ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00186.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00187.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00188.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00189.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00190.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryWe report on the mechanisms, the environmental changes and patient compliance with regard to conventional and new dust and mite avoidance measures to prevent allergic symptoms caused by mite allergens, taking into account both allergen contamination and the developmental success of pyroglyphid Acari. Twenty patients with persisting rhinitic complaints were selected and matched. Although the patients had performed some conventional dust and mite avoidance measures (patient compliance was 90%), the dwellings proved to be a stimulus for mite development. Moisture problems due to faulty construction and excessive moisture production were common. Since humidity conditions could not be changed at short notice, the 20 homes were subjected to the new variants of mite allergen avoidance based on intensive cleaning without (control) and with an acaricide incorporated (acaricidal cleaner [Acarosan]). After the carrying out of conventional avoidance measures, these patients still had allergic symptoms, and dust from only 23 to 52% of their textile objects was under the proposed guanine (mite faeces indicator) risk level. Only the acaricidal cleaner was able to decrease the allergenic mite load (and the burden of the patients) significantly in this 12 month period. With respect to mite‐extermination, acaricidal cleaning was 88% better than intensive cleaning. Reduction of guanine was 38% better in the Acarosan treatment group.Clinical results have been reported elsewhere. A significant difference in favour of the acaricidal cleaning was seen in both subjective (as regards symptoms) and in objective data (total IgE). Another 50 patients were questioned. About 90% were willing to spend two weekends (70%), or at the most one weekend (20%) per year sanitizing the dwelling by cleaning it with the whole family.The authors of this report consider acaricidal cleaning to be a significant improvement in the management of mite‐allergic diseases, such as rhinitis. Compared with the replacement of home textiles, this treatment is less expensive and more effective. Patient compliance is acceptable, but depends on acceptance by physicians and the initial motivation and consequent burden on the pati

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummarySixteen subjects with mild stable asthma participated in a randomized double blind study on the effects of low dose fenoterol against histamine induced bronchoconstriction. Fenoterol aerosol at concentrations of 10, 50 and 200 μg and placebo were delivered at random through a metered dose inhaler as a single dose 30 min before histamine challenges on four separate occasions. Compared to placebo a fenoterol dose of 10 μg provided significant bronchodilatation (sRaw [s.d.] 8.3 [2.73]vs 6.3 [1.74] cm H20 * s [P<0.05]) and protection (PC100sRaw [s.e.m.] 0.72 (1.31) vs 1.45 (1.39) mg/ml). The bronchodilatory and protective actions of fenoterol were more pronounced after the inhalation of 200 μg (P<0.05) with no difference between 10 and 50 μg fenoterol aerosol. The magnitude of bronchodilatation and protection was not correlated (r= 0.15). The results from this acute study may suggest that fenoterol at doses up to 20 times lower than routinely recommended may be an effective treatment in mild asthmat

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryWe have developed a guinea pig model of trimellitic anhydride‐induced airway hypersensitivity responses. In one group of guinea pigs, injected intradermally with 0.1 ml 30% trimellitic anhydride (TMA), we examined the specificity of the bronchopulmonary response to TMA comparing the effect of intravenous TMA conjugated to guinea pig serum albumin (GPSA) with a control hapten (procion dye) protein conjugate (PD‐GPSA). A significant increase in pulmonary inflation pressure (PIP) was provoked in sensitized animals following intravenous injection with TMA‐GPSA (20%; 0–400, median; range) as compared to intravenous injection of PD‐GPSA. In the second group we compared three different methods of sensitization: single injection of 0.1 ml of 0.3% TMA; four injections of 0.1 ml of 0.1% TMA; and a single high dose injection of 30% TMA. Following intravenous TMA‐GPSA guinea pigs sensitized with a single injection 0.3% TMA had an increase in PIP of 395%; 220–600, while those given four repeat injections of 0.1% TMA had an increase in PIP of 343%; 315–490. These results were significantly higher than the increase in PIP (160%; 0–220) which occurred in guinea pigs sensitized with a single dose of 30% TMA. Four of 11 guinea pigs given low dose injections of TMA had bronchopulmonary responses to inhaled TMA‐GPSA. All sensitized guinea pigs had specific IgG1 antibodies demonstrated by enzyme linked immunosorbent assay (ELISA) and confirmed by ELISA inhibition. Four guinea pigs sensitized by low dose injections of TMA had IgE antibodies demonstrated by passive cutaneous anaphylaxis.We conclude that intradermal sensitization to free TMA induces a specific immune and airway hypersensitivity response to TMA‐GPSA. Single low dose injection of TMA is the most effective method of sensitization. Intradermal sensitization to free TMA may be a valuable method of sensitization for the developing of an animal model of occupational asthma caused by low molec

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00193.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryMast cell degranulation is thought to be an important component of the pathogenesis of allergic rhinitis. Quantitative studies on mast cells in nasal mucosa after allergen exposure have given widely divergent results, ranging from an overall decrease via redistribution to an overall increase. We investigated this problem by employing a combination of anti‐IgE and toluidine blue staining of biopsy specimens. In allergic patients anti‐IgE was found to identify all mast cells and toluidine blue to detect mast cells that were not (totally) degranulated.The study was composed of two parts done in different patient groups. In the first part of the study biopsies were performed in 23 patients with isolated grass‐pollen allergy, once during natural provocation in the summer and once in the winter. Biopsies were also performed in 12 controls. Non‐allergic controls were found to have the same number of mast cells in the lamina propria as asymptomatic allergic patients. The controls seldom have mast cells in the epithelium. The patients with isolated grass‐pollen allergy showed an increase in the numbers of mast cells in the lamina propria during natural provocation and the same seemed to occur in the epithelium as well. During natural provocation almost all of the mast cells in the epithelium and half of those in the lamina propria were degranulated.In the second part of the study 17 patients with isolated grass‐pollen allergy and four controls were challenged daily with allergen extract during a 2‐week period in the winter. During this period biopsies were performed at eight different occasions, i.e. once before, six occasions during and once after the provocation period. The results of this part of the study showed that during provocation mast cells migrate to the surface of the nasal mucosa, where they become degranulated, and that the pool of mast cells in the lamina propria was apparently replenished by migration of mast cells from the vessels in the lamina propria. The total number of mast cells in the lamina propria remained approximately the same while the mast cells residing in an increasingly thick layer measured from the basal membrane into the lamina propria became degranulated. After 2 weeks, 82% of the mast cells in the lamina propria was degranulated and it was only in the deepest layers that some toluidine blue positive cells were found.This study can explain the seemingly conflicting reports in the literature on mast cell dynamics and degranulation and shows that the reported differences are due to differences in the techniques used and the time

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00194.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryAntihistaminic drugs are widely prescribed across a multitude of medical specialities such as Allergy and Dermatology. The potentially serious sedative effect of these valuable agents has previously restricted their full use and the choice of drug has been dictated more by individual patient acceptability than by any laboratory demonstrations of comparative efficacy. Unsurprisingly therefore, there is a trend towards prescribing those newer preparations which leave the central nervous system unclouded. We have studied the most frequently prescribed non‐sedating antihistamine preparations, terfenadine (Triludan, Triludan Forte), cetirizine (Zirtek) and loratadine (Clarityn) in pharmacodynamic and relative efficacy trials using a quantifiable and reproducible extension of the classic Lewis model. The results indicate that two preparations, terfenadine 120 mg (Triludan Forte) and cetirizine 10 mg (Zirtek) are superior to their immediate rivals in degree of efficacy and/or speed of action. These results should assist clinicians in the positioning of effective, rapidly acting antihistamines for the symptomatic treatment of immediate hypersensitivity reactions such as urticaria and rhiniti

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1992.tb00195.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY