reference extract from the pollenof Parthenium hysterophoms, which is responsible for the high incidence of allergic rhinitis in India, was generated and examined by skin test, radio‐allergosorbent test inhibition and isoelectric focusing.Partheniumreference allergen discs and positive reference serum were also generated. These reference reagents could not only be used for the quantitation ofPanhenium‐specific IgE in the sera of rhinitis patients but also for the evaluation of allergenic activity (relative potency and lot‐to‐lot variation) of different batchesof Parthen

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01790.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThis paper investigates the relationship between venom IgG levels and protection from stings. Venom‐specific IgG antibody levels have been measured by radioimmunoassay in untreated wasp‐ (n= 38) and bee‐allergic (n=16) patients presenting with systemic reactions to stings and in a sub‐group of these (wasp= 15; bee = 9), before and after the initial course of venom immunotherapy (VIT). A history was taken of all reactions, the last systemic reaction being graded on a scale of 1–8 and of the number and timing of stings. In untreated patients venom IgG levels were much higher in bee‐allergic patients (mean ± s.e. = 68.2 ± 7.1 % positive pool) than in the wasp group (27.1 ± 4.2%)(P<0.05 Mann‐Whitney U‐test). There was a marked rise in venom IgG after the initial course of VIT in the wasp group (geometric mean and 95% confidence intervals = 40.5%, 28.8−54.3) but a much smaller rise in the bee group (15.3%, 6.6–24.1), with no overlap in the 95% confidence intervals. Bee patients, who were mainly beekeepers or their relatives, had been more heavily immunized with venom than wasp patients. They had received: (i) more stings (mean number of stings: bee, 26; wasp, 4;P<0.001) and (ii) more stings per year. Wasp patients received their smaller number of stings over a much longer period, up to 40 yr. There was no correlation between the severity of the last systemic reaction and the venom IgG levels alone or venom IgG and IgE levels in combined analysis in either bee or wasp patients. This study shows that the pattern of IgG response differs in bee and wasp‐allergic subjects, and that most bee‐allergic subjects with systemic reactions have high levels of venom IgG. The degree of immunization with venom seems to be an important determinant of the venom IgG level. Our findings suggest thai venom‐specific IgG levels do not predict systemic reactions to stings and are not useful for monitoring VIT. If protection from stings is IgG‐mediated, our observations suggest that the relevant immune response is more complex, possibly involving IgG sub‐classes, IgG antibodies to individual venom antigens or antibody affinity, and not adequately reflected by measurement of the con

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01791.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryIn the first part of this study the proliferative response of lymphocytes (lymphocyte transformation test) to house dust mite (HDM) stimulation in cultures was studied in normal children (n= 16), asthmatic children who never received hyposensitization (HS) (n = 50) and asthmatic children receiving HS with HDM for at least 6 months (n = 20). The results are expressed as disintegrations per minute (d.p.m.) and as stimulation index (SI = d.p.m. in the presence of the allergen/d.p.m. in the control culture). A positive SI (>2) was found in 54% of the asthmatic children who never received HS, in 30% of the asthmatics receiving HS and in none of the normal children. Furthermore, between asthmatics with and without HS, the SI was not statistically different, although asthmatics without HS tended to have a higher SI (median value: 2.13 vs 1.38) (P= 0.10). In a second series of experiments the effect of adding interleukin‐2 (IL‐2) to the lymphocyte cell culture was studied in asthmatic children with and without HS. Interleukin‐2 induced an additional stimulatory effect on the lymphoproliferative response to HDM and to phytohaemagglutinin in patients who never received HS, but had no effect in patients receiving HS. We conclude that HS treatment seems to have an inhibiting effect upon this proliferative response, not only inhibiting the degree of the allergen‐induced lymphocyte proliferation, but also inhibiting the sensitivity of proliferating lymphocytes for IL‐2. These inhibiting effects upon lymphocytic activation could be responsible for the anti‐inflammatory effects (i.e. suppression of the late asthmatic reac

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01792.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummarySixty‐three adults with symptomatic chronic rhinosinusitis had computerized tomegraphic (CT) scans of the paranasal sinuses, which were used to quantify disease severity. These patients were divided into three closely age‐ and sex‐matched groups: a CT scan‐negative group (chronic rhinitis only), a mild sinusitis group and a severe sinusitis group. Serum dust mite‐specific IgG levels were found to be significantly elevated in the sinusitis patients compared with a matched group of asymptomatic normal individuals. Levels were highest in the more severe sinusitis group, in which the mean titre was 559 U/ml and the incidence of litres greater than 400 U/ml was 48%, as compared with a mean titre of 139 U/ml and only a 10% incidence of litres greater than 400 U/ml in the normal subjects (P<0.005 and<0.01). In contrast, although the frequency of immediate hypersensitivity to dust mite, as assessed by intradermal skin tests, tended to be higher in patients with sinusitis, it was not significantly different from normal individuals. The association between mite IgG and disease was most striking in the patient sub‐group with negative mile skin tests. In this group, mite IgG levels were significantly higher than normal, even in those patients with only chronic rhinitis. These findings demonstrate that increased serum levels of IgG against dust mites are strongly associated with chronic rhinosinusitis, especially in the sub‐group of patients who are not alle

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01793.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryIn patients with asthma there is only a weak relationship between airway responsiveness to hypertonic saline and methacholine. We tested the hypothesis that airway responsiveness to hypertonic saline in asthma is related to the presence and activity of inflammatory cells in the peripheral blood. Nineteen atopic asthmatic adults (19–28 yr; PC200.06–12.4 mg/ml), not receiving steroid treatment, entered a methacholine and hypertonic saline period in random order. Dose‐response curves to doubling doses of inhaled methacholine (0.03–256 mg/ml) or hypertonic saline (0.9–14.4% NaCl) were obtained twice in each period, 7 days apart. The response was measured by FEV1Methacholine responsiveness was measured by PC20METH of FEV1and responsiveness to hypertonic saline was expressed as the percentage fall in FEV, after 14.4% NaCl (HYP14.4%). Peripheral blood was collected before the second challenge test of each period. Apart from leucocyte counts and serum eosinophilic cationic protein (ECP) level, sub‐sets of lymphocytes (CD4+/CD3+, CD8+/CD3+, CD25+/CD4+and VLA‐1+/CD4+) were determined using flowcytornetry. HYP14.4% was positively correlated to basophil, eosinophil and monocyte counts (r = 0.64, 0.54 and 0.44, respectively;P0.05). We conclude that airway responsiveness to hypertonic saline is positively related to the number of peripheral blood basophils, eosinophils and monocytes. Basophil count is an independent correlate of responsiveness to hypertonic saline, after correction for mcthacholine responsiveness and baseline lung function. This fits in with active involvement of basophils in airway narrowing to hypertoni

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01794.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryWe investigated the effect of elimination diets on T cell responses to ovalbumin (OA) in hen's egg‐sensitive atopic dermatitis (AD) patients. The proliferative responses of both peripheral blood mononuclear cells (PBMCs) and T cells with monocytes to OA decreased after elimination diets, but those toCandida albicansor phytohemagglutinin (PHA) did not decrease after elimination diets. The proliferative responses of CD4+T cells with monocytes to OA decreased after elimination diets. In these patients, clinical symptoms of AD improved. These results indicate that T cells, especially CD4+T cells, respond to food antigens in food‐specific lymphocyte responses, and that elimination diets may be able to initiate reduction of the responsiveness of food‐sensitive T cells, especially CD4+T cells. Moreover, the surface marker phenotypes of the T cells responding to OA were analysed. Our results showed that CD4+CD45RA+T cells tended to increase. The increase in circulating CD4+CD45RA+T cells might function as systemic suppression against immune responses in the

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01795.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryCough variant asthma is an occult form of asthma in which the only sign or symptom is chronic cough. It is a common problem amongst all ages that frequently goes unrecognized, leading to under diagnosis and under treatment. To characterize the pathophysiological abnormalities in these patients, we performed bronchial provocation tests with methacholine using the stepwise doubling concentration technique, and measured the concentration of methacholine and the severity of airway obstruction when wheezing was first detected. Airway hyper responsiveness, defined as PC20 in the cough variant asthma group was not significantly different from that of classic asthma. There was a good correlation between the PCW (the concentration of methacholine causing wheezing) and the PC20 with the PCW values higher than PC20 values in both groups. However, in the cough variant asthma group, the PCW: PC20 ratio was greater than that of the classic asthma group. Furthermore, the mean % fall in FEV1at which wheezing was first detected in the former group was significantly larger than that of the latter group. The results indicated that the mechanism for the manifestation of cough without wheeze in the cough variant asthma may be a higher wheezing threshold, i.e. wheezing becomes audible at the greater degree of airway obstruction than classic asthma. They suggested that patients with cough variant asthma may represent a subset of asthmatic subjects whose airways are less able to produce a wheeze.

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb01796.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY