摘要:

A significant portion of infants and young children develop acute lower airway obstruction (wheezing) accompanying viral lower respiratory infections. These wheezing‐associated respiratory illnesses, particularly bronchiolitis, are often associated with evidence of prolonged airway obstruction and airway hyperreactivity following the initial infection. The factors that determine the type of clinical infection that initially develops and long‐term respiratory consequences of this infection are complex, including the genetic background of the child, the age at the time of infection, the respiratory virus involved, and environmental factors such as exposure to cigarette smoke. Several animal models have been developed to describe the pathophysiology of viral respiratory infection and have helped to define several potential mechanisms for the resulting airway obstruction. Data from these studies and studies in humans emphasize the importance of the immune system and of neural modulation of airway smooth muscle tone in determining the outcome of respiratory virus infection. These observations also help define the pivotal role of the airway epithelium in the regulation of airway smooth muscle tone and the host inflammatory response in the airway. Consequently, the interplay of host and environmental factors, as well as the relative importance of the different mechanisms potentially active in airway obstruction, determine the acute clinical outcome of infection for an individual child and the propensity of that child to develop recurrent episodes of wheezing (asth

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

We describe a patient with severe combined immunodeficiency and transplacental transfer of maternal T cells who received an unfractionated HLA‐identical sibling bone marrow transplant without prior conditioning. He presented prior to transplantation with a dermatitis later diagnosed as mild graft versus host disease. He had a normal absolute lymphocyte count, but proliferative responses to mitogens were very low. Antigens of the noninherited maternal HLA haplotype were detected on his blood lymphocytes. After transplantation, he developed a severe reaction including fever, cutaneous erythema and hepatosplenomegaly. Lymphocytes carrying the noninherited maternal HLA haplotype disappeared from his circulation, and his unprimed mononuclear cells became spontaneously cytotoxic to maternal lymphoblasts. He subsequently developed a lymphocytosis of 69,000/mm3, diarrhea, elevated transaminases and a worsening rash, necessitating treatment with immunosuppressive agents. Full T‐cell engraftment and evidence of B‐cell function later ensued and spontaneously cytotoxic lymphocytes against maternal cells disappeared by 47 days post‐transplantation. We postulate that the patient's constellation of signs and symptoms after transplantation represented a combination of severe graft versus graft and mild graft versus host re

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

In 70 children with defined chronic chest disease, immunoglobulins, IgG subclass levels and antibody concentrations specific forHaemophilus influenzaeb (Hib), and pneumococcal antigen, were related to disease severity. Bronchological examinations revealed 30 children with chronic bronchitis, 21 with bronchial deformations and 19 with bronchiectasis. Of the 70 children 12 (17.1%) showed an underlying immunodeficiency. The commonest finding was an IgG subclass deficiency, 7 were IgG2and 1 IgG3deficient, followed by IgA deficiency in 3 patients. All patients had normal IgG and IgM levels except one who had immunodeficiency with elevated IgM. Pneumococcal antibody levels were found to increase between patient groups in the order healthy children

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00193.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Four different types of chronic granulomatous disease (CGD) were analysed with the monoclonal antibody, 7D5, directed against the small 23 kD subunit of cytochrome b558using a flow cytometric fluorescence analytical method. 7D5 immunofluorescent surface staining of granulocytes was absent in 12 patients with X‐linked cytochrome b558deficiency, in 2 patients with variant X‐linked CGD with residual (X‐forming activity and in 2 patients with autosomal recessive cytochrome b558deficiency. The mothers of the patients with the X‐linked form of CGD had 2 cell populations, one 7D5 negative or weakly positive and one 7D5 positive. The granulocytes of both parents of one patient with autosomal recessive cytochrome b558deficiency had slightly reduced fluorescence intensity comparable to their reduced cytochrome b558content. Three CGD patients with normal cytochrome b558and their parents had granulocytes normally stained with antibody 7D5. 7D5 antibody enables rapid detection and classification of CGD patients with cytochrome b558deficiency as well as rapid identification of heterozygous c

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00194.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

We have studied 21 babies with IgE‐mediated food allergy (FA) sensitized via breast milk. The diagnosis of IgE‐mediated FA was based on the response to elimination diet and challenge tests, and was confirmed by positive RAST and skin tests. The children exhibited immediate symptoms, such as urticaria, angioedema, and asthma. Only 5/21 children developed tolerance to the offending food at the median age of 14 years. The children who failed to develop tolerance still have high levels of IgE antibodies towards the offending food. In conclusion, the results of our long‐term follow‐up study show that the natural history of FA in children sensitized via breast milk may be less optimistic than generally r

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00195.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

During a prospective study of 1654 children, followed from birth for 11 years, we evaluated the validity of a detailed questionnaire for establishing the prevalence of atopic disease in preadolescence. In 133 randomly selected children the questionnaire‐based diagnoses were accurate in 128 (96.2%). If the cord blood IgE concentration was high (? 0.9 kU/l) then it was 1.7 times more common to have any prevalent atopic disease. The corresponding relative risk for multiple atopic disease was 11.5. Boys had high IgE levels significantly more often than girls, regardless of the degree of pubertal maturation. Sensitization to timothy pollen developed more often in children born during May compared to November. At least one allergy test (IgE, Phadiatop or SPT) was positive in 20 of 70 (28.6%) 11‐year‐old children with no history of atopic disease, indicating latent allergy. Among the healthy children with positive tests, those with cord blood IgE ? 1.3 kU/l were over‐represented. IgE concentrations at 11 years of age corresponded poorly with neonatal IgE concentrations, indicating that after birth environmental influences are more important for the present IgE level than genetic

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00196.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The aim of this study was to investigate the feeding habits in the first year of life and prevalence of atopic dermatitis (AD) in a group of Somali children born and living in Italy and in a group of Somali children born and living in Somalia. The first group comprised 59 children (median age 15 months; range: 12–24 months) and the second group 95 children (median age 16 months; range: 12–24 months). The mothers were asked to fill in a questionnaire on the duration of breast feeding and weaning age of their children. In the Somali children born and living in Rome we observed earlier introduction of cow's milk (p<0.001), and earlier weaning (p<0.001). The prevalence of AD was higher in the Somali children born and living in Italy (p<0.0

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00197.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY