摘要:

SummaryTwenty‐one patients, who had previously experienced an anaphylactic reaction to suxamethonium during general anaesthesia, were selected for this study. Initially, skin tests with muscle relaxants were carried out in the twenty‐one patients, detection of specific anti‐choline IgE in nineteen, and leucocyte histamine release in seventeen. These three tests were then repeated between 1 year and 4 years after the initial evaluation. In the majority of patients, sensitization to the muscle relaxants persisted for more than 1 year after the anaphylactic reaction. Only three patients out of twenty‐one (4%) had negative skin tests when retested 1–4 years later. A reduction in leucocyte histamine release was noticed in one of the seventeen retested patients (6%). Modifications of anti‐choline IgE were observed in five of nineteen patients (26%). The persistence of sensitization to suxamethonium may result from repeated stimulation by occasional contacts with quaternary ammonium compounds. This study demonstrates the reliability of skin tests, leucocyte histamine release and detection of anti‐choline IgE to diagnose allergic reactions to suxamethonium, even when they are performed a long time after the initial anaphyla

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02030.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryThe influence on the adrenocortical function of high‐dose topical glucocorticoids inhaled via conventional devices and via a Nebuhaler®, was studied in ten children with asthma. In patients treated with dosages of beclomethasone dipropionate or budesonide, in excess of 2100 μg/1.73 m2body surface, the 24‐h urinary excretion of free cortisol increased when the inhaler device was changed from a conventional one to a Nebuhaler. This suggests a decreased systemic influence of the inhaled glucocorticoids when these were administered via a Nebu

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02031.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryThe biological potency of therapeutic allergen extracts is fundamentally important in terms of maximal security of immunotherapy, especially when changing batches. As regards pyridine‐extracted alum‐precipitated allergen preparations, the potency is commercially controlled by the RAST technique. In the present study, titrated intradermal tests were performed in thirty‐three adult grass‐pollen rhinitis patients with three ten‐fold dilutions of two batches of Allpyral® 5‐grass mix with different RAST activity. The difference in potency was estimated as the horizontal distance at the midpoint of the two dose–response curves after performing linear regression on the log‐dose/log‐weal area response, and as the concentration of each batch eliciting a weal equal to the histamine HCI 0.1 mg/ml reference. The difference in potency as estimated by RAST was a factor 5.0vsa factor 8.3 and 7.2 (median) estimated by the horizontal distance and histamine‐equivalent reaction, respectively. Considering the biological variation, the RAST‐estimated difference in potency is in the same order as that found by skin test. It is. therefore, concluded that the routine control of new production batches by RAST is acceptable with the use of standardized reference sera as regards alum‐precipitated grass

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02032.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryIn an extended study of a group of confectionery workers sensitized by exposure to egg spray, it was found that their blood serum contained antibodies to avian serum proteins. Comparison of the ratio of IgG antibodies determined by ELISA to egg yolk ‘livetins’ and pigeon serum in these patients and in pigeon breeders showed that the phenomenon is entirely due to immunological cross‐reactivity among avian blood serum proteins. These avian serum proteins in hens' eggs, not ovalbumin, were identified as the major sensitizing ant

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02033.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryThe Phadiatop® test, which is based on a multi‐allergen allergosorbent, proved to be a test that is simple to perform in the laboratory and produces reliable results. When compared with the more conventional RAST atopy screening test for grass, mite and IgE antibodies it produced similar results, except in those rare instances of patients who were RAST‐positive only for moulds where the Phadiatop test was decidedly superior. The Phadiatop test disc contains only inhalant allergens and so it could not be used for screening infants and very young children whose IgE response, if any, is probably limited to f

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02034.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryThe prevalence of IgE‐mediated hypersensitivity to respiratory allergens, includingLepidoglyphus destructor(a storage mite) andDermatophagoides pteronyssinus, was studied in a rural population of Gotland, a Swedish island in the Baltic Sea. A sample of 440 farmers underwent examination, comprising skin‐prick tests (animal danders, pollens, moulds, house dust mite and wheat) and blood sampling for radio‐allergosorbent tests (RAST) (birch, Timothy grass, dog,D. pteronyssinus, CladosporiumandL. destructor). The highest prevalence of positive skin‐prick tests was noted forD. pteronyssinus(6.0%). Low prevalences of positive skin‐prick tests, 0.7‐2.7%, were found for pollens, animal danders and moulds. Among the tested allergens,D. pteronyssinusandL. destructoryielded the highest prevalences of positive RAST results, namely 5.2 and 6.8%, respectively. Most farmers with allergy to pollens and animal danders had symptoms both from the upper and lower airways and from the eyes. Among farmers with both asthma and rhinoconjunctivitis, the prevalence of positive RAST results forL. destructorandD. pteronyssinuswere similar. The present study clearly demonstrates that mites are by far the most important allergens in the farming population on Gotland, whereas otherwise common allergens such as pollen and animal danders are clearly less

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02035.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryIn patients with respiratory symptoms, several studies have provided data supporting the hypothesis that there is a causal relationship between allergen exposure and variations in bronchial reactivity. In order to determine if this relationship holds when atopy is defined only on the basis of positive skin tests to common allergens, we compared bronchial reactivity in a group of twelve healthy subjects with positive skin tests and twenty‐eight healthy subjects with negative tests. The two groups were comparable in terms of gender, age, smoking habits and family history of atopic diseases. The slopes of the dose‐response curves, using airway conductance as an index of response, were similar in the two groups. Thus, in this healthy group of subjects, there was no relationship between skin and bronchial reactivity. It can be hypothesized that, if genetic factors determine bronchial reactivity, such reactivity might not be revealed until skin‐test positive subjects have received repeated bronchial stimulation through inhalant alle

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02036.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryThe results of skin‐prick tests to four concentrations of venom (0.1, 1, 10 and 1000 μg/ml) carried out on two occasions were analysed in relation to the history of adverse reactions to stings and to the level of venom‐specific IgE antibody in serum, in forty‐two subjects allergic to insect stings (sixteen to bee and twenty‐six to wasp). Fifty control subjects (some of whom had never been stung by bee or wasp) with no history of adverse reaction to stings were also studied. No subject gave a positive skin‐test reaction to 0.1 μg/ml, and small numbers reacted to either 1 or 10 μg/ml. The lowest concentration of venom to which most subjects had a positive skin test was 100 μg/ml. Our data suggest that in wasp‐allergic patients a positive skin test to 100 μg/ml is normally significant (reflecting the presence of specific IgE), whereas in bee‐allergic patients a skin test reaction to 100 μg/ml is usually non‐specific for the following reasons.(i) In the allergic patients when skin tests were repeated, a reaction to 100 μg/ml bee venom often became negative (in six of eight), whereas for wasp venom the reaction became more positive (at 10 or 1 μg/ml) in seven of eight patients. Whilst this might reflect lack of reproducibility, the consistent direction of change for either bee or wasp venom suggests responses to this concentration of these venoms may have different interpretations.(ii) In bee‐allergic patients, where positive skin tests to 100 μg/ml wasp venom were found they were repeatable in all patients, and occurred only in patients who had been stung by a wasp. In wasp‐allergic patients, skin test reactions to 100 μg/ml bee venom were not reproducible between studies in any patient and often occurred in subjects never stung by a bee.(iii) A better correlation between skin test and RAST occurred for wasp venom when a skin‐test reaction to 100 μg/ml was included as a positive (rather than reactions to 1 or 10 μg/ml only). For bee venom the correlation did not improve when skin‐test reactions to 100 μg/ml were included.(iv) In the control group, skin‐test reactions to 100 μg/ml bee venom were often false positives (seven of eight had never been stung by a bee). Four out of fifty controls reacted to wasp venom 100 μg/ml, but three of these had received a wasp sting.These findings suggest that in routine clinical practice skin tests should be carried out over the range 1–10 μg/ml in bee‐allergic subjects but in wasp‐allergic patients 100 μg/ml should also be

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02037.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryBronchial allergen challenge was performed twice in ten well‐defined stable asthmatic patients. On each provocation day the allergen was administered either by a standard method at tidal volume breathing or by a dosimeter method. Ten‐fold increasing concentrations of allergen were administered with an interval of 10 min. Total amount of allergen of 9, 90, 900, 9000 and 90000 SQ units using the standard method, whereas the corresponding amount by the dosimeter method was 0.5, 5, 50, 500, and 5000 SQ units. The bronchial response was determined by forced expiratory volume in the first second (FEV1) and by total resistance to breathing (Rt) measured by an opening interrupter method. The provocation was stopped when a decrease of at least 20% of the post‐saline FEV1and a 4O% increase in post‐saline Rt, was observed. A PC20‐FEV1and a PC40‐Rtwas calculated by interpolation on the log dose‐response curve. The late reaction was recorded and defined as a 20% reduction in peak expiratory flow (PEF) occurring during the 24‐hr period after challenge. The comparability of PC20‐FEV1and PC40‐Rtobtained with the standard method and with the dosimeter was high.r= 0.89 andr= 0.88. Furthermore, no significant difference was found by comparing Δ FEV1and Δ Rtduring provocation by either method as well as the occurrence and magnitude of the late reaction. We conclude that there exists a high comparability of the bronchial response to an allergen challenge performed either by a standard method at tidal volume breathing by continuous inhalation of the allergen aerosol or by a dosimeter method of inhalation despite the difference in the total a

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02038.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryIn a factorial design study a murine anaphylactic shock model was used to analyse the effect of homogenization, pasteurization, and fat content on the ability of bovine milk to induce anaphylactic reactions. Mice were sensitized by either oral or subcutaneous immunizations with various types of bovine milk. In spite of a significantly higher antibody titre in the mice sensitized subcutaneously, there was no difference in the sensitivity between orally and subcutaneously immunized mice with respect to anaphylactic reactions. Pasteurization did not seem to change the ability of milk to induce anaphylactic reactions. However, increasing fat contents in combinations with homogenization resulted in an increase of the ability of the milk to induce anaphylactic reactions.

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1987.tb02039.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY