ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01196.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Spina bifida patients have been shown to be a high‐risk group for latex allergy. Of the several latex proteins identified from nonammoniated natural latex, a polypeptide with a molecular mass of about 23 kDa was shown to be one of the major allergens reacting with IgE in the sera from such patients. Using hybridoma technology, a monoclonal antibody (mAb) 1E2 against the 23‐kDa latex allergen was produced. The presence of the 23‐kDa or related allergens in finished latex products was evaluated using 1E2. Of the 16 extracts of finished latex products, 12 reacted with 1E2. The other four products are not used in health care. Since the majority of latex products used in health care are manufactured from ammoniated latex and ammoniation may alter latex proteins, we also investigated the effect of ammoniation on the 23‐kDa allergen. Although ammoniation degraded latex proteins, the 23‐kDa antigen could still be detected by using mAb 1E2 on immunoblot of ammoniated latex proteins. Furthermore, ammoniation resulted in the appearance of additional proteins in high molecular weight positions not present in nonammoniated natural latex, which retained the 23‐kDa epitope. The 23‐kDa allergen could also be detected on surgical gloves after exte

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01197.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This was a 4‐week, open‐label, parallel‐group study designed to compare the efficacy and safety of the long‐acting inhaled bronchodilator, salmeterol, with the established inhaled bronchodilator, terbutaline, in the treatment of patients with mild to moderate asthma. A total of 243 adult patients was randomized to receive treatment with either salmeterol 50 μg bd via a DiskhalerTM(Glaxo) inhaler (n=121) or terbutaline 500 μg qds via a reservoir powder inhaler device (n=122). Apart from all bronchodilator treatment which was withdrawn at the start of the run‐in period and replaced by inhaled salbutamol to be used as required for symptom relief, all concurrent medications were kept constant throughout the study. Salmeterol produced a significantly greater increase in mean morning peak expiratory flow (PEF) than terbutaline (difference in adjusted means after treatment=28 l/min; 95% CI=19–37 l/min;P<0.001). Likewise, the increase in mean evening PEF was significantly greater following treatment with salmeterol than with terbutaline (difference in adjusted means=9 l/min; 95% CI=0–17 l/min;P=0.045). Salmeterol was associated with a significant reduction in diurnal variation in PEF by comparison with terbutaline (difference in adjusted means=−18 l/min; 95% CI=−24, −12 l/min;P<0.001). Significant improvements with salmeterol by comparison with terbutaline were also observed in daytime and night‐time asthma scores, percentage of symptom‐free days and nights, use of additional inhaled bronchodilator, and percentage of days and nights when no additional inhaled bronchodilator was needed. The greater overall improvement in the control of asthma and its symptoms after treatment with salmeterol was further evident from the lower incidence of asthma‐related adverse events in patients taking salmeterol compared with those taking terbutaline (2% and 15%, respectively). While both treatments were well tolerated, more patients withdrew from the terbutaline group than from the salmeterol group (12 and 3 patients, respectively) and terbutaline was associated with a higher incidence of drug‐related adverse events (26% and 9% in the terbutaline‐ and salmeterol‐treated groups, respectively). This study demonstrated that salmeterol 50 mUg bd via a Diskhaler was significantly more effective and associated with fewer adverse events than terbutaline 500 μg qds via

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01198.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

A previous study revealed an increased occurrence of work‐related respiratory complaints among Swedish woodwork teachers. For determination of whether an IgE‐mediated mechanism was the cause of the symptoms, 127 woodwork teachers and 111 reference subjects (other school personnel) in Stockholm gave serum for analysis of total IgE, Phadiatop, and RAST to extract of sawdust from five commonly used Scandinavian woods (pine, birch, juniper, alder, and linden). The total serum‐IgE level was similar in the woodwork teachers (geometric mean 35, range<2–1700 kU/l) and the reference group (34,<2–860 kU/l), and the frequency of positive Phadiatop was equal (29.9% and 31.5%, respectively). RAST was positive only in three cases, two reference subjects (birch and pine) and one woodwork teacher (alder). Hence, no correlation between exposure and sensitization to wood dust was found, and the results do not support the assumption that the complaints related to exposure to dusts from the examined Scandinavian woods are IgE

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01199.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In patients treated with penicillins, adverse cutaneous reactions can occur within minutes or may take several days to develop. IgE antibody‐mediated reactions are well documented, but other mechanisms may also be involved. In particular, nonimmediate reactions have not been studied extensively, and the purpose of the present work was to establish the incidence of such reactions among a large group of patients and to study the penicillins involved. A total of 380 subjects with a history of a cutaneous reaction following administration of a penicillin antibiotic was included in the study. Skin tests and specific IgE measurements (RAST) were carried out using various penicillins and penicillin‐related reagents, and patients were also challenged with various penicillins. In some patients with delayed skin test responses, skin biopsies were carried out. The tests confirmed that 74 subjects (19.4% of total investigated) had suffered a cutaneous reaction to a penicillin derivative, and 29 of these subjects (7.6%, of total or 39% of confirmed) showed evidence of having suffered a nonimmediate reaction. The latter group were identified by giving a positive delayed direct challenge, and in 65% of the cases a delayed skin test response was detected. In most cases, these responses were to amino penicillins. Skin biopsies showed a lymphomonocytic cell infiltrate. Nonimmediate reactions to penicillins are a reproducible phenomenon, suggesting that a specific mechanism is responsible. By direct challenge, 93 Q of responders were positive to amino penicillins (10.3% ampicillin, 82.7% amoxicillin), indicating a major role for these penicillins in nonimmediate reactions. The high percentage (65%) of subjects in this group who showed delayed skin test responses, taken together with the biopsy results, suggests that a lymphocyte‐mediated reaction occurred. However, the possibility that other mechanisms may also have been involved cannot be rul

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01200.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We compared the history of sting reactions with venom skin prick test (SPT) and CAP RAST reactions in beekeepers in order to assess the value of structured questions and symptom backgrounds. The study population consisted of 102 beekeepers, who were 25–75 years of age. Bee and wasp venom SPT was performed with concentrations of 10, 100, and 300 μg/ml. The CAP Phadiatop® test was used in the screening of IgE antibodies against common inhalant allergens. Eorty‐two beekeepers had never experienced large local or systemic reactions after a bee sting. Of the 31 subjects with a history of systemic reactions, 13 had experienced these during the previous year. A significant difference (P<0.01) between systemic reactors and nonreactors was found in bee venom CAP and SPT (300 μg/ml). However, due to considerable overlap, these tests are unable to discriminate between allergic and nonallergic beekeepers. Both bee venom SPT (300 μg/ml) and CAP tests were positive in 65% of systemic reactors and in 34% of nonreactors (P=0.008). Venom SPT (300 μg/ml) correlated significantly with CAP for both venoms. No correlation was observed between venom allergy and atopy. Clinically, the most practical concentration for evaluating bee and wasp venom sensitization by SPT proved to be 3

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01201.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

To determine optimal conditions for allergen preservation, we investigated the influence of different stabilizing additives and of storage temperature on the allergen activity of apple protein preparations, obtained by extraction in phosphate buffer or by precipitation in diacetone alcohol and resolubilization in phosphate buffer in the presence or absence of enzyme inhibitors. For this purpose, the extracts were stored for 6 months either in frozen state at −20° C or in lyophilized state at −20° C, 4° C, or room temperature and were characterized by SDS‐PAGE, immunoblot, ELISA inhibition, and prick test. The highest stability revealed the extracts that were prepared by precipitation in the organic solvent in the presence of enzyme inhibitors, lyophilized, and stored at −20° C. For storage of extract solutions at 4° C, PBS/glycerol and cysteine/sodium citrate/glycerol were found to be the most effective stabilizi

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01202.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We describe six patients with severe occasional anaphylaxis, caused by stings of bumblebees. Sensitization to bumblebee venom was confirmed by intracutaneous tests and RAST with purified bumblebee venom. Three patients changed their occupation and will probably not be stung by bumblebees in the future. The other patients started immunotherapy with newly purified bumblebee venom extract. After 1 year of treatment, no severe side‐effects had occurred and clinical benefit in two patients could be demonstrated, as both skin sensitivity or serum IgE to bumblebee venom had decreased. Moreover, both patients were unresponsive to in‐hospital sting challe

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01203.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The capacity of laboratory tests and clinical signs to predict allergic manifestations up to 18 months of age was assessed in 129 newborn babies, most of whom had family members with atopic disease. The parameters assessed included family history; skin dryness; erythema toxicum; skin reactivity to histamine and IgE levels; eosinophil counts; and peripheral white blood cell, leukocyte diflferential, and platelet counts in cord blood (CB). Erythema toxicum and white blood cell and platelet counts were of no value as predictors of allergy. The sensitivity of family history, skin dryness, and sensitivity to histamine, as well as IgE levels and eosinophil counts, varied 25–79% and the specificity 40–74%. The efficiency was never higher than 58%. Logistic regression, applied in order to evaluate the joint predictive power of the five parameters, showed a P value of<0.001. The estimated probability for atopy before 18 months of age was 0.33 for neonates with normal skin texture, a CB IgE of less than 0.5 kU/l, and a history of fewer than two family members with atopy. The probability increased to 0.89 for babies with a dry skin, a history of two or more atopic family members, and a CB IgE of ≥0.5 kU/1. In conclusion, not one parameter nor any combination of them seems suitable for general screening. However, a combination of family history and CB IgE and skin assessment may be used to identify babies at high risk of allergy for participation in prevention st

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01204.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Mucosal exudation of nonsieved bulk plasma is a key feature of airway defense and inflammation. We have previously observed in guinea pig tracheobronchial airways that endogenous nitric oxide (NO) of the mucosa may tonically suppress the permeability of the subepithelial microcirculation, and that topical administration of the NO donor nitroprusside may reduce plasma exudation responses. The present study examines whether nitroprusside affects histamine‐induced mucosal exudation of plasma in the human nasal airway. In a dose‐finding tolerability experiment, using changes in nasal patency as response, placebo and nitroprusside (1.2 and 3.6 mg per nasal cavity) were applied on the mucosal surface with a nasal‐spray device. Nasal peak expiratory flow (PEF) rates were measured before the application and thereafter every third minute for 15 min. Nitroprusside produced a dose‐dependent decrease in nasal PEF rates compared to placebo. Placebo or nitroprusside (7.2 mg) was then given to the right nasal cavity, followed 3 min later by challenge with saline or histamine (600 μg). The drug and the challenge were both applied with a nasal‐spray device. With a nasal pool‐device, the same large part of the nasal mucosal surface was lavaged before and after the treatment/challenge. The lavage fluid levels of a2‐macroglobulin were measured as an index of mucosal exudation of bulk plasma. The histamine‐induced lavage fluid level of aj‐macroglobulin was significantly higher after treatment with placebo than with nitroprusside. The present data indicate that nitroprusside may have antiexudative effects in human airways. Hence, unlike other microvascular permeability active agents, this pharmacologic principle may be active in both guinea pig

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01205.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY