摘要:

Acupuncture, homoeopathy, mind‐body therapies, and nutritional, herbal, and environmental medicine have all been used in the management of patients with asthma. This paper reviews the evidence base for the use of these unconventional or complementary therapics. Although there is a paucity of large randomized, controlled trials in this area, there is sufficient evidence to suggest that many of these therapies can produce objective and subjective benefit in selected groups of patients. In view of the increasing popularity of complementary medicine among patients and general practitioners, there is now an urgent need for high‐quality research to determine how, or whether, these therapies may be interwoven with the more orthodox treatments currently availa

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00020.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

To describe the distribution of serum total IgE and specific IgE. to common aeroallergens by sex and age and to study their relationship to each other, we measured serum total IgE and specific IgE (CAP) to house‐dust mite, timothy grass, cat, birch, andCladosporiumin a random sample of 2496 subjects, aged 20–70 years from the Dutch general population. We found that total IgE was higher in men, independently of smoking, and that total IgE had no relationship with age after adjustment for specific IgE and smoking in linear regression analysis. At least one positive specific IgE test was found in 32% in both sexes. Men had higher prevalences of specific IgE to house‐dust mite and lower prevalences of specific IgE to birch than women. The proportion with positive specific IgE decreased with age. The mean total IgE increased with the number of positive specific IgE tests. Thus, total IgE is higher in men and has no relationship with age if specific IgE is taken into account. The prevalences of specific IgE to aeroallergens are high and decrease with increasing age. We suggest that sex differences in total IgE should be considered when using tota

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00021.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This paper investigated the chemotactic capacity of blood eosinophils (EOS) in response to C5a and formyl‐leucyl‐phenylalanine (FMLP) in 15Parietaria‐pollen‐allergic patients with mild asthma during theParietariapollen season. Data showed that EOS chemotaxis toward C5a was significantly reduced during the peak pollen count, compared with the values obtained in normal subjects. On the other hand, FMLP could induce EOS chemotactic activity only inParietaria‐allergic patients, the highest value being registered during the height of theParietariaseason.In vitrocimetidine modulation of chemotactic function in comparison with C5a led to a recovery of the impaired results obtained in the presence of high histamine levels. Moreover, diphenhydramine preincubation of EOS induced a reduction of the enhanced chemotactic activity obtained with low concentrations. The data suggest that different serum histamine levels give rise to an impaired immune‐phlogistic response in allergic patients and that histamine‐receptor antagonists may modulat

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00022.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We evaluated a new method of computer‐based scanning of skin prick test wheal areas. To test the calibration of the program, we scanned five constructed circles of exactly defined areas between 5 and 255 mm2. One of these circles was scanned in different degrees of contrast (modes), the middle mode being used in the other experiments. We also investigated the inter‐and intraoperator variation. Finally, results obtained by measuring diameters of wheals and by the new method of area determination were compared for 82 histamine and 75 egg wheals. The areas found agreed well with the real areas (P<0.01) (mean 97.4–100.8%), except for the smallest wheal (5 mm‘) (NS). Areas obtained in the “middle position” closely resembled the real area. The intraoperator coefficient of variation (C.,) was 1.4% (0.3–4.3), the day‐to‐day C.V. was 1.9% (0.2–5.3), and the interoperator C.V. was 2.3% (0.7–5.7), with a higher C.V. for small areas. Histamine and egg wheals were significantly larger with the diameter method (126% and 129%, respectively) than with the area method. The difference between the methods was most pronounced for small wheal areas. The C.V. of the scanning method was significantly lower than that of the diameter method. The new program is precise and is recommended for registration of skin test reactions in scientific trials. Although the scanner works well and has high precision, the major problem in skin testing seems still to be the reproducibility of the skin te

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00023.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The development of symptoms possibly related to allergy or other forms of hypersensitivity was studied in a group of 638 children on two occasions: when the children were 3 and 18 months of age. Standardized questions were used to collect basic information about the child. technical characteristics of the home, and the mother's perception of the indoor climate. All reported exposure factors were analyzed in relation to the child's symptoms at 18 months of age, by logistic regression techniques. A family history of atopy was associated with a high incidence of most of the investigated symptoms. Attendance at a day nursery before 18 months of age increased the risk of recurrent colds and the need for several courses of treatment with antibiotics. If the mothers smoked, the children more often suffered from protracted coughing episodes. If the child had a sibling, the risk of developing a wheeze, repeated colds, and the need for antibiotic treatment increased. No building factors, such as size of the home, heating and ventilation system, type of foundation, dampness, or presence of wall‐to‐wall carpets, showed a significant correlation to symptoms reported in the children. However, if the mothers reported symptoms that are often connected with “sick buildings”, the children more often had eczema, dry skin, or reactions to food. The mothers' complaints about indoor air quality and climatc and mucous membrane symptoms were significantly related to the type of building and presence of condensation on the windows in winter, a finding which may indicate that indoor climate factors also have some effect on the health of the children. This study reports the prevalences of symptoms until the age of 18 months. At this age, the allergic manifestations are usually nonspecific, and follow‐up examinations to 4–5 years of age are needed before any definite conclusions can be drawn about the development of atopic diseases due to indoor clim

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00024.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In recent years, it has been possible to demonstrate mediator release into the nasal secretion after nasal allergen challenge in patients with allergic rhinitis. Using the nasal provocation model, we determined whether the mediator release was altered in immunotherapy‐treated patients. Seventeen grass‐pollen‐allergic patients were examined under controlled, reproducible conditions. Serial challenges with increasing doses of grass pollen produced increasing numbers of clinical symptoms and release of mediators such as kinins, TAME‐esterase activity, and histamine. Ten patients received a semidepot perennial grass‐pollen extract for 4 years. Seven patients served as controls and did not receive immunotherapy during the observation period. Data from the group of patients receiving immunotherapy over the first year already showed a partially significant decline in the maximal mediator release after nasal allergen challenges compared to the results of pretreated challenges, whereas controls did not show any significant changes. Nasal allergen challenges after termination of 4 years' immunotherapy significantly modified the mediator release compared to pretreatment values (TAME‐esterase activity P<0.05, kinins P<0.01, and histamine P<0.01). Decrease of mediator release paralleled the symptom‐medication scores and quantitative skin prick test. Finally, we could demonstrate a significant correlation between specific IgG increase and mediator decrease in the

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00025.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

To explore the natural history of asthma and its relation to allergic responses, we examined the relation between total serum IgE in early adulthood and a history of respiratory symptoms, airway hyperresponsiveness (AHR), and atopy during childhood. We studied 180 subjects aged 18–20 years who had been studied since the age of 8–10 years. We measured wheeze in the previous year by questionnaire, AHR by histamine inhalation test, atopy by skin prick tests, and serum IgE levels by immunoassay. Subjects with AHR in early adulthood had higher IgE levels (mean 257.0 IU/ml) than subjects with past AHR (mean 93.3 IU/ml) or with lifelong normal responsiveness (mean 67.6 lU/ml) (P<0.001). Subjects who had symptoms had higher IgE levels (mean 125.9 IU/ml) than those who were lifelong asymptomatic (mean 63.1 IU/ml) (P<0.001). Recent wheeze, AHR, and allergic sensitization all had a positive relation to serum IgE, but IgE was not more predictive of AHR than skin prick tests. The finding that young adults who are sensitized to common allergens are highly likely to have AHR even in the absence of symptoms is further evidence of the fundamental role of IgE‐mediated responses in the natural history of AHR throughout childhood and into adul

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00026.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The role of allergic reactions in the pathogenesis of inflammatory bowel disease and irritable bowel syndrome has been disputed. This study aimed to determine the prevalence of adverse reactions to food in patients with gastrointestinal disease. A total of 375 adult patients of a gastroenterologic outpatient clinic were examined by history, skin tests, measurements of laboratory parameters, and intestinal provocation with food allergens by colonoscopy. Some 32% complained of adverse reactions to food as a cause of their abdominal symptoms. In 14.4%, the diagnosis of intestinal food allergy could be suspected according to several criteria such as elevated total IgE, specific IgE against food antigens, eosinophilia, responsiveness to cromoglycate, and clinical signs of atopic disease. In 3.2%, the diagnosis could be confirmed by endoscopic allergen provocation and/or elimination diet and rechallenge. In conclusion, the data suggest that allergic reactions to food antigens may be a causative factor in a subgroup of patients with inflammatory and functional gastrointestinal disease.

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00027.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The incidence of positive skin test responses among alopic subjects with suspected respiratory allergy was investigated with commercial and autochthonous pollen extracts of various cultivars ofOlea europaea. Pollen was collected from olive trees of well‐defined cultivars, extracted, and separated by SDS‐PAGE. Immunoblots were used to identify the various IgE‐binding proteins of the pollen extracts of the various cultivars. The results revealed six predominant IgE‐binding bands, some of which appear in all the cultivars examined. The 18–20‐Da band (Ole e 1) appeared in only eight of the cultivars, but not in the nine others. The presence of specific IgE‐binding bands in the various pollen extracts and their correlation with the incidence of positive skin tests

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00028.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We describe immunologic responses in subjects exposed to glutaraldehyde (GA) who were diagnosed as having occupational asthma, or who described work‐related respiratory symptoms. A series of GA‐modified proteins was characterized, and used to analyse sera from 20 GA‐exposed workers and 21 unexposed workers for IgE antibodies. Inhibition studies were used to determine the specificity of binding. The reaction of GA with albumin in different molar ratios produced a range of modified proteins, which were used to measure specific IgE antibodies. A significant difference between exposed and unexposed subjects with serum IgE less than 150 kU/1 could be detected for GA‐specific IgE antibodies (P=0.026), and 31% of exposed workers with occupational asthma had antibody levels greater than the unexposed population (mean +2.5 SD). False‐positive results were obtained with serum from unexposed workers who had total IgE levels greater than 150 kU/l, but this binding was not inhibited by GA‐modified proteins. We report the first evidence of immunologic sensitization in some workers exposed to GA. However, GA may behave like many other low‐molecular‐weight chemicals in that specific antibodies can be detected in only a small percentage of exposed workers who report work‐related res

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb00029.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY