Cypress allergy: an underestimated pollinosis.
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Biomedical subjects
Publications and source records attributed to A Mari.
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Insulin sensitivity is frequently assessed with the minimal model (MM) and the insulin-modified intravenous glucose tolerance test (MIVGTT). To ascertain the validity of this approach, the mechanisms by which the MM estimates glucose effectiveness and insulin sensitivity (SG and SI, respectively) from the data are analyzed theoretically. Published data and new labeled MIVGTTs in normal and non-insulin-dependent diabetic (NIDDM) subjects are used as reference data. One reason for the reported difficulty in estimating SI in NIDDM is the inadequacy of the MM to describe the data. SG is a biased estimate of the fractional glucose clearance (FGC) at basal insulin, and SI is a biased estimate of the average slope of the insulin concentration-FGC curve. The monocompartmental assumption and the role of glucose production in the MM are causes of bias. The bias is fairly constant across the spectrum of glucose tolerance (SG: approximately 150% overestimate; SI: approximately 30% underestimate). Also, SI is not expected to account satisfactorily for hepatic insulin sensitivity. Finally, by the use of SG and SI, FGC at a target insulin level (FGCMM) can be estimated. FGCMM agrees well with the analogous clamp index (difference 10%; correlation: r = 0.88, P < 0.002) and, in NIDDM, has a lower coefficient of variation than SI (57 vs. 82%). In conclusion, this analysis indicates that the MM is a sufficiently reliable method for the assessment of insulin sensitivity if it is used cautiously.
Few people are more severely handicapped than patient with facial deformities. The face forms a centre point of attention in human relationships with particular emphasis placed on cosmetic acceptance. Surgical ablation of head and neck cancer often creates significant functional and aesthetic problems. In addition to the numerous physiologic problems that can befall the patient, devastating changes in appearance may occur with serious psychologic sequel. Our purpose here is to discuss the numerous physiologic and psychological problems occurring after major ablative surgery of the head and neck. A team effort is essential to the effective treatment of those patients, including: surgeon, oncologist, radiotherapist, prosthodontist and last but not least psychologist, who has a main role in strengthening the patients and helping them to lead an acceptable quality of life.
The aim of the paper is to review the four decades' long history of salt fluoridation, and to report on experiments and activities in Hungary in the course of the last three decades, aiming the country-wide introduction of domestic salt fluoridation. Salt fluoridation, as a caries preventive method was first introduced in Switzerland, in 1955, later caries-reducing effects were studied in Columbia, Spain and Hungary. The results of the clinical experiments of K. Tóth performed in Szeged, Hungary, showed after 17 years a caries reduction of about 66%. These results contributed significantly to the introduction of salt fluoridation in several (France, Costa Rica, Jamaica, Germany) countries. Leaders of Hungarian dentistry tried to introduce salt fluoridation since 1972, but due to the antifluoride lobby, and organisational difficulties, the authorization was delayed. However, in the last three years in the course of several discussions and debates within the top-commissions, a positive statement was issued recently by the Hungarian Academy of Sciences on the support for the country-wide introduction of domestic salt fluoridation at earliest possible convenience.
BACKGROUND: Cupressus arizonica and C. sempervirens, two species belonging to the Cupressaceae family, are recognized as an important cause of respiratory allergies in countries with a Mediterranean climate. OBJECTIVE: The relationship between pollen extracts from these two species was studied by evaluating the reactivity with polyclonal rabbit antisera and human IgE. METHODS: The two extracts were analyzed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. Cross-reactivity was evaluated by ELISA and immunoblotting inhibition experiments. RESULTS: The electrophoretic patterns of the two extracts are quite different, although some components display identical molecular weights. The immunoblotting developed with human IgE from subjects allergic to members of the Cupressaceae family indicated that two major IgE-reactive components, displaying molecular weights of about 43,000 and 36,000 d, were similarly detected in both extracts. Inhibition experiments showed a high degree of crossreactivity between the two extracts when tested with rabbit polyclonal antibodies against C. arizonica and C. sempervirens. When tested with human IgE inhibition methods, both extracts were able to reciprocally inhibit all of the IgE-reactive bands, although C. arizonica extract was always a better inhibitor. CONCLUSIONS: C. arizonica and C. sempervirens extracts are highly cross-reactive at the IgE level and share a number of common epitopes also identified by polyclonal rabbit antisera.
BACKGROUND: There is increasing evidence for the relevance of Cupressaceae pollinosis among persons living in geographic areas where these species are native or imported. OBJECTIVE: Previously reported problems in obtaining valid allergenic extracts to be used in the diagnosis of this winter pollinosis prompted us to assess the value of available Cupressaceae pollen extracts for in vivo and in vitro diagnosis. METHODS: Commercial and in-house allergenic extracts from Cupressaceae and Taxodiaceae families were used for skin prick testing and specific IgE detection in six groups of subjects exposed to a high concentration of Cupressaceae pollen. RESULTS: Four commercial and two in-house Cupressus sempervirens pollen extracts showed low cutaneous reactivity. Positive test results were recorded in 26% of the 713 subjects tested. C. arizonica in-house pollen extracts gave rise to larger cutaneous reactions. Furthermore, the skin prick test response was positive in a greater number of subjects (38%) of the same group. Six commercial immunoassays were able to detect specific IgE to C. sempervirens in rates ranging from 8.1% to 81.1%. Specific IgE to C. arizonica was detected by means of an in-house immunoenzymatic method in 70.3% of 54 patients with suspected "cypress" allergy, and specific IgE to C. sempervirens was detected in 75.9% of these patients by using a commercial system. High rates of cross-reactivity within the Cupressaceae family and with species of the Taxodiaceae family were recorded with both in vivo and in vitro tests. CONCLUSIONS: The use fo C. sempervirens in vivo diagnostics should be carefully evaluated until better characterized extracts are developed. In-house-characterized extracts of C. arizonica seem to be more reliable in the diagnosis of Cupressaceae allergy by means of skin prick testing. the sensitivity of commercially available in vitro methods to detect specific IgE to C. sempervirens should be carefully evaluated; nevertheless, valid results can be obtained with some already available immunoassays.
The Drosophila dishevelled gene (dsh) encodes a secreted glycoprotein, which regulates cell proliferation, acting as a transducer molecule for developmental processes, including segmentation and neuroblast specification. We have isolated and characterized cDNA clones from two different human dsh-homologous genes, designated as DVL-1 and DVL-3. DVL-1 and DVL-3 putative protein products show 64% amino acid identity. The DVL-1 product is 50% identical to dsh and 92% to a murine dsh homologue (Dvl-1). Both human DVL genes are widely expressed in fetal and adult tissues, including brain, lung, kidney, skeletal muscle and heart. DVL-1 locus maps to chromosome 1p36 and DVL-3 to chromosome 3q27. DVL-1 locus on chromosome 1 corresponds to the murine syntenic region where Dvl-1 is located. DVL-1 and DVL-3 are members of a human dsh-like gene family, which is probably involved in human development. Although the precise role of these genes in embryogenesis is only conjectural at present, the structural and evolutionary characteristics suggest that mutations at their loci may be involved in neural and heart developmental defects.
DiGeorge syndrome (DGS) is a developmental defect of some of the neural crest derivatives. Most DGS patients show haploinsufficiency due to interstitial deletions of the proximal long arm of chromosome 22. Deletions of 22q11 have also been reported with patients with the velocardio-facial syndrome and familial conotruncal heart defects. It has been suggested that the wide phenotype spectrum associated with 22q11 monosomy is a consequence of contiguous-gene deletions. We report the isolation of human cDNAs homologous to the Drosophila dishevelled (dsh) segment-polarity gene. Sequences homologous to the 3' UTR of these transcripts (DVL-22) were positioned within the DGS critical region and were found to be deleted in DGS patients. Human DVL mRNAs are expressed in several fetal and adult tissues, including the thymus and, at high levels, the heart. Two transcripts, 3.2 and 5kb, were detected, in northern blot analysis, with different expression patterns in the surveyed tissues when different cDNAs were used. The isolated cDNAs exhibit high amino acid homology with the mouse and Xenopus Dvl-1 gene, the only other vertebrate dsh homologues so far isolated. The pivotal role of dsh in fly development suggests an analogous key function in vertebrate embryogenesis of its homologue genes. Since DGS may be due to perturbation of differentiation mechanisms at decisive embryological stages, a Dsh-like gene in the small-region overlap (SRO) might be a candidate for the pathogenesis of this disorder.
Atrioventricular canal defects (AVCD) constitute the predominant congenital heart defect in Down syndrome. For this reason, a candidate gene involved in atrioventricular canal development was previously searched and excluded in dominant pedigrees of AVCD, using linkage analysis of polymorphisms from chromosome 21. Because of the striking association between 8p deletion and AVCD, a search for an AVCD gene was carried out in two pedigrees of individuals with autosomal dominant AVCD using a set of DNA markers of the 8pter-->q12 region. These two families include affected individuals and subjects who have transmitted the defect but are not clinically affected. Two-point lod scores were significantly negative for all markers at penetrance levels of 90% and 50%. Multipoint analysis excluded the region covered by the markers LPL-D8S262 and 30 cM to either side of this area. This result corroborates heterogeneity of this heart defect and indicates that the genetic basis of familial AVCD is different from AVCD associated to either trisomy 21 or 8p deletion.
Two monoclonal antibodies (MoAb) specific for Parietaria judaica allergenic components were selected on the basis of their capability to recognize either the Parietaria judaica major allergen (MoAb 1A6/1D1) or several other allergenic components (MoAb 1A4/2F8) except the major allergen. These two antibodies, either individually or combined, were used to develop an ELISA-inhibition system using a reference Parietaria judaica extract (in-house Reference preparation, IHR). The assays performed with these reagents were firstly standardized by testing the IHR several times. A good reproducibility, evaluated both at the level of 50% inhibition values, and in terms of analysis of the variance of the slopes of the regression curves, was obtained. Subsequently, the potency of several Parietaria judaica extracts, either obtained by manufacturing companies or produced in other laboratories, was evaluated by these tests. Data obtained by interpolation with the IHR values and expressed in terms of arbitrary units (AU) were compared with those obtained by classical human IgE inhibition, performed with sera from allergic patients. Results indicate that the monoclonal antibodies produced in our laboratory can be successfully employed, either individually or combined, in the standardization of allergenic preparations in addition to, and possibly replacing, the classical IgE-based standardization procedures which require human specimens often available in limited amounts only.
Williams syndrome (WS) is caused by deletion of the elastin (ELN) gene. We have analyzed an intragenic restriction fragment length polymorphism (RFLP) and the gene dosage of ELN using a new probe (FP4) in a series of 60 sporadic patients with a clinical diagnosis of WS. Deletion of the ELN gene was shown in 54 cases, while clinical revaluation of the 6 patients without the deletion did not confirm the diagnosis of WS. These results support the genetic homogeneity of WS, and the high accuracy of ELN molecular analysis, which can be confidenty used for providing genetic counselling to WS families.
Tetralogy of Fallot (TF) is a congenital conotruncal heart defect commonly found in DiGeorge (DGS) and velo-cardio-facial (VCFS) syndromes. The deletion of chromosome 22q11 (del22q11) is a well established cause of DGS and VCFS, and it has been demonstrated also in sporadic or familial cases of TF. In order to investigate the prevalence of del22q11 in patients with TF, we analyzed the DNA of 137 consecutive patients with syndromic and isolated TF, using the HD7k probe, which detects hemizygosity for the D22S134 locus. Del22q11 has been detected in 11/26 (42%) syndromic patients. Evidence for hemizygosity was obtained in all patients with DGS and in 8/15 patients with VCFS. None of the 107 patients with isolated TF had del22q11. Our experience suggests that children with TF and del22q11 always present major or minor extracardiac anomalies. These features, including subtle facial dysmorphisms, should be checked routinely in patients with TF and other conotruncal heart defects.
Classical in vivo kinetics are based on the analysis of the blood disappearance curve of a substance. This curve is determined by the interplay of the substance transport in the circulatory system and the kinetics of the body tissues. The characteristic response of the body tissues, that is, their single-pass impulse response, is obscured in the disappearance curve by multiple recirculations in the heart-systemic loop. The single-pass impulse response can be appropriately determined with circulatory models. This paper investigates the theoretical aspects of the determination of the impulse response and proposes suitable algorithms for the analysis of experimental data with circulatory models. The problem of what information the most typical experimental configurations yield on the single-pass impulse response, and what assumptions are necessary for determining the impulse response in a given configuration is studied first. It is shown that assumptions are usually necessary, unless a proper experiment design is adopted. Two algorithms are then developed for the determination of the impulse response from experimental data, in the general case. The first calculates the response from an exponential description of the disappearance curve, while the second is based on a state space representation of circulatory models. The first method has the important limitation that it does not always ensure physiologically plausible results; the state space approach overcomes this limitation, and is the method of choice. With the state space approach, the determination of the single-pass impulse response is a standard parameter estimation problem with finite dimensional linear systems. The analysis of real data from a study on glucose kinetics illustrates the practical relevance of the results.
Mites have been recognized as the most important allergen in the house dust. This review deals with morphology, ecology and biology of house dust mites including factors affecting the distribution, abundance and seasonality of the species. Clinical, diagnostic and therapeutical aspects of the allergy to domestic mites are also reviewed. Finally, preventive and control measures against house dust mites are suggested.
Both whole-body models and the regional arteriovenous (AV)-difference method have been used to calculate systemic glucose rates of appearance (Ras) under non-steady-state conditions. Although whole-body models have been experimentally validated in the dog, direct comparison of the whole-body and regional-balance approach has not been made in man. We reanalyzed published data obtained by combining the double-tracer technique ([3H]glucose infusion with ingestion of a [14C]glucose-labeled load) with hepatic vein catheterization. Steele's monocompartmental model underestimated the Ra of oral glucose ([RaO] by 12%, P < .0001) and overestimated the Ra of endogenous glucose ([RaE] by 19%, P < .0001) in comparison to a two-compartment (2-c) model calculation. Splanchnic balance data were used to compute the total glucose Ra (RaT) with either steady-state or non-steady-state equations (the latter by estimating splanchnic transit times). Except for one early time point (15 minutes), the two calculations agreed well with one another. The glucose RaT by the balance method was well correlated with that calculated by the 2-c whole-body model (r = .72, P < .0001 on all data points); however, the former significantly underestimated the latter by 0.62 mg.min-1.kg-1 (or 13%, P < .01) on average throughout the absorptive period. This bias was small in comparison to the estimated random error affecting the calculation of glucose RaT by the model, which averaged 1.4 mg.min-1.kg-1 (corresponding to a variation coefficient of approximately 30%).(ABSTRACT TRUNCATED AT 250 WORDS)
Species of the Cupressaceae family are an important cause of respiratory allergies in countries with a Mediterranean climate. An allergenic extract from Cupressus arizonica pollen was prepared with two extraction steps followed by ammonium sulfate precipitation, giving a protein yield of about 3%. Cupressus arizonica pollen extract was also characterized by means of sodium dodecylsulfate-polyacrylamide gel electrophoresis, followed by IgE and IgG immunoblotting and lectin blotting. IgE reactivity was restricted to six components, whereas IgG binding showed a more complex pattern. A 43 kd component, predominant both in its intensity and frequency of recognition by human IgE antibodies, was identified as the major allergen of C. arizonica. Four of the six IgE-binding components, including the major allergen, seem to be glycoproteins, as confirmed by the lectin blotting analysis. The extract produced inhouse was used to set up an immunoenzymatic test to evaluate the specific IgE binding in a panel of sera from 33 immunotherapy-free subjects who were monosensitized to cypress pollen. The percent of positivity obtained was much higher than that reported in the literature for commercial immunoassays.
IgG antibody response to the inhalant allergen Parietaria judaica (Pj) and IgG subclass distribution were studied in 82 normal subjects, divided into three groups according to age (0-1, 1-20, and 20-60 years) and in 32 allergic subjects aged 20-60 years. Both normal and allergic subjects showed an IgG response, and all had IgG1 antibodies specific for PjE. Serum IgG2, IgG3, and IgG4 against PjE were detectable in 36%, 46%, and 22% of normal subjects, and in 58%, 31%, and 65% of allergic subjects, respectively. A significant difference in class distribution between allergic and age-matched normal subjects was found only for IgG4 antibodies against PjE (65% and 17%; P < 0.01). The ELISA results were also analyzed quantitatively, taking into account the relative proportion of specific antibodies. Thus, in normal subjects IgG1 antibodies showed a decreasing trend as the age rose, while no differences according to the age of the subject were found for IgG2 and IgG4. When data from allergic subjects (20-60 years) and the age-matched normal group were compared, they were different for the relative percentage of IgG2 only, showing for this a significantly lower value (P < 0.001). The present data indicate that normal and allergic subjects show differences in the IgG isotype distribution depending on their sensitivity and duration of allergen exposure.
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