ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00337.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.tb00338.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.tb00339.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.tb00340.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryNedocromil sodium is a non‐steroidal prophylactic agent developed for the management of asthma. We have assessed the steroid sparing potential of inhaled nedocromil sodium 4 mg four limes daily in a randomized, double blind, placebo controlled study in 69 asthmatic subjects controlled on inhaled beclomethasone dipropionate in the dose range 1000 2000 μg daily. Following a 4 week run‐in period subjects added nedocromil sodium or placebo by metered dose inhaler to their usual medication for a further 4 weeks. The dose of inhaled steroid was then reduced at fortnightly intervals according to a predetermined schedule, with monitoring of asthma severity, symptom scores, bronchodilator use and peak flow recordings. Sixty subjects entered the steroid reduction phase and achieved median (range) % decreases in steroid dose of 80 (17‐100)% with nedocromil sodium compared to 65 (0‐100)% with placebo (P = 0.34) with 14 patients in the nedocromil sodium group and 10 in the placebo group being withdrawn completely from inhaled steroids. Subjective global assessment scores were significantly better with nedocromil sodium (mean 2.14) than with placebo (2.93; P<0.02) though there was no difference between individual daily symptom scores. In this study therefore in asthmatic patients controlled on high doses of inhaled steroids, nedocromil sodium was well tolerated but the smalt differences in steroid sparing effect between nedocromil and placebo were not statistically sig

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00341.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryAdult fleas, spent and unspent culture media were extracted and the radio‐atlergosor‐bent test (RAST) performed with sera of 48 cat flea skin test‐positive individuals from the Tampa Bay area of Florida. Sixteen sera (33.6%) had a positive RAST to the cat flea extract prepared in our laboratory [1.7‐11.4% of the total counts (TC) added]. Six of the 16 sera (12.5%) also contained specific IgE to allergens in thespent medium (0.8‐3.3% TC). The allergen composition and strength were studied by RAST inhibition of two commercial cat flea extracts and compared with our in‐house flea extract. The results demonstrated similar allergen compositions and different potencies. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS‐PAGE) of the in‐house flea extract showed several Coomassie blue‐stained bands (10–85 kD). SDS‐PAGE immunoblols revealed five IgE‐binding bands at 34, 35, 39, 54 and 60 kD. Flea allergens were quantified in eight house dust samples using RAST inhibition assays and expressed as RAST inhibition units; five of these samples contained detectable levels. Cat flea allergens may contribute to the allergenicity of house dust in areas of

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00342.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryA new set of allergens fromDermatophagoides pteronyssinusandD. farinae(provisionally named DPS and DF5, respectively) was isolated from the whole culture of mites. The apparent molecular weights of both allergens were shown to be 25000 on SDS‐PAGE under a reducing condition and 27000 on Sephadex G‐75 gel nitration chromatography. Both DP5 and DF5, as well asDer fIII, possessed proteolytic activity. The results of substrate specificity and susceptibility to various protease inhibitors of DP5 and DF5 strongly suggested that they belonged to the chymotrypsin‐like serine protease family. In sera from 88 mite‐allergic patients, specific IgE antibodies to DP5 and/or DF5 were detected in only 41% of the sera by radio‐allergosorbent test, while 90% and 93% had specific IgE antibodies toDer pI and/orDer fI andDer pII and/orDer fII, resp

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00343.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryFood hypersensitivities contribute to disease exacerbation in a sub‐group of children with atopic dermatitis (AD). It has been shown that only selected foods are capable of causing clinical reactions when ingested, whereas other foods, to which the patient is equally sensitive by skin‐prick testing, may be tolerated. The purpose of this study was to examine the cutaneous late‐phase response (LPR) to food antigens in food‐allergic patients with AD and to determine if the skin reacted differently to ‘relevant foods’ (foods eliciting positive skin‐prick tests and positive oral challenges) than to ‘non‐relevant foods’ (foods eliciting positive skin tests but negative oral challenges). Using blister chambers adfixed to the skin, six children with AD were challenged epicutaneously with foods to which they had previously been shown to be sensitive. Histamine and PGD2 were measured hourly for 10–12 hr in parallel with quantitation of the cellular traffic. There appeared to be no difference in any of the measured parameters between relevant foods and non‐relevant foods, and the patterns of the LPR cells and mediators were similar to those previously described with aero‐allergens in patients with respiratory allergy. Histamine rose to 13.0±24 ng/ml (P<0.005) during the first hours, declined to<1 ng/ml by the fifth hour, and then rose a second time to 6.72 ± 3.4 ng/ml (P<0.05) during the 12th hour. PGD2 rose to an average of 312 pg/ml(P<0.05) during the first 3 hr followed by a decline to baseline. The cellular traffic was similar to that observed during the LPR in atopic adults without AD. Neutrophils peaked at 11.2 ± 6.8 × 104cells but did not reach significance because of background traffic in the control chambers. Eosinophils were significantly increased (P<0.05) and rose to 2.52 ± 1.7 × 104cells. Mononuclear ceils (P<0.05) and basophils (P<0.38) were also increased but less than either neutrophils or eosinophils. These studies suggest that selectivity in gastrointestinal antigen absorption or differential antigen processing, transport and/or clearing may explain the differences in clinical reacti

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00344.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryWe are interested in understanding the pathogenesis of the cutaneous IgE‐mediated late phase reaction. A double‐blind, placebo‐controlled, randomized cross‐over study with 10 subjects of the effect of the non‐sedating antihistamine, terfenadine (Selddane), on the cutaneous reaction to antigen (ragweed or mixed grass) administered intradermally and over denuded blister bases was performed. The activity of terfenadine on anti‐IgE‐induced mediator release from the skin mast cell, lung mast cell and basophil was also examinedin vitro. Terfenadine significantly inhibited the size of the cutaneous reaction at every hour between hours 1 and 9 (hr 9, control 2250 ± 500 mm2vsdrug 1250 ± 250 mm2,P<0.01,n=10) and showed some inhibitory effect at hours 10–12. While terfenadine blocks histamine release after nasal antigen challenge the release of mediators at skin blister sites was unaffected. The infiltration of leucocytes into the blister supernatant was unaffected by terfenadine although previous studies have shown significant inhibition with another antihistamine, cetirizine.In vitro, terfenadine. like other antihistamines, was found to have inhibitory activity on anti‐IgE‐induced mediator release at concentrations of 10−4‐10−5M in lung and skin mast cells and basophils. We conclude that the effects of the newer antihistamines on cellular movement into the skin may be diverse, that terfenadine may show organ specificityin vivoand that terfenadine significantly decreases both the early and late gross inflammatory response of the skin to antigen. We cannot, as yet. explain the mechan

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00345.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryA total of 71 patients with documented birch and grass pollen allergy participated in this randomized, double‐blind, parallel‐group study initiated to compare the long‐term therapeutic efficacy of twice daily levocabastine, a new topical H1‐receptor blocker, with that of sodium cromoglycate four times daily in the treatment of pollen‐provoked conjunctivitis. There was no statistically significant difference in therapeutic efficacy between the two treatment groups, although a positive trend in favour of levocabastine was observed. Global evaluations of therapeutic efficacy were similar in both treatment groups. A total of 94% of levocabastine‐treated patients rated treatment to be excellent or good compared with 86% of patients in the sodium cromoglycate group. Moreover, there were no significant differences in the severity of allergic symptoms reported on the patient diary cards. Patients were permitted to use rescue medication (oral terfenadine and betamethasone nasal spray) if symptoms became severe. The use of rescue medication was lower in the levocabastine group than in the sodium cromoglycate group. The mean number of days on which rescue medication was used was 12.8 and 26.9 in the two groups, respectively. The incidence, and type, of adverse reactions was similar in both patient groups. Levocabastine is well‐tolerated and at least as effective as sodium cromoglycate in the treatment of pollen‐provoked

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1993.tb00346.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY