ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02578.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02579.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Levels of specific serum IgE to cow's milk, whole hen's egg, egg white, and egg yolk were compared to the outcome of double‐blind, placebo‐controlled food challenge ‘DBPCFC) with fresh egg and/or milk in 21 adults with a case history of immediate hypersensitivity to egg and/or milk. Specific serum IgE was measured by four different commercially available tests and by an inhouse Maxisorp RAST using freshly prepared food extracts. Sensitivities and negative predictive accuracies were generally high with egg white and milk, but low with egg yolk. Specificities and positive predictive accuracies were low for all allergens and tests. Changing the cutoff levels did not improve the ability of the tests to predict clinical allergy. Among commercially available test allergens, egg white gave the most consistent results in levels and class scores, and the highest degree of concordance with DBPCFC, whereas egg yolk and milk varied more. Applying freshly prepared food extracts in Maxisorp RAST did not improve diagnostic value. Measuring specific serum IgE levels in control subjects tolerant to egg/milk showed that false positive reactions occurred frequently among patients with another food allergy and atopic dermatitis, whereas most tests were likely to be negative in pollen‐allergic and nonallergic volunteers. In conclusion, specific IgE measurements with egg white and milk were useful for exclusion of symptomatic hypersensitivity to egg and milk in patients with a positive history, whereas DBPCFC is still mandatory in patients with positive history and positive test. Measuring egg‐yolk‐specific IgE or using freshly prepared food extracts for specific IgE measurements added no further diagnostic information. The rate of clinically insignificant positive test results seems to be influenced by the prevalence of other food allergies and/or atopic dermatitis in the population

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02580.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Pityrosporum orbiculare and Candida albicans extracts were separated bySDS‐PAGE, and IgE binding was detected by immunoblotting with 21 patient sera that were RAST positive to both yeasts. Cross‐wise inhibition was performed of IgE binding of a serum pool containing IgE antibodies to both yeasts. The pool was mixed with serial dilutions of P. orbiculare or C. albicans extracts, and incubated with strips containing separated allergen. IgE binding was quantified by densitometric scanning and percent inhibition was calculated as well as the respective ratios between required extract concentration for 50% inhibition in heterologous compared to homologous inhibition for each component ‘inhibition ratio). Ten componentsof P. orbiculare were detected by more than 60% of the sera. IgE binding toC. albicans was weak, and only to four bands was IgE binding detected by more than 30% of the sera. The most important C. albicans allergen was a 48‐kDa band, to which IgE of half of the patient sera bound. There was little inhibition of IgE binding to P. orbiculare with C. albicans. Thus, all but three components exhibited an inhibition ratio higher than 100.The inhibition ratio of the 48‐kDa C. albicans compound was 50, thus indicating some degree of cross‐reactivity. Significant cross‐reactivity was shown by C. albicans compounds of 18, 24, 26, 34, and 38 kDa, the inhibition ratios of which were less than 10. There was some degree of cross‐reactivity between apparent protein allergens of the two yeasts, but IgE antibodies to C. albicans donot merely reflect sensitization t

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02581.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Inhaled formoterol is a potent selective β2‐agonist with rapid onset and at least 12‐h duration of bronchodilation. The aim of the study was to compare the bronchodilating effect of inhaled formoterol dry powder ‘dp) 12 μg b.i.d. with salbutamol dp 400 μg q.i.d. and placebo in patients with reversible obstructive airway disease ‘ROAD). The study design consisted of a closed 12‐week double‐blind, placebo‐controlled, multicenter trial followed by an open noncomparative, multicenter, 12‐month follow‐up trial, in which the tolerability of formoterol dp was assessed. A total of 304 patients ‘146 men, 158 women) aged 18‐79 years, ill during 0.1‐64 years, were randomized. No demographic or baseline differences were found among the different treatment groups. The bronchodilating effect of formoterol, assessed by morning premedication PEFR, was significantly superior to placebo ‘P<0.0001) and salbutamol ‘P<0.0001). Efficacy was maintained during the open follow‐up study with 12 μg b.i.d. in most of the patients. A few patients, however, needed 24 μg b.i.d. to control their ROAD. Formoterol 12 μg b.i.d. significantly reduced morning and evening asthma symptoms and sleep disturbances, and reduced significantly the need for rescue medication. The tolerability of the three treatment groups was comparable. In conclusion, formoterol 12 μg dp b.i.d. was significantly superior to both salbutamol 400 μg dp q.i.d. and placebo, and reduced asthma symptoms significantly. Overall, formoterol showed a tolerability profile comparable to that of salbutamol, and no tachyphylaxis wa

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02582.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Over a period of 5 years, an isolated light chain ‘K = 9, λ= 12) was detected in 21 sera by immunofixation electrophoresis. Further analysis with anti‐δ‐ and anti‐ɛ‐specific antisera identified four δ heavy chains, all associated with a λ light chain, and no ɛ heavy chains. For evaluation of the role of two‐dimensional polyacrylamide gel electrophoresis ‘2D‐PAGE) in the diagnosis of IgD paraproteins, as a possible alternative or complement to immunofixation, IgD paraproteins were retrospectively analyzed by 2D‐PAGE. δ Heavy chains migrated to gel areas clearly distinguishable from other heavy chains α, γ, or μ, and in a wide range of isoelectric points ‘pl: 5.4‐8). In one serum, the monoclonal δ chain had a pi range comparable to that of albumin and was undetectable. However, all four δ chains were easily identified when analyzed from affinity‐purified immunoglobulin fractions. These observations showed the following:1) IgD paraproteins are not rare among apparently isolated monoclonal light chains detected by routine immunofixation, Ostrongly confirming the need for further analysis with anti‐δ antisera, before assumption of a light‐chain disease.2) 2D‐PAGE analysis of affinity‐purified immunoglobulin fractions allowed correct identification of IgD monoclonal gammopathies in all cases.3) However, although 2D‐PAGE analysis is now easy to perform, well standardized, and highly sensitive, this technique remains time‐consuming and expensive, and does not appear suitable for routine practice as a first‐line diagnostic procedure.2D‐PAGE should find its place as a complement to immunofixation and in the definitive demonstration, in selected ambiguous cases, of the clonal

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02583.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Ampicillin and benzylpenicillin conjugated to human serum albumin were used as immunogens in order to obtain antihaptenic IgG responses in outbred guinea pigs according to different schedules, all involving complete Freund's adjuvant. The individual responses were characterized by ELISA and by ELISA inhibition using ampicillin, benzylpenicillin, and carbenicillin peptidic conjugates for coating and for inhibition. In several instances, drastically reduced cross‐reactivity and even its absence were observed, although the penicillin antigens differ only in the side‐chain. The notion that the invariantly present thiazolidine ring will always provide significant binding to antibodies against all penicillins differing only in the side‐chain has to be dropped. The experiments were performed in relation to newer findings of clinical penicillin‐allergy skin testing which suggest that benzylpenicillin‐based reagents alone are not able to detect or predict all reactions against semisynthetic penicillins. The experimental evidence here obtained corroborates this c

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02584.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

An optimal stimulation of CD4+cells in an immune response requires not only signals transduced via the TcR/CD3 complex, but also costimulatory signals delivered as a consequence of interactions between T‐cell surface‐associated costimulatory receptors and their counterparts on antigen‐presenting cells ‘APC). The intercellular adhesion molecule‐1 ‘ICAM‐1, CD54) efficiently costimulates proliferation of resting, but not antigen‐specific, T cells. In contrast, CD28 and CD2 support interleukin ‘IL)‐2 synthesis and proliferation of antigen‐specific T cells more efficiently than those of resting T cells. The molecular basis for this differential costimulation of T cells is poorly understood. Cypress‐specific T‐cell clones ‘TCC) were generated from four allergic subjects duringin vivoseasonal exposure to the allergen. Purified cypress extract was produced directly from fresh collected pollen and incubated with the patients' mononuclear cells. Repeated allergen stimulation was performed in T‐cell cultures supplemented with purified extract and autologous APC. The limiting‐dilution technique was then adopted to generate allergen‐specific TCC, which were also characterized by their cytokine secretion pattern as ThO ‘IL‐4 plus interferon‐gamma) or Th2 ‘IL‐4). Costimulation‐induced proliferation or apoptosis was measured by propidium iodide cytofluorometric assay. By cross‐linking cypress‐specific CD4+and CD8+T‐cell clones with either anti‐CD3 or anti‐CD2, anti‐CD28, and anti‐CD54 monoclonal antibodies, we demonstrated that CD4+ clones ‘with ThO‐ or Th2‐type cytokine production pattern) undergo programmed cell death only after anti‐CD3 stimulation, whereas costimulation with either anti‐CD54 or anti‐CD28 protects target cells from apoptosis. The costimulation‐induced protection from apoptotic death was associated with a significant rise in IL‐4 secretion in both Th0 and Th2‐type clones. In contrast, cypress‐specific Th0 CD8+clones were more susceptible to stimulation‐induced apoptosis via either anti‐CD3 or anti‐CD2, alone or in combination with anti‐CD54 or anti‐CD28, thus displaying only slight but nonsignificant modifications in the pattern of IL‐4 secretion. The death‐promoting costimulatory effects were not observed with highly purified normal resting CD4+or CD8+lymphocytes. Taken together, these results suggest that TcR engagement by an allergen in the context of functionally active APC induces activation‐dependent cell death of some, perhaps less specific, cells, and this may be an important homeostatic mechanism through which f

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02585.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The study investigated the effect of the oral H1‐blocker terfenadine on allergen challenge in subjects with nasal allergy in comparison with the topical steroid, budesonide. A randomized, placebo‐controlled, double‐blind, crossover study with 3 experimental days was performed outside the pollen season. Seventeen nonsmokers with hay fever ‘symptoms, positive skin prick test, and RAST against timothy) were treated for 14 days before each experimental day, where the response to nasal challenge with four different concentrations of timothy was measured every 15 min for 6 h. The nasal cavity dimensions were measured by acoustic rhianometry and the olfactory function as the threshold for the sense of smell of butanol. Nasal symptoms were determined by questionnaires. Both terfenadine and budesonide dry powder had an effect on the hay fever symptoms during nasal pollen challenge. Terfenadine was more efficient than budesonide against histamine‐mediated symptoms such as sneezing and itching. Budesonide increased nasal airway dimensions better than terfenadine ‘P<0.01). A marked effect of budesonide was seen 1‐2 h after challenge, suggesting an effect on ‘early late phase’ reaction in the nose. In 7/17 subjects, a significant ‘P<0.05) improvement of olfactory function after budesonide treatment was seen. In conclusion, topical steroid ‘budesonide) is superior to antihistamine ‘terfenadine) in treatment of nasal congestion in hay fever, especially for the postchallenge reaction, and may, in some cases, relieve the decreased sense of smell

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02586.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The low‐affinity IgE receptor ‘FcɛRII) of B cells and monocytes ‐ also known as CD23 ‐ is released from the cell surface by proteolytic cleavage to yield a series of soluble fragments which can accumulate in cell culture supernatants and body fluids. Of these, the most stable is a 25‐kDa molecule which is generated from transient intermediates ranging in size from 29 to 37 kDa. It has been claimed that these latter species act as IgE‐promoting factors while the 25‐kDa molecule is endowed with various cytokine‐like activities which are independent of IgE binding. We describe here a novel enzyme‐linked immunosorbent assay ‘ELISA) which allows for the distinction between these two classes of soluble CD23. It is based on the observation that the CD23 antibody EBVCS1 can capture recombinant 29‐kDa and 37‐kDa fragments of CD23 but does not bind to the 25‐kDa species: when EBVCS5 is used as the capture antibody, all three fragments are bound. The availability of these differential ELISA should facilitate investigations on the biological properties of CD23 fragm

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb02587.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY