ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04484.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04485.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We investigated whether sodium cromoglycate 10 mg three times daily, delivered as an aerosol via Nebuhaler (in addition to terbutaline 0.5 mg three times daily), could replace inhaled steroid in children with mild‐to‐moderate asthma. Children (mean age 10.3 years) were randomly allocated to 12‐week treatment with sodium cromoglycate 10 mg plus terbutaline 0.5 mg (group A;n= 30) or placebo plus terbutaline 0.5 mg (group B;n= 32), both taken three times a day. The daily steroid dose was reduced by 50 μg/week for 4 weeks from a starting dose of 200 μg. Fewer patients withdrew owing to worsening asthma from group A (n= 1) than group B (n =11). Symptom scores, morning and evening peak flows, and additional β2‐agonist usage, recorded on diary cards, were better in group A than group B. Lung function measured at clinic visits was unchanged in either group. Overall opinions of efficacy favoured Group A. Adverse events were similar in the groups. Sodium cromoglycate plus terbutaline substituted effectively for inhaled stero

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04486.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In 12 house‐dust‐mite‐infested double beds, one of the mattresses was replaced by a new one, the other being regarded as a mite source. Allnewmattresses were treated in a double‐blind fashion, with either benzyl benzoate or placebo before being placed on the bed as well as 1 year later. They were examined for mites and allergen concentrations over a period of 18 months. This period of time covered two mite seasons. Dust samples were taken bimonthly and analyzed by guanine test strip, microscopic mite counting, and determination of the mite allergens Der p 1 (Dermatophagoides pteronyssinus) and Der f 1 (D. farinae) by ELISA. Although, at the end of the observation period, the new mattresses still had significantly lower mite and allergen levels than the old mattresses, there were no significant differences between the placebo and the benzyl benzoate groups. In our setting, benzyl benzoate plus frequent cleansing was not significantly more effective in controlling mites than frequent cleansin

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04487.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Allergic disease is reflected in a chronic inflammatory response to an allergen. It is thought that local allergen priming underlies this chronicity. To assess the effect of allergen priming on the amplitude and histologic effect of the allergic reaction, four sequential, intracutaneous skin tests were done with 48‐h intervals in 13 patients allergic to the house‐dust miteDermatophagoides pteronyssinus(Dpt). Reactions were measured at 15 min, and at 6, 24. and 48 h. Subsequently, epicutaneous tests were done on Dpt‐primed spots (n= 5). At 6, 24, and 48 h, reactions increased after priming (P<0.006), with unaltered early reactions. Epicutaneous reactions to Dpt on primed spots were larger than in epicutaneous controls on similarly primed skin. Local intradermal priming results in greater inflammatory responses at both intra‐ and epicutaneous challenge. This mechanism may explain the chronicity of allergic reactions at epithelial s

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04488.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We have previously reported the cases ofCandida albicans (C. alb) acid protease (CAAP)‐induced atopic asthma. In this study, the allergenicity of the released enzyme CAAP was examined among asthmatic patients with positive immediate skin response to crudeC. albantigen. Among 49 patients with positive skin response to crudeC. alb, anti‐crudeC. albIgE antibodies were detected in 40 and anti‐CAAP IgE antibodies were detected in 18. Moreover, anticrudeC. albIgE antibodies were detected in all of the patients in whom anti‐CAAP IgE antibodies were detected. No correlations between IgG antibodies to both antigens or between IgE and IgG antibodies to CAAP were observed. CAAP induced significant T‐cell proliferation in 20/28 patients showing positive T‐cell proliferation response to crudeC. albantigen. Most of the patients showing positive conjunctival response to crudeC. albantigen also showed positive response to CAAP. Most of the patients showing high levels of serum IgE antibody and positive histamine‐release response of peripheral blood leukocytes to CAAP showed positive conjunctival response. The results indicate that CAAP is an important allergen inC. alb‐related

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04489.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Sedation is regarded as a common side‐effect of most H1‐antihistamines. This view must be accepted. yet can hardly be assessed under treatment of allergic disorders. Since central sedative potency is hard to evaluate, different methods of measurement have been introduced in the four phases of clinical investigation. While tests of high complexity in early trials can detect true central effects, they seem to have the disadvantage of not taking into consideration the important interactions of drugs with the disorder. Therefore, we used a visual analog scale (VAS) as an instrument to demonstrate sedative effects in five clinical studies carried out between 1989 and 1994 with a total number of 1070 patients. Thereby, we could assess the result of the different components of the central interaction. In 1989, in a double‐blind, placebo‐controlled trial, we could show that the vigilance of patients suffering from seasonal allergic rhinitis increased significantly more under treatment with an antihistamine (mizolastine) than under placebo. From 1992 until 1994, we compared azelastine nasal spray either by the double‐dummy technique with oral antihistamines (cetirizine, loratadine, and astemizole) or by the double‐dummy or placebo‐controlled design with monotherapy or combined therapy with azelastine tablets. A marked or statistically significant improvement of vigilance was found for all compounds (loratadine:P<0.0001; cetirizine:P<0.0254; and azelastine nasal spray:P<0.1409 toP<0.0001). Even when taking azelastine as oral application, patients, in spite of the warning, reported a similar increase in vigilance (P<0.2628 toP<0.0001). Finally, we assessed the range of physiologic vigilance using the same VAS in healthy volunteers. In conclusion, we could prove that in all trials the baseline values of vigilance of untreated symptomatic patients were far below physiologic condition and improved under treatment to the upper range of healthy persons. Therefore, any sedative properties of modern H1‐antihistamines should not limit their therapeutic use. since the truly threatening sedation results from the

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04490.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Although asthmatic children are often sensitized to the house‐dust mite (HDM) during early childhood, it is not clear what antigenic components are associated with the early immune response of these children. To investigate this problem, we evaluated IgE, IgG, and IgG4 antibody responses toDermatophagoides farinae(Df) by immunoblotting among three groups of children: group I aged 0–4 years, group II aged 5–9 years, and group III aged 10–14 years. In the group I subjects, positive IgE‐binding reactions to 15– and 25‐kDa components were found in 76% and 44% of sera, respectively. Those to other components were generally low in frequency. In contrast, positive IgG‐binding reactions to 15– and 25‐kDa components were found in 44% and 24% of sera, and those to 30– and 110‐kDa components in 48% and 88% of sera, respectively. Positive IgG4 reactions to 15– and 25‐kDa components were found in 48% and 24%, respectively, and those to other components were very low. Positive IgE‐binding reactions to these components gradually became more frequent with increasing age in groups II and III, while IgG and IgG4 reactivities were not markedly different in these age groups. These results suggest that the 15‐and 25‐kDa proteins of Df are important antigens associated with the initial IgE response to HDM in early childhood, while the 30– and 110‐kDa proteins are associated wit

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04491.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A case of occupational bronchial asthma due to morphine in a nonatopic 46‐year‐old woman is presented. The following diagnostic tests were used: a workplace trial with bronchodilator and placebo, and single‐blind, placebo‐controlled nasal and bronchial challenge with 0.5% morphine HCl. For the nasal challenge, four asthmatic patients were selected as a control group. The nasal washings were done before and 30 min, 3 h, 24 h, and 48 h after all challenges. In the nasal lavage fluid, the total numbers of eosinophils, neutrophils, basophils, and mast cells were counted, and, after the nasal challenge, total protein and albumin levels were measured. During the workplace trial, the PEF variability ratio increased from 5% to 38%. After the challenges, a decrease in the spirometric parameters (VC and FEV1) of about 30–40% was observed, with minimums at 24 and 48 h. An influx of granulocytes with an increase in the relative number of eosinophils and basophils from 3 h until 48 h after the challenge was observed in the nasal lavage fluid. The protein level in the nasal lavage fluid increased from 190 to 1275 μg/ml 24 h after the challenge with an increase of relative albumin level from 24% to 40% at 24 h. In the control group, no changes in relative number of basophils and eosinophils and albumin/total protein ratio in the nasal lavage fluid or in the spirometric parameters were observed after the

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04492.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

We describe two uncommon cases of oral allergy syndrome (OAS) after eating pistachio nuts (p.n.) in subjects (a 54‐year‐old man and a 3‐year‐old girl) with exclusive skin prick test (SPT) positivity toParietaria (P.) and pistachio nut (p.n.) allergens. SerologicP.‐and p.n.‐specific IgE determinations were also carried out. A double‐blind, placebo‐controlled food challenge (DBPCFC) was performed, for ethical reasons, only in the adult patient, but we observed a positive intraoral reaction only after slight scratching of the oral mucosa. Since this patient had put three whole p.n. with their shells into his mouth, breaking them with his teeth, before the onset of symptoms, we suggest that slight injury of the oral mucosa may enhance the local response. Preliminary results with SDS‐PAGE and immunoblotting demonstrate the occurrence of a slight degree of cross‐reactivity between these allergens, hut further studies are necessary to obtain a

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04493.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY