ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04631.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Determination of Hymenoptera venom (HV)‐specific serum IgE antibodies is a useful diagnostic method in patients with systemic anaphylactic reaction (SAR) to Hymenoptera stings. In a general population cohort, we determined the prevalence of SAR and HV‐specific IgE antibodies and assessed parameters associated with the latter. A total of 277 voluntarily participating inhabitants of rural Bavaria (Germany) (232 adults, mean age 38.0 years; 45 children, mean age 8.4 years) were investigated for a history of atopic disease or SAR to insect stings; in 258 of these, total IgE and specific IgE antibodies to HV (Apis melliferu, Vespulu vulguris/germanica) and four common aeroallergens (birch pollen, grass pollen, house‐dust mite, and cat dander) in the serum were determined. Nine (3.3%) subjects reported SAR to insect stings. In 27.1% of the sera, specific IgE antibodies to HV were found, to bee venom in 24.8%, and to wasp venom in 8.5% (P100 kU/1 (OR=3.88; CI 1.98‐7.60), and specific IgE antibodies to three of the four aeroallergens (grass pollen, OR = 7.24 CI 3.66‐14.38; birch pollen, OR=3.67 CI 1.54‐8.81; and house‐dust mite, ORz4.61 CI 2.08–10.32). It is concluded that immunologic sensitization to HV is common in the general population and is associated with atopy‐related I humo

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04632.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

An analytic procedure was established to characterize bovine dander proteins with allergenic properties. The proteins from dander extract were separated by size‐exclusion gel filtration, and the fractions were studied with SDS‐PAGE followed by immunoblotting. An 11‐kDa allergen was found in the same gel filtration fractions as 20‐ and 22‐kDa allergens, and this suggests that the 11‐kDa allergen is a dimer in its native form. Our method also detected two separate 22‐kDa allergens. The primary structure of the major bovine dander allergen (BDA20) was also studied. A protein sequencer was used to determine the amino acid sequences of enzymatically cleaved peptides. The homology searches revealed that BDA20 is not a previously known b

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04633.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In recent years, patients allergic to amoxicillin (AX) but with good tolerance of penicillin G (PG) have been described. It has been suggested that the epitope implicated in this type of sensitization might be located on the side‐chain of the AX molecule. Thus, cross‐reactivity between AX and cephadroxil (CEPH), a cephalosporin which shares an identical side‐chain with AX, is suspected. This study aimed to demonstrate clinical cross‐reactivity between AX and CEPH in patients allergic to AX and showing good tolerance of PG. In 76 of 576 subjects with suspected allergic reaction to PG and/or AX, the diagnosis of allergy was confirmed. All of these had specific IgE to PG, penicillin V, or AX, and/or positive skin tests to PPL (penicilloyl‐polylysine), or MDM (minor determinant mixture), or PG. or AX, and/or positive challenge tests with PG and/or AX. Sixteen subjects (21%) allergic to AX (11 with positive skin test and five with positive challenge test to AX) and good tolerance of PG (all with negative parenteral challenge test) were selected. These 16 patients were subsequently challenged with CEPH (up to 500 mg). Fourteen patients tolerated CEPH, and two (12%) had an immediate allergic reaction. Our study indicates that allergy to the side‐chain of aminopenicillins seems to have little clinical relevance in patients with allergic reactions to aminopenicillins but with good tolerance of PG, as 88% of patients with this clinical characteristic tolerate a cephalosporin which shares an identical side‐chain. It seems that IgE from most of these patients recognizes an epitope different from the side‐chain and th

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04634.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A group of 28 patients from Italy was studied who had asthma after consumption of snail. All patients also had asthma and/or rhinitis caused by house‐dust mite. RAST analyses confirmed the combined sensitization to snail and mite. In a few sera, IgE antibodies reactive with other foods of invertebrate origin (mussel and shrimp) were detected. RAST inhibition showed that most IgE antibodies against snail were cross‐reactive with house‐dust mite. In contrast, the mite RAST was not significantly inhibited by snail. This indicates that house‐dust mite was the sensitizing agent. Immunoblot analyses revealed multiple bands in snail extract recognized by IgE. In contrast to what has been described for cross‐reactivity between shrimp and mite, tropomyosin played only a minor role as a cross‐reactive allergen in these patients. The observations in this study indicate that snail consumption can cause severe asthmatic symptoms in house‐dust‐mite‐allergic patients. It might, therefore, be advisable to screen mite‐allergic asthma patients for allergy to snail and other invert

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04635.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Histamine is one of a range of mediators which play an important role in asthma, and the “releasability” of basophils has been shown to be upregulated in this disease.In vitro, β2‐agonists and to a lesser extent corticosteroids have been shown to reduce histamine release. Theex vivoeffects of salmeterol and inhaled corticosteroids on histamine release were studied in 78 asthmatic patients with variable disease severity and 20 control subjects. Spontaneous and anti‐IgE‐induced histamine release was measured in all subjects. Fifteen patients were not receiving any form of treatment, 42 were treated with inhaled corticosteroids, and 21 received inhaled corticosteroids and salmeterol. Seven patients treated with inhaled corticosteroids and seven patients treated with inhaled corticosteroids and salmeterol were tested twice to assess the effect of salmeterol on histamine release. Nine patients treated with inhaled corticosteroids were tested before and after 1 month of salmeterol treatment to determine the possible inhibition by salmeterol. Patients who were treated with inhaled corticosteroids and salmeterol showed significantly lower levels of spontaneous histamine release (median: 2.5%) than untreated (5.2%) and inhaled corticosteroids‐treated asthmatics (3.4%). No tachyphylaxis to salmeterol was observed when patients were tested twice at a 3‐month interval. This study suggests that salmeterol may have an additive anti‐inflammatory effect with inhaled corticosteroids, although this hypothesis must be tested by further studies involving cells obtained by bronchoalveolar lavage and studies with br

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04636.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In the literature, bronchial allergen challenge is usually reported to result in an increase in histamine‐induced airway responsiveness (AR). The present study investigated the relation between baseline AR and allergen‐induced changes in AR. The effect of allergen challenge on AR was investigated in 21 atopic asthmatic patients. Allergen challenge resulted in a significant decrease in PC20histamine after 24 h. When the group was divided into three subgroups according to baseline PC20histamine, a significant decrease in PC20histamine was found only in patients with relatively high baseline PC20histamine (groups 1 and 2). A significant inverse correlation was found between baseline PC20and allergen‐induced PC20histamine. The effect of repeated allergen challenge on AR was studied in eight patients. The first allergen challenge resulted in a significant decrease in PC20histamine; no further decrease in mean PC20histamine was seen after the second allergen challenge. These results suggest that allergen‐induced changes in AR occur mainly in patients with relatively high baseline PC20values. Once an increase in AR is induced, further allergen challenge does not always result in further increas

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04637.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In order to establish the most efficient thresholds for serum allergen‐specific IgE measured by the Pharmacia CAP System, a “second‐generation”in vitromethod, we evaluated results from 89 subjects with suspected inhalant allergies, using receiver‐operating characteristic (ROC) curve analysis. Sera samples were analyzed by the Pharmacia CAP System for specific IgE, the choice of allergens to be tested being based upon the symptoms and clinical history of each patient. Results were analyzed by ROC analysis for the five most representative allergens, cat dander (e1),Dermatophagoides pteronyssinus(dl),Lolium perenne(g5), wall pellitory (W19), and wormwood (w5). The areas under the ROC curves were found to be satisfactory, ranging from 0.931 (e1) to 0.974 (g5) when we excluded w5, which had a significantly smaller area (0.81). To establish the most efficient threshold for each allergen, we calculated the clinical sensitivity, specificity, efficiency, and negative and positive predictive values. The thresholds giving a higher diagnostic efficiency were as follows: 0.40 kUa/l for dl, 0.55 kUa/l for g50.50 for el, 0.65 kUa/l for w19, and 1.00 kUa/l for w5. It is concluded that quantitative reporting of specific IgE measurement has numerous advantages, but the choice of the positive threshold seems to be a prerequisite for obtaining the optimal clinical efficiency. It is also suggested that a specific threshold should be adopted for each

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04638.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Docena GH, Fernandez R, Chirdo FG, Fossati CA. Identification of casein as the major allergenic and antigenic protein of cow's milk. The objective of this study was to analyze both the allergenicity and immunogenicity of cow's milk proteins. To this end, 80 milk‐atopic patients were selected on the basis of the presence of cow's milk‐specific IgE antibodies in serum and compatible clinical history. Fifteen patients allergic to other allergens and 10 nonatopic subjects were studied as controls. The specificity of serum IgG and IgE antibodies was determined by immunoblotting, employing both cow's milk and milk components, i.e., α‐ and β‐casein, β‐lactoglobulin, and α‐lactalbumin separated by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDS‐PAGE). The experiments showed that casein‐specific IgE antibodies were present in all (80/80) sera examined; 10/80 showed reactivity to β‐lactoglobulin, and 5/80 showed reactivity to α‐lactalbumin. None of the 25 negative control sera analyzed showed the presence of specific IgE antibodies against milk proteins. These results were similar to those corresponding to the detection, by the radioallergosorbent test, of IgE antibodies against the milk components coupled to paper disks. All sera from milk‐atopic patients also showed IgE reactivity against a high‐molecular‐mass fraction that hardly enters the gel. This fraction, after separation by gel filtration and treatment with β‐mercaptoethanol and urea, was shown by SDS‐PAGE analysis to be formed by casein monomers. All sera analyzed by immunoblotting reacted against the components corresponding to casein monomers. Inhibition of immunoblotting by adsorption with different milk components confirmed that those high‐molecular‐mass aggregates are formed by casein components. The results presented here strongly suggest that casein is th

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04639.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We report a female patient with adult onset of cow's milk protein allergy. For 1 year, she experienced repeated gastrointestinal symptoms and had a single exercise‐induced anaphylactic reaction. In addition to positive skin tests and specific IgE to milk proteins and a positive challenge test, immunohistochemistry of the small intestine showed a marked increase of IgE‐positive mast cells. This finding is highly specific and could provide an additional tool for diagnosing cow's milk protein allergy and possibly also other food allerg

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04640.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY