ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00735.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In atopic dermatitis (AD), a high prevalence has been reported of type I reactions and specific IgE to extracts of the commensal lipophilic skin yeast Pityrosporum ovale. In the present study, a highly significant correlation (r=0.77) was found between levels of anti‐P, ovale IgE and of IgE reacting with extracts ofCandida albicans, both measured by a sensitive ELISA method. In a series of 128 AD sera, 34 sera reacted positively with both yeast extracts, 38 reacted with P. ovale but not with C. albicans, and only one of the 56 anti‐F. ovafe‐negative sera showed a very weak reaction with C.albicans. The correlation was due to a marked cross‐reactivity, as shown by inhibition ELISA. Eluid‐phase preincubation of double‐positive sera with either of the two yeast extracts resulted in a dose‐dependent, and at high concentrations complete, inhibition of the IgE reactions with both coatedP. ovaleandC. albicansallergens. Mutual inhibition of IgE‐binding could also be achieved with pools of glycoproteins and/or polysaccharides isolated from the crude extracts by Con A affinity chromatography.P. ovaleallergens were, however, more potent fiuid‐phase inhibitors than the correspondingC. albicanscomponents. The apparently higher avidity forP. ovaleallergens suggests that these antiyeast IgE antibodies in AD result from sensitization toP. ovaleand cross‐r

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00736.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Pityrosporum ovalehas recently been recognized as a source of allergens to which many patients with atopic dermatitis (AD) show type I skin reactions and specific IgE antibodies. In this study the IgE‐binding components and/or epitopes inP. ovaleextract were shown to be partially sensitive to pronase or trypsin treatment, whereas periodate oxidation resulted in a complete loss of IgE‐binding capacity, thus suggesting the involvement of carbohydrate structures. In Con A affinity chromatography most of the IgE‐binding capacity of crudeP. ovaleextract bound to the column, and could be eluted with mannoside. Gel filtration on Sephacryl S‐400 revealed a marked heterogeneity with respect to molecular mass, with most of the IgE‐binding activity associated with high‐mol.‐mass fractions (from 5 × 104up to 2 × 106Da). A similar heterogeneity was found after chromatofocusing, with IgE‐binding in the whole pI‐range from 7.0 to 4.0. Essentially identical results were obtained with extracts ofCandida albicans, in agreement with the previously shown cross‐reactivity of IgE‐binding components in the two yeast extracts. In inhibition ELISA, gel filtration and chromatofocusing fractions containing components with widely different mol. mass or pi showed complete reciprocal cross‐inhibition, and were all capable of inhibiting the binding of IgE to unfractionated extracts. We therefore conclude that the cross‐reacting anti‐P. ovale/anti‐C. albicansIgE antibodies in the sera of AD patients are mainly directed at a restricted number of carbohydrate epitope that are expressed on a heterodisperse range of high‐mol‐mass components

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00737.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In order to elucidate the mechanism responsible for infiltration of nasal mucosa by granulocytes, we tested neutrophil chemotactic activity (NCA) in nasal lavages, by the modified Boyden chamber method, in 16 patients with perennial allergic rhinitis (AR), six ASA‐sensitive patients with chronic rhinosinusitis (CRS), and seven normal, nonatopic control subjects (NC). Nasal secretions from all three groups showed significant NCA (mean 157.1±54.0, 62.2±20.7, and 39.4 ± 11.4% of FMLP chemotactic activity for AR, CRS, and NC subjects, respectively). Nasal secretions from patients with AR expressed significantly higher NCA (P<0.02) than did secretions from NA patients.NCA was unchanged by heating at 56°C for 60 min and was not susceptible to degradation by trypsin. Nasal challenge withDermatophagoides pteronyssinusantigen induced clinical symptoms and resulted in significant increases in total protein and albumin concentrations in nasal lavages in AR patients, but failed to change the mean NCA activity for up to 40 min after the challenge. These results indicate that nasal secretions from both atopic and nonatopic patients express NCA, but its relation to allergic inflammation remains to be establ

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00738.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We compared the results obtained with a new specific IgE assay (Pharmacia CAP system) to those of RAST and intradermal skin tests (ST) performed in 87 patients with a history of generalized reaction to honeybee or yellow jacket venom. When CAP and RAST were compared with positive ST performed with honeybee venom, CAP sensitivity was not significantly higher (98%) than that of RAST (95%). When yellow jacket venom was tested, CAP sensitivity (93%) was clearly superior to that of RAST (40%). When we compared the specificities of RAST and CAP to bee venom, RAST was positive in 21% of the 24 subjects with negative ST, and CAP in 42%. Among the 29 patients with negative ST to yellow jacket venom, RAST was positive in 17% and CAP in 28%. These results do not reflect a lower specificity of CAP, because CAP positivities could be inhibitedin vitro, and because, in three patients with a history of anaphylactic reaction (one to honeybee, two to yellow jacket), CAP was the only positive test confirming the clinical observation. Among the 53 patients who were able to identify the offending insect (honeybee, 31; yellow jacket, 22), the cause of the anaphylactic reaction was usually confirmed by ST and CAP: honeybee venom 97% for both ST and CAP; yellow jacket venom 82% for ST, 86% for CAP. This was not the case for RAST, which confirmed honeybee venom hypersensitivity in 87% and yellow jacket venom hypersensitivity in only 41%. Thus, CAP is both more sensitive and more rapid than RAST, without losing specificity.

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00739.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The protective effects of deflazacort against the inflammation that follows the conjunctival provocation test (CPT) by specific allergen were assessed in 24 patients with rhinoconjunctivitis caused byParietaria judaicain a double‐blind study. After a screening CPT, patients were randomized into four treatment groups, each being given deflazacort (oral tablets) at 6, 30, and 60 mg once daily, or matching placebo, for 3 d, outside the pollen season. Clinical evaluation (itching, hyperemia, lacrimation, and swelling of eyelids) and cytologic assessment (number of inflammatory cells in conjunctival scraping and evaluation of ICAM (intercellular adhesion molecule)‐1/CD54 expression on epithelial cells) were performed at base line, 30 min (early‐phase reaction (EPR), 6 h and 24 h (late‐phase reaction (LPR)) after specific CPT, and before and after treatment. Neither the EPR clinical reactions nor the EPR total number of inflammatory cells was modified by deflazacort. However, the LPR clinical effects were significantly reduced by deflazacort at 30 or 60mg/d (P<0.01), as compared with placebo. The total number of inflammatory cells during LPR was significantly reduced by deflazacort at 30 or 60 nig/d ((P<0.01), as compared with placebo. Furthermore, CD54 expression was significantly reduced by deflazacort at 30 or 60 mg/d both in the EPR ((P<0.01) and LPR ((P<0.01), as compared with placebo. None of the studied indicators were modified at the 6 mg/d dose. This study shows that deflazacort has a highly protective action against clinical and cellular LPR effects induced by the specific CPT, In addition, deflazacort markedly reduces CD54 expression on the conjunctival epithelium during both EPR

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00740.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The efficacy of loratadine and terfenadine in perennial allergic rhinitis was evaluated in a double‐blind, selected cross‐over study consisting of two phases. During the first phase, 76 patients with perennial allergic rhinitis, 8–67 years old, were included in the study. Of these, 41 patients received loratadine 10 mg daily, and 35 patients received terfenadine 60 mg twice daily, for 2 weeks. According to symptoms and side‐effects, 32 patients were classified as responders to loratadine, and 28 patients as responders to terfenadine. All observed symptoms were significantly reduced in both treatment groups, but with no significant differences between the two groups. Side‐effects were few and mild. In patients with normal IgE, loratadine was significantly superior to terfenadine in relieving nasal secretion, whereas terfenadine was significantly superior to loratadine in relieving nasal congestion. In patients with increased IgE, patients treated with loratadine showed significantly greater reduction in sneezing than patients treated with terfenadine. A positive correlation between total IgE and reduction in overall symptoms was found for patients treated with loratadine, whereas a negative correlation was found for patients treated with terfenadine. During the second study phase, the nonresponders received the other drug for 2 weeks. All seven nonresponders to terfenadine responded to loratadine after crossing over, whereas four of nine nonresponders to loratadine responded to terfenadine. Nonresponders to one drug may respond to the other drug. Thus, more than one antihistamine drug should be tried in perennial allergic rhinitis if the fi

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00741.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Eighteen children with perennial asthma and allergy to house‐dust mite (HDM) underwent a bronchial challenge with HDM. Before and 24 h after the test, a venous blood sample was taken to determine levels of eosinophils, eosinophil cationic protein (ECP), soluble interleukin‐2 receptor (IL‐2R), and interleukin‐6 (IL‐6). A histamine challenge was performed before and 24 h after the HDM challenge. All subjects showed an immediate asthmatic reaction (IAR). A definite late asthmatic reaction (LAR) was observed in 15 children, a probable LAR in two, and no LAR in one. Because of persistent bronchial obstruction (FEV1>70%), eight children were unable to perform a histamine challenge 24 h after the allergen challenge. These were the children with the lowest prechallenge provocation dose (PD20) of histamine. In the other 10 children, the mean PD20histamine decreased after the HDM challenge (mean PD20before was 0.56 mg/ml; after challenge it was 0.14 mg/ml;P= 0.007). After the HDM challenge, an increase was detected in the mean values of blood eosinophils (mean before was 446/mm3; mean after was 733/mm3;P= 0.002), ECP (mean before was 26.3 μg/1; mean after was 34.3 μg/1; P<0.040), and IL‐2R (mean before was 116.35 U/ml; mean after was 128.52 U/ml; P0.001) and IL‐2R (mean: 80.30 U/ml compared with 116.35 U/ml) (P =0.009), but not of IL‐6 (mean: 11.34 pg/1 compared with 9.47 pg/1) (P = 0.436).A correlation was found between the duration of asthma and the severity of the LAR expressed as area under the curve (AUCLAR) (r = 0.50;P<0.040). Furthermore, a correlation was detected between the level of total IgE and the level of ECP (r = 0.51;P<0.030). The decrease in FEV1during the LAR tended to correlate with the increase of IL‐2R (r = 0.48; P = 0.050). This tendency was not found with the increase of eosinophils, nor with the increase of ECP. We conclude that both lymphocytes and eosinophils are activated by an allergen challenge, but that only the activation of lymphocytes tends to correlate with the LAR, suggesting that lymphocytes are also closely involved in the pathogenesis of

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00742.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We evaluated the safety of immunotherapy in 419 patients who attended our allergy department for treatment. They were suffering from rhinitis and asthma caused by sensitization to grass pollen orDermatophagoides pteronyssinus. Immunotherapy was given by biologically standardized aluminum hydroxide adsorbed extracts according to a conventional schedule. Local reactions were recorded in 10.5% of the patients and systemic reactions in 4.8%. Only 0.37% of the doses administered were associated with systemic side‐effects. We found that 84% of the patients who showed systemic reactions were asthmatic subjects (P<0.01), and most of them were sensitized toD. pteronyssinus(71%). Side‐effects occurred more frequently during the dose‐increase period (P<0.05). After 9482 doses had been administered, no anaphylactic shock or life‐threatening reactions were registered. We believe the risk associated with immunotherapy to be drastically reduced when treatment is carefully monitored by skilled personnel. In such conditions, as shown by our study, immunotherapy

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00743.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

LyophilizedDermatophagoides pteronyssinus(Der p) allergen extract (AE) and partially purified Der p extract (PAE) Were Prepared and characterized. Partial purification of AE was performed by gel filtration on Sephadex G‐1OO and Sephacryl S‐300. Crossed immunoelectrophoresis (CIE) disclosed the same precipitating lines in AE and PAE preparations. The relative potencies of AE and PAE were determined and compared with the WHO International Standard forDer pby the RAST inhibition method. The potencies were 6.5 × 105IU and 1.5 × 106IU, respectively. Biologic standardization by quantitative skin testing was performed with AE (20 selected patients) and PAE (12 patients). Median Chwas calculated by linear regression analysis (log‐log model). One ampoule of AE contained 65 300 BU and 1 ml (vial) of PAE contained 166000 BU.Der pAE could serve as a Croatian national standard for further production ofDer pallergenic e

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1993.tb00744.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY