ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02655.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02656.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryThe clinical manifestations of atopie dermatitis comprise a complex mixture of pharmacological, physiological and immunological responses. Circumstantial evidence suggests that atopic disease may arise consequent upon the migration of bone marrow‐derived cells into the target tissue of skin or respiratory mucosa. Mediator release from such cells has been shown to be abnormal in atopic dermatitis, and itch, the hallmark of the disease, may be the result of chronic inflammatory mediator release into the skin. Abnormal release of mediators has been shown to correlate with inadequate nucleotide control of cell function. In particular, elevated cyclic AMP‐specific PDE activity causing cyelic AMP hyporesponsiveness has been found in peripheral blood mononuclear leucocytes in atopic dermatitis. Investigation of this pathway has led to the discovery of additional abnormalities of other secondary messenger systems, including abnor‐malities of protein kinase C activity and of inositol activation. The biochemical abnormalities may be a consequence of down‐regulation of the second messenger systems because of chronic exposure to low levels of inflammatory mediators, but may themselves subsequently permit further mediator release. They may provide a biochemical mechanism for many of the immunological abnormalities seen in atopic dermatitis. In particular, they offer a biochemical explanation for the paradox of increased type 1‐mediated immunity and diminished cell‐mediated immunity commonly observed in this comp

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02657.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02658.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryInhaled corticosteroids may produce systemic effects which include decreased hypothalamic pituitary‐adrenal (HPA) axis activity. Four tests of HPA axis function were assessed in 12 healthy volunteers, during inhalation of two actuations of beclomethasone dipropionate (250 μg) aerosol four times daily for 15 days, to determine the most appropriate test for this effect of inhaled corticosteroids. Measurement of basal adrenal activity showed that both 24‐hr urinary free cortisol and 0900 hr plasma cortisol were decreased by the fourth day of steroid treatment. All 12 subjects had decreases in basal adrenal activity. Overall the 24‐hr urinary free cortisol showed the greater change, with mean pre‐steroid baseline values of 497 and 515 nmol/24 hr reduced to 167 nmol/24 hr on the ninth day of treatment (P<0.001). The single‐dose metyrapone test showed marked changes in each of the six subjects tested. The mean 11‐deoxycortisol response was 96 nmol/l on the eleventh day of treatment, compared to baseline and eighth‐day post‐treatment values of 439 and 407 nmol/1 respectively (P<0.001). In contrast, no consistent treatment‐related changes were observed with the short tetracosactrin test. Only two out of six subjects had an abnormal short tetracosactrin test, although all showed a decrease in basal adrenal activity. From these results, the 24‐hr urinary free cortisol and single‐dose metyrapone test at 0600 hr are recommended to assess the effect of inhaled glucocorticoids on the HPA axis. The short tetracosactrin test failed to detect an effect from the same dose of inhaled beclomethasone dipropionate and cannot therefore be recommended to exclude the systemic effect

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02659.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryThe validity of Phadiatop® as a tool in the mass screening for inhalant allergies was investigated. Seventy‐nine out of 600 recruits (13.2%) were classified as allergic to inhalant allergens (68 oculorhinitis; 11 asthma) on the basis of positive history, confirmed by skin testing and/or RAST for the seven most common aero‐allergens in Italy. Another 74 subjects had positive RAST and/or skin tests, yet had never experienced allergic symptoms. Phadiatop was positive in 145/600: in 78 out of 79 allergies and in 67 RAST‐positive non‐allergies. Correlation between Phadiatop and RAST was statistically significant, though higher for grass pollens (r= 0.85,P<0.001) than forDermatophagoides pteronyssinus(r= 0.68,P<0.01). PRIST (cut‐off 220IU/ml) identified 36/79 allergies (45.6% sensitivity, whereas that of Phadiatop was 98.7%). As the high percentage of cases in the unselected population had specific serum IgE against inhalant allergens and no allergic symptomatology, the Phadialop‐positive predictive value falls to 53.7%, thus creating the need for Phadiatop‐positive subjects to undergo further investigation for an appropriate diagnosis. Given this limitation, Phadiatop appears to be an important step forward in the field of mass‐screening programmes for in

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02660.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryThe generation and degradation of hydrogen peroxide (H2O2) by platelets was investigated in aspirin hypersensitive and tolerant allergic subjects, and compared to that in general medical patients and healthy controls. H2O2generation following triggering with anti‐IgE. specific allergen, and with aspirin (ASA) and indomethacin was examined using a chemiluminescence assay. Platelet levels of the main intracellular enzyme responsible for H2O2metabolism–glutathione peroxidase–were measured by a quantitative functional assay. H2O2secretion could be triggered by anti‐IgE in platelets from 15/29 ASA‐tolerant atopies, and by relevant allergen in platelets passively sensitized with allergen‐specific IgE. A similar response was observed following triggering with ASA, and with indomethacin, in platelets from 8/25 ASA‐sensitive subjects. Mean platelet glutathione peroxidase activity was significantly lower in subjects with ASA‐induced asthma, but not in subjects with non‐asthmatic reactions to ASA, compared to all other groups. Within the ASA‐sensitive group there was no correlation between low peroxidase activity and ASA‐triggered chemiluminescence. Our findings emphasize the heterogeneity of ASA‐intolerance syndromes and point to abnormal oxygen/peroxide metabolism as a common pathway underl

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02661.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryPeripheral blood mononuclear cell (MNC) response to house dust (HD) stimulation in cultures was studied in a group of 35 subjects with asthma and a multiple positive skin test (ST) reaction to inhalant allergens including HD, and in 19 healthy controls. The MNC response to allergen stimulation was assessed by interleukin‐2 receptor (IL‐2R) expression identified with an anti‐Tac monoclonal antibody. Lymphocyte subpopulations of baseline and cultured cells were also analysed. The percentage of IL‐2R presenting cells increased significantly in HD‐driven cultures in the asthma group compared to controls. The increase in proportion of IL‐2R+cells was closely related to the increase in CD4+percentage of cultured cells and was accompanied by a decrease in proportion of CD8+lymphocytes and monocytes/macrophages, suggesting that HD‐activated cells were CD4+lymphocytes. Lymphocyte activation, measured by IL‐2R expression, was significantly higher in the group of asthmatics, and positive dual (early and late) skin reaction to HD, as compared to those with single

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02662.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryCetirizine is a new selective H1‐antagonist. In a double‐blind and placebo‐controlled study, 11 subjects underwent a conjunctival provocation test (CPT) with a grass pollen extract to determine the effect of cetirizine on allergen‐induced itching and redness of the eye. Results of CPTs were reproducible, as no difference was observed between the CPTs performed without any pre‐treatment and the CPTs after placebo. Compared to placebo, cetirizine administered orally (10 mg twice a day for 4 days) and in double‐blind fashion increased the conjunctival reaction threshold (P<0.004) by inhibiting both redness and itching of the eye. Cetirizine should protect patients against allergic con

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02663.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SummaryA multi‐allergen dipstick enzyme immunoassay ‘Quidel Allergy Screen’ (QAS) has recently been developed commercially for measuring IgE antibodies against nine allergens (house dust 1, house dust 2,Dermatophagoides pteronyssinus, D. farinae, Japanese cedar, ragweed, cat dander, sweet vernal grass, and egg white) at one time. To assess whether this assay is useful in screening allergen‐specific IgE antibody, we compared the titres of IgE antibodies against the nine allergens measured by QAS to those in the skin‐prick test and by RAST in 93 atopic asthmatics and 22 normal subjects. We found a good overall agreement between the results of the skin‐prick test and the results of QAS (sensitivity = 47.1‐81.4%, specificity = 84.5‐100%, and agreement =78.9‐88.9%). The sensitivities against house dust I,D. pteronyssinus.andD. farinaeranged from 77.2 to 81.4%. However, the sensitivities against house dust 2, Japanese cedar, ragweed, and cat dander were low (47.1‐68.8%). We also found a good overall agreement between the results of RAST and the results of QAS, except for egg white (sensitivity = 46.2‐94.4%, specificity = 87.4‐100%, and agreement = 77.4‐96.5%). The sensitivities against house dust 1 and 2,D, pteronyssinus, D. farinae, and Japanese cedar ranged from 86.0 to 94.4%. The sensitivities against ragweed, cat dander, and sweet vernal grass were low (46.2‐52.6%). There were strong correlations between the titres of RAST and the titres of QAS except cat dander and egg white (r= 0.701 0.924 for the seven allergens). Thus, we conclude that QAS is useful in screening IgE antibodies against multiple allergens at one time. However, because the sensitivities against some allergens tested were low, further improvement of some allergen preparations seems t

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1990.tb02664.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY