ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01166.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.tb01167.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.tb01168.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Blood levels of inhaled corticosteroids are significantly lower than those measured in the lung, but their concentration could still have anti‐inflammatory effects. To determine whether budesonide, at concentrations similar to those obtained in blood after drug inhalation (10−9M), could downregulate the allergen‐induced activation of mononuclear cells, we studied 21 atopic patients, sensitized toDermatophagoides pteronyssinus (Der p).On blood mononuclear cells, isolated from these patients, incubated withDer pallergen extract and with or without budesonide, we evaluated: 1) the proliferative response of T cells; 2) the expression of two surface activation markers, the HLA‐DR antigens and the interleukin (IL)‐2 receptors; and 3) the release of cytokines known to modulate the allergic processes. Allergen‐induced T‐cell proliferation was associated with increased HLA‐DR antigen and IL‐2 receptor expression (P<0.001), and with increased release of IL‐2, interferon‐gamma (IFN‐γ), IL‐1β, tumor necrosis factor‐alpha (TNF‐α), and granulocyte/macrophage colony‐stimulating factor (GM‐CSF). The addition of budesonide at the beginning of the cell cultures induced a dose‐dependent inhibition of T‐cell proliferation, still significant (P<0.05) at the lowest concentrations tested (10−9and 10−10M). A significant inhibitory effect on T‐cell proliferation was also present when budesonide (10−9M) was added to the cell cultures 3 or 5 days after the beginning of the cell cultures. In addition, budesonide 10−9M significantly decreased the expression of IL‐2 receptors (P<0.05), but not of HLA‐DR antigens, and significantly reduced the release of IL‐1β and GM‐CSF (JP<0.05), but not of IL‐2, IFN‐γ, and TNF‐α. Thus, the blood concentrations of budesonide, after drug inhalation, may exert some anti‐inflammatory effect, downregulating both “local” (through the

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01169.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Grass pollen immunotherapy is effective, although efficacy must be balanced against side‐effects. In a double‐blind, placebo‐controlled trial of 40 adult patients with summer hay fever, immunotherapy with a depot grass pollen extract (Phleum pratense, Alutard SQ) reduced symptoms and medication requirements with an acceptable minimal level of side‐effects (31). The original placebo group, as well as the actively treated group, have now received active immunotherapy in an open fashion for a further 3 years. An important question was whether continued injection treatment was accompanied by maintained clinical improvement. By analysis of diary symptoms, rescue medication, and visual analogue scores during the pollen season, we show that efficacy was maintained throughout the 3–4‐year study period. Clinical improvement was accompanied by a sustained and marked decrease in immediate conjunctival allergen sensitivity and a further significant decrease in the size of the allergen‐induced late cutaneous response. In contrast, an initial decrease in the allergen‐induced immediate cutaneous response was not maintained at 3–4 years. Of the patients, 37/40 completed the first year, 33/40 the second year, and 32/40 the third year of treatment. Patients dropped out for reasons other than the outcome of immunotherapy. During a total of 2598 injections, five immediate systemic reactions were observed, all during the induction (not maintenance) phase, and all occurred within 10 min of injection and responded promptly to adrenaline. Grass pollen immunotherapy is effective and safe, provided it is performed on carefully selected patients by trained physicians with immediate access to resus

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01170.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The aim of this study was to assess the ability of the H1‐receptor antagonist loratadine to modify anti‐IgE‐induced cutaneous wheal‐and‐flare and late‐phase reactions (WFR and LPR), as well as histamine release and leukocyte accumulation in skin chambers. For this purpose, 10 atopics with allergic rhinitis were entered into a double‐blind crossover study in which they received either placebo or loratadine (20 mg/day orally) for 8 days separated by a 7‐day washout period. Blisters were induced on both forearms on day 7 of each treatment period, and were unroofed on day 8 and covered with plastic skin chambers. Chamber fluids were collected during 7 h after 1‐h incubation with anti‐IgE or control IgG. Intradermal challenge with histamine and anti‐IgE was performed at the same occasion. As compared to placebo treatment, loratadine inhibited the immediate WFRs to anti‐IgE by 35% (wheal) and 65% (flare), respectively (P<0.01), and corresponding reactions to histamine challenge by 50% and 70% (P<0.001), respectively. Moreover, the initial phase (0‐2 h) of the LPR induced by anti‐IgE was attenuated by up to ∼60% (P<0.001) during loratadine treatment. Thereafter, no inhibition of the LPR was observed. The magnitude and time course of histamine release into skin chambers was virtually the same after loratadine and placebo treatment, with a peak during 0‐1 h and a progressive decline during the following 2 h. Accumulation of α2‐macroglobulin, reflecting extravasation of large plasma proteins, also peaked during the first hour and was unaffected by loratadine during the 8‐h observation period. Moreover, loratadine did not reduce the anti‐IgE‐induced recruitment of eosinophils or other subtypes of leukocytes. Altogether, loratadine inhibited both the WFRs to histamine and anti‐IgE and the initial phase of the IgE‐mediated LPR. However, loratadine did not express anti‐inflammatory activity with respect to mast‐cell mediator release or leukocyte recruitment. The latter findings are in contrast to the action of loratadine in allergic rhinitis and conjunctivitis, suggesting that the actions of loratadine may be organ specific and that the effects of loratadine cannot a

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01171.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The major allergen from birch pollen,Bet vI, and the cross‐reacting 18‐kDa major allergen from Golden Delicious and Granny Smith apples were isolated by micropreparative SDS‐PAGE followed by electroelution. In the case of apples, highly active, low‐temperature extracts were used. The purity of the allergens was checked by analytic SDS‐PAGE and immunoblotting with allergic patients’ sera, as well as by N‐terminal amino acid microsequencing, and the allergens were found to be very pure. The strong immunologic activity of the isolates was determined by the enzyme allergosorbent test (EAST) and EAST inhibition assays; this activity was, in the case ofBet vI, similar to that of a preparation obtained by monoclonal antibody affinity chromatography. The allergenic potency ofBet vI and of the cross‐reactive apple allergen was determined by EAST inhibition and dose‐related histamine release. With both assay systems, the allergenic reactivity ofBet vI was considerably higher than that of the major apple allergen. Fürthermore, skin prick tests with the purified allergens and with whole allergenic extracts were performed on a group of 33 patients suffering from birch‐pollen and apple hypersensitivity, and on a control group of 10 patients. The frequency of positive prick test results in the allergic patient group ranged from 73% for the major allergen from Golden Delicious apples to 97% withBet vI and whole birch pollen extract, respectively. In contrast to our low‐temperature extracts, commercial prick test solutions of four different manufacturers were found to be unreliable for the diagnosis of apple allergy. The skin test results again indicated the strong immunologic activity of the allergen isolates and the predominance of the major allergens in context with birch‐pollen and apple hypersensitivity. Taken together, the results support the view that the 18‐kDa major allergen represents most of the allergenicity of the the apple fruit, and that all allergenic epitopes of the apple pro

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01172.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Extracts from birch (Betula verrucosa) pollen were prepared at different pH, with constant pH monitoring and adjustment to preset values in the range 5.5‐8.5. The total protein content of these extracts was directly correlated with the pH. Coomassie brilliant blue‐stained isoelectric focusing and SDS‐PAGE gels and immunoblot analysis demonstrated qualitative differences: some proteins were lost while others appeared when pH was changed. At pH 8.5, formerly unknown birch pollen allergens were detected with pi 9, 9.10, and 9.30 by about 30% of birch pollen‐sensitive sera. Birch pollen extracts prepared at a pH close to neutrality, namely, 6.5 and 7.5, showed the greatest protein and different allergen diversity. Thus, extraction pH values are necessary to analyze the whole pattern of allergenic components in an

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01173.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

A female patient experienced a severe allergic reaction after consumption of vineyard snails. The patient proved to be sensitized to house‐dust mite (HDM) and demonstrated a positive skin test and specific IgE to snail (Eobania vermiculata, Lofarma). The snail RAST was>80% inhibited by HDM, whereas the mite RAST was<10% inhibited by snail extract. This is possibly another example of food allergy related to primary sensitization by an aeroallerge

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01174.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This paper describes the identification of important allergens from the granary weevil (Sitophilus granaries) (Sg). Sera from Danish bakers whose skin prick tests were positive to extracts of Sg were screened for IgE against Sg extracts. We found that 54% (n= 66) had elevated levels of IgE (RAST classes 1–3, by luminescent immunoassay) against whole‐body extracts of Sg. The specificity of patient IgE was investigated in an inhibition‐dot immunoblotting assay. IgE binding was inhibited in all sera but two, thus indicating that the patients’ IgE was indeed specific for the Sg extract. In crossed immunoelectrophoresis, 23 different proteins were identified. All RAST‐positive sera were investigated in crossed radioimmuno‐electrophoresis. At least 11 proteins in the Sg extract were capable of binding IgE. All individual sera reacted with at least four different proteins. The two most prominent allergens bound IgE from 88% and 100%, respectively, of the patients. These two are considered to be the most important allergens from Sg, and will be useful as markers in environmental immunochemical assays to detect allergens in samples from bakeries, grain

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1995.tb01175.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY