摘要:

The pathophysiology of atopic eczema (AE) is still poorly understood. One possible concept favors IgE‐mediated reactivity towards allergens that enter the skin from the outside or through the blood. Microorganisms of the cutaneous flora also might represent a stimulus for allergic skin reactions. Abnormal bacterial skin colonization is a characteristic feature of AE.Staphylococcus aureus (S. aureus) is the most common pathogen. Binding to host cells involves special receptors, such as fibronectin or laminin. Specific IgE antibodies toS. aureuscan be detected in the blood. Whereas the clinical relevance of anti‐staphylococcal antibodies is still controversial, specific IgE antibodies toPityrosporumspecies as well as positive type I prick test reactions to these yeasts seem to correlate with the intensity of eczematous lesions in the head and neck regions of patients with AE. Both antimicrobial and antifungal treatment has been shown helpful in some cases of

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02051.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02052.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We evaluated the allergy status of 134 immigrants from Asia, Africa, the Middle East and South America, who were referred to our clinic during the past 10 years. Fifty Swedish patients were used for comparison. When the atopy state was not taken into account, no significant difference was found between the two groups with respect to total IgE levels. However, IgE levels of non‐atopic immigrants were significantly higher than the IgE levels of non‐atopic Swedes. While there was no significant difference in IgE levels between atopic and non‐atopic immigrants, this difference was significant in Swedish patients. In general, IgE levels of immigrants showed a decline with time and reached approximately the same levels as for the Swedish patients in 10.5 years. In the immigrant group atopic women had a considerably lower IgE level than the atopic men. Among the atopics there were no differences between sexes. In Swedes and immigrants pollen was the most common group of allergens. The spectrum of allergy in the immigrant group changed with time in Sweden, and gradually became more similar to the Swedish spectrum. Skin and/or RAST positivity to birch increased from 16% within 2.5 years to 53% after more than 10.5 years in Sweden. Our data indicate that environmental factors rather than hereditary differences determine the IgE state. Within a few years the immunologic status of immigrants adapts to the new enviro

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02053.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A double‐blind, placebo‐controlled study of immunotherapy was conducted in 19 patients with grass‐pollen hay fever to evaluate the efficacy and safety of a formalinized depot grass allergoid. The patients were assessed before and during IT by clinical (symptom‐medication scores during the grass‐ pollen season, specific nasal and skin reactivity) and immunological (specific IgE, IgG, IgG1and IgG4antibodies) parameters. High doses of grass allergoid, corresponding to a cumulative pre‐seasonal dosage of 46050 PNU, were administered, with only one systemic reaction. The actively treated patients had significantly lower symptom‐medication scores than placebo (p<0.01) during the month of May and showed a significant decrease in specific skin (p<0.01) and nasal (p<0.05) reactivity, and a significant early increase in specific IgE (p<0.01), IgG (p<0.0005), IgG1(p<0.001) and IgG4(p<0.05), with a subsequent decrease of IgE and IgG1. No differences were detected in any of these parameters in the placebo group. A correlation was found between high IgG4/IgG1ratio and the specific skin reactivity decrease (r = 0.691,p<0.05), whereas a high IgG4/IgG1, ratio was associated with higher symptom‐medication scores (r = 0.654,p<0.05). Possible explanations of these apparent discrepanci

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02054.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Biological standardization (BS) aims at equilibration of the activity of allergen preparations from different types of allergen source materials. The biological unit (BU), proposed in the Nordic guidelines for 20 patients, has been found reproducible among different countries in Europe, but to be relatively imprecise, with a 95% confidence interval of about that power of 10. A more precise estimate of the biological activity of allergens or difference in sensitivity between populations would be of value. We used Ch, i.e. the concentration of allergen eliciting a what of the same size as histamine in the individual patient, estimated by regression line analysis. The Ch, of 36 patients included in a BS trial was used. One of the 36 Ch, ‐values was drawn randomly, and then sent back to the sample. This procedure was repeated 10, 20, 30, 40 and 60 times to create “samples” of different sizes. Ten samples of each size were produced. With 60 “individuals”, the 95% confidence interval of the sample and the confidence interval of the medians were reduced to less than a factor of 2, i.e. to 74 to 128% of the median of th

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02055.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We studied the tolerance of soft contact lenses (CL) in 24 atopic (16 with hay fever) and 52 non‐atopic subjects with a mean age of 20 years. They were examined when they first came to an ophthalmologist to have CL and re‐examined after an average of 1.7 years. All subjects were allowed to use CL throughout the year, icluding the pollen season. Of the 76 subjects, 31 (41%) reported some kind of eye symptoms during the use of CL. Six subjects (8%) had stopped using CL because of symptoms. Altogether, in 29/76 subjects (38%) some objective sign was detected in the examination, confirming the subjective symptoms (conjunctivitis 16, keratoconjunctivitis 8, increased limbal blood vessels 4, and eczema palpebrae 1). Fourteen of the 24 atopics (58%) had experienced symptoms compared with 17 of the 52 non‐atopics (33%) (p = 0.034). Eleven atopics had seasonal eye symptoms, and eight of them (73%) had problems with CL use. Eosinophils and neutrophils found in the conjunctival scrapings at the first examination appeared to predict poor CL tolerance when the occurrence of symptoms in different groups was first compared by bivariate analysis. The risk factors that could predict poor CL tolerance were also evaluated, with logistic regression analysis controlling potential confounders. History of an atopic condition increased 5‐fold the risk of experiencing various external eye symptoms during the use of CL. We conclude that seasonal atopic allergy is a especially risk factor for wearing soft contact lenses, and their use should be restricted during the

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02056.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Sera from a group of 12 patients with anaphylactic reactions to vespids were studied. Field observations and RAST values suggested that the offending insect wasPolistes dominulus(PD). Specific IgE antibodies to PD appeared in all cases and toVespula germanica(VG) in nine. Absorption studies in these basal sera showed that IgE antibodies to VG were due to cross‐reactivity with PD. The RAST value to both venoms was higher after immunotherapy (IT) in six cases. IgE antibodies increased to determinants common to both vespids, and in 41% of the cases to specific epitopes of VG venom allergens not initially detected in the basal sera. In one case antibodies increased only to VG without a corresponding rise to PD. These results indicate that if the correct venom to which the individuals are sensitized is not administered IgE antibodies may appear which were not initially detected in the patients's era. The levels of these antibodies declined during the course of I

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02057.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Circulatory basophilia could be induced in inbred guinea pigs systematically immunized with ovalbumin and consequently provoked repeatedly with dissolved ovalbumin applied onto the mucosa of the nares or the outer eye. The degree of the increase in circulatory basophil granulocytes depended on the adjuvant used and was significantly more pronounced after immunization with Freund's complete adjuvant than with alhydrogel (A1(OH)3). The degree of basophilia was also dependent on the animal strain, but different in two strains selected for high‐asthma trai

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02058.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The protective effect of terfenadine on inOammatory processes following the early phase of conjunctival provocation tests by specific allergen was assessed in 24 patients suffering from seasonal allergic rhinoconjunctivitis, in a single‐blind, randomized, placebo‐controlled, parallel‐group study. Patients were randomly assigned to four treatment groups, each being given terfenadine 60, 120, 180 mg daily, or placebo, respectively, for 7 days, out of the pollen season. Clinical severity (burning, itching, lacrimation and hyperemia), and number of inflammatory cells obtained by conjunctival scraping (neutrophils, eosinophils, lymphocytes, and monocytes) were evaluated before and after treatment. Pre‐treatment with terfenadine resulted in a significantly higher allergen threshold dose than placebo (p<0.01), regardless of drug dose. Patients given terfenadine experienced a significant reduction (p<0.03) in conjunctival symptom severity, as compared with placebo, following conjunctival challenge. Accordingly, the number of inflammatory cells in terfenadine‐treated patients was significantly lower (p<0.01) than in the placebo‐treated after the conjunctival provocation test. The results of this study suggest that terfenadine has a significant protective effect on the early‐phase cellular and clinical events of conjunctival reaction induced by allergen challenge in at

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02059.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Sixty‐nine outpatients with symptomatic perennial rhinitis were recruited to this double‐blind, parallel‐group study to compare budesonide nasal spray with oral astemizole. Following a 1‐week run‐in on placebo, 67 patients achieved a mean daily total symptom score of at least 4 (scoring for each symptom was 0 = none, 1 = mild, 2 = moderate, 3 = severe), and were randomized to study treatments ‐ 33 to budesonide, 100 ug in each nostril morning and evening, and 34 to astemizole, one 10‐mg tablet each morning, for a period of 4 weeks. No antihistamine preparations other than eye drops and no corticosteroids were permitted during the active treatment period. Patients recorded symptoms of blocked nose, runny nose, sneezing, itchy nose, sore eyes or runny eyes in diary cards each evening before retiring. Diary card data showed that there was significantly greater improvement in blocked nose, runny nose and runny eyes during the first 2 weeks of budesonide treatment than during the same period on astemizole. A similar, although non‐significant, trend was observed for sneezing and itchy nose, but there was no apparent difference in the reporting of sore eyes. After 4 weeks, blocked nose and runny nose remained significantly less troublesome in the budesonide group. Both treatments were well‐tolerated and no major adverse effects were reported. Patient ratings for treatment efficacy were significantly higher for budesonide than astemizole at both 2

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb02060.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY