ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02088.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Pollen is rarely investigated as a cause of winter respiratory symptoms. Infectious coryza and asthma are particularly common during winter, and it has been shown that environmental antigens can cause at least some cases in Paris. Recent experimental data with from Calhoun et al. (1991) indicate that pollen may act synergistically with viral respiratory infections, which are particularly prevalent in winter. In the present study, we investigated, in 130 consecutive patients presenting with winter aggravation of asthma or rhinitis, winter pollinosis by skin test, radioallergosorbent test (RAST), and specific endonasal challenge test. Totals of 35, 24, and 21 patients reacted positively in skin, RAST (>0.70 PRU/ml), and endonasal tests, respectively. Clinical features during the season established the diagnosis of winter pollinosis in 20 cases; it was due to alder pollen in 10 patients and hazel pollen in 12. The positive predictive value of the skin test was only 0.57, as compared with 0.86 for the specific endonasal test, which had a negative predictive value of 1. Our results indicate that hazel and alder pollens should be prick‐tested for more often as causes of winter respiratory symptoms in Paris, even if similar manifestations were absent during previous winters, were previously present during spring or summer, or were both absent in previous winters and present in spring or summe

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02089.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The variation in skin prick test (SPT) results was evaluated clinically during terfenadine treatment in 39 adult patients with pollen rhinitis. A change in the perceived state of the patient as regards sensitization to a specific pollen allergen or atopic constitution was judged to be clinically important. A randomized, double‐blind, crossover design was used, comprising 2 weeks on terfenadine 120 mg once a day and 2 weeks on placebo. SPT for two pollen allergens and histamine (10mg/ml) were evaluated at the start of the study and at the end of each period. When SPT was used as a discovery test and liberal definitions were applied, predictive values for a positive test were 100%. 1‐Sensitivity ranged between 10 and 54% with substantially lower values when a histamine wheal reaction was noted. The inhibitory effect of terfenadine was detectable 2 weeks after withdrawal as a reduction in the median of the mean diameter for the histamine‐induced wheal response of 1 mm (0–1.5). The data implied that apositiveSPT is reliable when liberal definitions are adopted for sensitization and atopy; anegativeSPT is presumably reliable when the measurement artifact is considered and the wheal reaction to histamine is det

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02090.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A two‐site immunometric assay based on monoclonal antibodies (mAb) was developed for the measurement of a 20‐kDa major allergen of cow. The sensitivity of this assay was (BDA20) 1 ng/ml. It was used to measure airborne allergen concentrations in 10 Finnish cowsheds. The mean concentration of the BDA20 measured at two stationary sites was 280 ng/m3. Concentrations varied more than 10‐fold among cowsheds (54–804 ng/m3). The mean intertest coefficient of variation was 8.2%, and the mean intratest variatio

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02091.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Exposure to house‐dust mites (Dermatophagoidesspp.) was investigated in 30 asthmatic patients before and after moving to homes with mechanical ventilation systems. Median house‐dust mite concentration was 110 mites per gram of mattress dust at the initial investigation and 20 mites per gram at the first follow‐up after a mean of 4.7 months in the new homes. This was lower (P<0.05) than counts in a control group of 23 asthmatic patients that had unchanged counts. At a second follow‐up, after 15.0 months, mite counts in the study group were further reduced (P<0.01) from initial values. Among 16 patients, with initial mite counts above the recommended threshold limit value (TLV) of 100 mites per gram of dust, the mite counts fell, in most cases, below this TLV. Air‐exchange rates increased (P<0.001) from a median value of 0.40 air changes per hour (ach) to 1.52 ach at the second follow‐up investigation. Furthermore, a reduction (P<0.01) was found in indoor absolute air humidity, with a median value of 5.6 g of water/kg. No such changes were found in the control group. The present study indicates that reduction of air humidity through an increased supply of fresh air may significantly diminish and, in some cases, even eliminate house‐dust m

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02092.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ELISA is increasingly used to measure antibodies in new circumstances. Recently, it has been applied to the measurement of IgG subclass antibodies against common antigens in early childhood. These studies have raised concerns about the specificity of some of these assays. This paper details the results of experiments which have assessed the specificity of IgG 1 binding to allergens of dust mite (Dermatophagoides pteronyssinus) and ryegrass (Lolium perenne) pollen by inhibition ELISA in the sera of 2‐year‐old children of atopic parents. Six sera which showed binding of IgG 1 toD. pteronyssinusand six toL. perennewere used. All had IgG1 antibody against ovalbumin. In the children's sera, binding to D. pteronyssinus was substantially inhibited by preincubation with the homologous antigen, but not with ovalbumin, thereby confirming the specificity of the assay. However, suppression of IgGl binding toL. perennewith the homologous antigen was comparatively small, and ovalbumin could cause an equivalent inhibition, indicating poor specificity. Furthermore, the level of IgG1 binding toL. perennewas closely correlated to the level of IgG1 binding to ovalbumin (r= 0.98;P<0.001). When the assay was reversed, IgG1 binding to ovalbumin was only slightly inhibited byL. perenne, indicating that most antibody binding to ovalbumin was specific. Thus, binding IgG1 in both adult and child sera toD. pteronyssinusappeared to be specific, while child, but not adult, IgG1 binding toL. perenneshowed poor specificity. This disparity may be due to differences in the affinities of the respective antibodies, and it illustrates the importance of determining assay specificity when making measurements in early childh

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02093.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The hypothesis was tested that wall‐to‐wall carpets on school classroom floors have a negative effect on the respiratory health of asthmatic children. Asthmatic patients (n= 98) were selected from the records of the Sophia Children's Hospital in Rotterdam. The patients were between 5 and 11 years old. All children had peak‐flow measurements three times a day for a 1‐month period. The parents of the children completed a diary in which respiratory symptoms and medication use were recorded daily for the same period. Dust samples were taken from classroom floors, living‐room and bedroom floors, and mattresses of the children. The dust samples were analyzed forDer pI content, the major allergen of the house‐dust miteDermatophagoides pteronyssinus.The results of the study showed that there was no significant difference between children visiting schools with or without carpeted classroom floors in peak‐flow variability, acute respiratory symptoms, or medication use. TheDer pI content of dust collected from classroom floors was much lower than of dust collected from homes. There was a significant correlation between peak‐flow variability and mattress dustDer pI content in asthmatic children sensitized to dust mites, but not between peak‐flow variability and classroom floor dustDer pI content. We concluded that carpeted classroom floors do not contribute to asthma symptom severity, possibly because of the low levels

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02094.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

How are the serum concentration of eosinophil cationic protein (S‐ECP) and the blood eosinophil count (B‐Eos) related to symptoms of asthma, allergy, and bronchial hyperresponsiveness (BHR)? We measured S‐ECP, B‐Eos, and total and specific IgE in serum in blood samples from 699 randomly selected persons 20–44 years old. They also underwent a structured interview, spirometry, a methacholine provocation test, and skin prick tests as part of the European Community Respiratory Health Survey. B‐Eos and S‐ECP were found to be closely related to asthma symptom score (P<0.001), total IgE (P<0.001), and BHR (P<0.001). On the basis of the results, the subjects were divided into four groups: healthy controls, patients with allergic rhinitis, patients with nonallergic asthma, and patients with allergic asthma. There were significant differences in both B‐Eos and S‐ECP among the groups (P<0.001), the highest values being found in the allergic asthma group. B‐Eos and S‐ECP each had an additive value in predicting the occurrence of asthma. Among persons with high concentrations of both variables, asthma was eight times more common than in those with low concentrations. Allergy and BHR were also found to be independently related to B‐Eos and S‐ECP levels. Furthermore, both B‐Eos and S‐ECP showed good correlation to subjective and objective measures of asthma activity. We conclude that both B‐Eos and S‐ECP and their interrelationship may be of value in assessing the activity of asthma. However, their role in disease management was not establis

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02095.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This study investigated the association of asthma, allergic rhinitis, and eczema in United Arab Emirates (UAE) schoolchildren with allergic conditions in their parents. A cross‐sectional, population‐based study among schoolchildren aged 6–14 years was conducted in Al‐Ain City, UAE. The field survey was conducted from October 1992 to May 1993. A questionnaire was distributed to 850 UAE government school students from representative, randomly selected schools with a majority of UAE nationals. The student and both or either of the parents were present during the interview. A detailed clinical history of asthma and wheezing in the target children and a history of asthma and allergic rhinitis in their parents and siblings were obtained. It was found that 13.1% of asthmatic children had mothers with asthma (relative risk (RR) = 2.67; 95% confidence intervals (CI)= 1.65–4.35), and 15.2% had fathers who were asthmatic (RR = 2.85; 95% CI = 1.81–4.49). This contrasted with 4.4% of nonasthmatic children who had fathers with asthma, and 4.1% who had mothers with asthma. A similar pattern was seen with symptoms of allergic rhinitis when it was found that 34.3% of children who had asthma had mothers with allergic rhinitis (RR: 2.74; 95% CI: 1.90–3.94). The corresponding figure for fathers was 12.7% (RR: 0.92; 95% CI: 0.5–1.7). The frequency of either parent of the asthmatic children having allergic rhinitis was 28.6%; for both parents, it was 14.5%. It was also found that asthmatic children had 12.5% of their fathers, 32.8% of their mothers, 26.4% of either of their parents, and 33.3% of both their parents suffering from allergic rhinitis. Siblings of the asthmatic children were also studied to establish the relationship between allergic conditions in the siblings and asthma in the study sample. It was found that in the asthmatic study population the frequency of siblings having asthma was 31.9%; of those having allergic rhinitis, 21.3%; and of those having eczema, 16.1%. Twenty‐nine percent of either of the parents of the children with eczema had the same condition, and the corresponding figure for allergic rhinitis was 36.5%. The prevalence rate of asthma in the schoolchildren studied increased dramatically to 22% when wheeze, asthma, or nocturnal cough were grouped together. When eczema and allergic rhinitis were also considered together along with the above, the rate increased to 31%. The size of the family did not seem to affect the parent/child association of allergic symptoms. Our findings indicate that there is a strong association between respiratory allergies and eczema in parents and in their asthmatic children, thereby indicating a strong genetic basis for the occurrence of asthma in particular and

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02096.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In a French region where farmer's lung (FL) is common, we determined the prevalence of FL precipitins in dairy farmers and analyzed the relation between the presence of FL precipitins and the clinical probability of the disease. All the exposed dairy farmers of both sexes (n= 2555) from five districts of the Doubs department were asked to respond to a medical and professional questionnaire. A total of 1763 (69%) farmers agreed to participate. Precipitins tests were conducted in 551 (31%) farmers who showed any respiratory symptom and in a random sample of 100 asymptomatic farmers. Serum for each farmer was analyzed by both double diffusion and immunoelectrophoresis againstMicropolyspora faeni(MF) and extracts of moldy hay (HE) from Doubs. The 651 farmers were then divided into four groups (G 1–4) with a decreasing probability of FL (G1: typical FL symptoms; G4: asymptomatic farmers). The estimated prevalence of precipitins in the whole population was as follows: 1) by double diffusion, against HE: 83%, against MF: 27%; 2) by immunoelectrophoresis, against HE: 26%, against MF: 19%. There was a close “linear” relation between the prevalence of precipitins detected by immunoelectrophoresis against HE and the symptoms: 51% in G1, 36% in G2, 29% in G3, and 13% in G4. Precipitins detected by immunoelectrophoresis were also related to exposure and geography (more immunization in tableland area than in plain or mountain area). Presence of precipitins detected by double diffusion was not related to symptoms, exposure, or geography. This study shows that the prevalence of precipitins is high in the exposed dairy farmers of Doubs, and suggests that immunoelectrophoresis (with the antigens used) is a more effective method for the diagnosis of FL than double diff

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb02097.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY