摘要:

Species of the genusParietaria(pellitory) are a prevalent cause of allergy in the Mediterranean area and the most important in some European regions such as southern Italy and coastal Spain (14, 26, 27, 29, 30, 31, 36, 59, 69). Up to now, however,Parietariahas received little attention in northern Europe and the US because of its limited regional distribution. Therefore, less is known aboutParietariaallergy than about other inhalant allergens such as those of grasses, ragweed, and mites.During the last 5 years, only 31 reports onParietariaallergy have appeared in the literature, as compared with 37 papers on birch pollen. This ratio may appear unbalanced, considering that millions of people suffer from pollinosis caused byParietaria, while a much smaller number have rhinitis and/or asthma caused by birch pollen.The increasing movement of people throughout Europe and to and from the US is reason to broaden our knowledge of patterns of inhalant allergy in each geographic area, especially where tourism and immigration are high.This paper briefly reviews available data and personal studies on the botanical, aerobiological, immunochemical, and clinical features ofParietariaallergy.

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00661.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In human beings, as in mice, two distinct patterns of cytokine secretion have been defined among CD4 + helper T‐cell clones. Human type 1 helper (Th1), but not type 2 helper (Th2), cells produce interleukin‐2 (IL‐2), gamma‐interferon (IFN‐γ), and tumor necrosis factor‐β, whereas Th2, but not Th1, cells secrete IL‐4 and IL‐5, but not IL‐2 or IFN‐γ. Other cytokines, such as IL‐3, IL‐6, GM‐CSF, or TNF‐α, are produced by both Th1 and Th2 cells. The cells, a third Th subset, show combined production of Th1‐and Th2‐type cytokines. The different cytokine patterns are associated with different functions. In general, Th2 cells provide an excellent helper function for B‐cell antibody production, particularly of the IgE class. On the other hand, Th1 cells are responsible for delayed type hypersensitivity reactions and are cytolytic for autologous antigen‐presenting cells, including B cells. Most allergen‐ or helminth‐antigen‐specific human CD4 + T‐cell clones exhibit a Th2 phenotype, whereas most clones specific for bacterial antigens show a Th1 profile. Allergen‐specific Th2 cells seem to play a crucial role in atopy. These cells induce IgE production via IL‐4 and favor the proliferation, differentiation, and activation of eosinophils via IL‐5. In addition, Th2‐derived IL‐3 and IL‐4 are mast‐cell growth factors that act in synergy, at leastin vitro.Recent evidence indicates that allergen‐specific Th2 cells are selectively enriched in tissues affected by allergic inflammation, such as the bronchial mucosa of subjects with allergic asthma. However, the reason why allergens preferentially expand Th2 cells in atopics is unknown. A number of factors may influence Th subset differentiation into Th1 or Th2 cells. At present, the IL‐4 produced in the microenvironment in which antigen is presented to Th cells seems to be the major factor favoring Th2 development. In this connection, the aberrant production of IL‐4 (and IL‐5) exhibited by T cells from atopic

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00662.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Proteins of the serpin family (serine protease inhibitor) control key steps in the inflammatory, coagulation and complement systems. C1‐inhibitor deficiency predisposes to hereditary angioneurotic oedema, and other serpins control proteolytic enzymes that may cause complement activation or the forming of oedema. We investigated whether deficiency of proteins of the serpin family may predispose to cold urticaria and therefore screened 7 male patients with severe cold urticaria for the presence of deficieney alleles of some of the members of the serpin antiprotease family. There were no findings of C1‐inhibitor, α1‐antitrypsin, α2‐antiplasmin, antithrombin III, tissue plasminogen activator inhibitor or thyroxine binding protein deficiency. The prevalence of heterozygous α1‐antichymotrypsin deficieney was significantly higher than expected (prevalence ratio 25.8 (95% confidence interval 6.0‐112), p<0.0001). This finding is in concert with previous studies that have shown lower mean levels of α1‐antichymotrypsin among patients with cold urticaria and suggests that heterozygous deficiency of this antiprotease, which controls neutrophil eathepsin G and mast cell chymase may predispose to cold urticaria. The present series is, however, small and the results need confirmation in

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00663.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Histamine release from basophil granulocytes in whole blood by benzylpenicilloyl poly‐l‐lysine (PPL) was investigated in 7 patients with penicillin allergy. All patients presented with systemic immediate hypersensitivity reactions after i.v. administration of penicillin G. Total histamine (of 7 patients) ranged from 27.5 ng/ml to 62.1 ng/ml (mean 43.2 ng/ml). The spontaneous histamine release ranged from 0.15% to 5.1% (mean 1.8%) of the total content. Addition of PPL in various concentrations resulted in values between 0.8 and 9.6%. Although PPL is a reliable allergen for prick‐ and intradermal testing in the diagnosis of penicillin allergy ‐ demonstrating a histamine liberation in the skin ‐ thein vitroexperiment using the same allergen showed no histamine release above 10%. Using a threshold of 5% out of 7 patients, 4 (57%) would show a positive histamine release. Therefore it might indicate that in penicillin allergy a threshold of 5% must be used. In addition, basophils in whole blood and skin mast cells may be activated di

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00664.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We investigated the diagnostic value of a newin vitrotest, Pharmacia CAP System (Pharmacia Diagnostics AB, Uppsala, Sweden), for the quantitative measurement of allergen‐specific IgE antibodies by comparison with RAST in 2 groups of patients, 71 atopic and 48 non‐atopic. In the last 20 years RAST has supplied a good diagnostic tool, but this test presents some problems, the main one being sensitivity. The new test has a solid phase able to bind even very small amounts of specific IgE and an anti‐IgE tracer with very low cross‐reactivity with other immunoglobulins, thus presenting more favourable conditions. From the analysis of our results, Pharmaeia CAP System gave higher sensitivity (94% compared to 88% of RAST) with no loss of specificity (96% for both tests). The reliability of these results is ensured by the proper selection of patients who were all suffering from pollinosis and were clinically diagnosed as certainly hypersensitive to a single pollen. A positive trend was found between severity of asthma and levels of specific IgE for timothy. Pharmacia CAP System appears to identify a larger number of atopic patients th

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00665.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Based on a 3‐year prospective study of 20 pollen‐allergic patients, where a detailed analysis of the IgE, IgG, and IgG4immune response was performed, we propose that a common regulatory mechanism exists between the IgE and IgG1synthesis and between IgE and IgG4synthesis during immunotherapy. It was found that the IgE immune response to a number of antigens was quantitatively diminished during the period of immunotherapy when IgG1was present early (week 12), and for other antigens there was a rise in IgE without an early IgG1antibody response. Additionally, it was found that for some antigens a rise in IgE antibodies was contrasted by a fall in the IgG4antibody response and for other antigens the opposite was true, indicating a regulatory mechanism between the IgE and the IgG4synthesis. A statistical analysis showed that these findings were statistically significant at the 0.01 % level for the IgE/IgG1relationship and at the 0.05% level for the IgE/IgG4relationship. These findings could have implications for future immunotherapy regim

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00666.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We have evaluated thein vitroleukocyte histamine release tests for the diagnosis of allergy to muscle relaxant drugs in 40 patients (Group A) and a control group of 44 subjects with negative leukocyte histamine release (Group B). Non‐IgE dependent histamine release, expressed as a percentage of the total blood histamine, was 3.94%± 0.49 in Group B. The upper limit of positivity was estimated to be 5% (mean + 2 SD). Leukocyte histamine release tests were positive in 65 % of the patients from Group A. The concordance between LHR and QAS‐RIA was 64%. The maximal histamine release was observed at dilutions of 10−2–10−4in 20 of the 26 positive cases. The maximal histamine release was 43.8%± 23.3. The spontaneous histamine release was as low as 1.7%± 1.1. Cross‐reactivity among the 5 different muscle relaxant drugs has been investigated and compared by intradermal testing. The muscle relaxant drugs which gave the lower skin reaction (M2) and the drug responsible for shock (M1) were selected for the study ofin vitroleukocyte histamine release. Of 20 patients, 10 had, simultaneously, a positive test to Ml and a negative to M2. All of the 10 cases had negative ID tests with M2. Three of these patients subsequently underwent general anesthesia with the muscle relaxant chosen as harmless (M2) without any cli

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00667.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Salmeterol is a new β2‐receptor agonist with a prolonged duration of action after inhalation, exceeding 12 h in most patients. We have performed a 12‐month open follow‐up study on 11 patients with reversible asthma. All patients were given salmeterol inhalations (50 μg twice daily). Additional asthma treatment included inhaled corticosteroids in all patients, and oral slow‐release theophylline or β2‐receptor agonists in a minority of patients (3 and 1, respectively). Before salmeterol treatment was initiated and after 3, 6, 9 and 12 months of salmeterol treatment, a cumulative dose‐response curve to inhaled salbutamol (100, 300 and 900 μg) was performed, and FEV1measured. We also evaluated the effect of each salbutamol dose on finger tremor, systemic blood pressure and heart rate. Blood tests, including white blood count and electrolytes, were taken at each visit. After salmeterol treatment was initiated, morning FEV1, measured before the morning asthma medication, was significantly improved (p<0.05). The responsiveness to inhaled salbutamol was not decreased during salmeterol treatment, except in one patient with asthma worsening over the study year. Baseline finger tremor measured before salbutamol dose‐response curves, was significantly lower at the 12‐month visit than before treatment was initiated (p<0.05). Effects of salbutamol on systemic blood pressure, heart rate or finger tremor was not significantly changed during salmeterol treatment. We found a successive and significant decrease in blood eosinophils (p<0.05) during the 12 months of salmeterol treatment, when the patient with asthma worsening was excluded in the analysis. Also platelet count was significantly decreased during the treatment period (p<0.001), although within the normal range for all patients. In the present study, we found no evidence that long‐term treatment with inhaled salmeterol (50 μg twice daily) produced decreased β2‐recept

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00668.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The distribution of total serum‐IgE and factors of importance for the level of IgE was studied in a random sample of 508 children and adolescents, aged 7–16 years, from Copenhagen. A detailed history about asthma, rhinitis, dermatitis and urticaria was obtained, and a physical examination, skin prick test with 9 common allergens, lung function test, bronchial challenge with inhaled histamine and exercise, and measurement of IgE (kU/1) were performed. The distribution of IgE among children and adolescents was found to exhibit a log normal distribution and a positive skin prick test, allergic symptoms, a family history of allergic diseases, age and smoking were found to be significantly related to an increased level of IgE. No relationship was found between increased bronchial responsiveness and IgE. The geometric mean of “normal” values of IgE (* 1 SD and *2 SD) of the Danish children and adolescents was 18 kU/1 (*4.7, * 18.2), suggesting that normal IgE values were within 330 kU/1. Measurement of IgE as the only screening for allergic disease is unreliable, as the predictive value of an elevated IgE in population samples was found to be 50%, whereas misclassification (1‐specificity) of asymptomatic subjects as allergic because of an increased IgE was low (4%). In conclusion, total IgE is highly influenced by allergen skin reactivity. Further, this study suggests that normal IgE values were within 330 kU/1, although the range

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00669.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The natural history of IgE antibodies to food without related symptoms is unknown. We have followed the progress of 7 children with various atopic diseases and asymptomatic immediate hypersensitivity to fish, treated with elimination diet in spite of full alimentary tolerance. During the diet period, between 24 and 113 months, all 7 patients presented immediate symptoms upon accidental exposure to or challenge tests with fish (skin symptoms in all 7 cases, digestive in 5, respiratory in 4, and anaphylaxis in 2), which differed from those related to atopic diseases previously present. The levels offish‐specific IgE (prick test, RAST) remained unchanged or were increased. These findings suggest that during elimination diet, and perhaps due to minimal and hidden contact with the allergen, the patients’ degree of sensitization may increase, turning an asymptomatic into a symptomatic immediate hypersensitiv

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1992.tb00670.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY