[Apropos of sublingual specific immunotherapy].
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Administration, Sublingual↗
Biomedical subjects
A Sabbah
Publications and source records attributed to A Sabbah.
[Postanesthesia allergic complications].
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Anaphylaxis↗
[Allergic immunobiology and anesthesiology].
A protocol has been produced for the study of anaphylactic accidents that occur post-operatively that allows definition of the anaphylactic origin, and so reactions that are mediated by IgE in post-operative accidents. This protocol occurs in two stages, the first is done in the minutes and hours that follow the anaphylactic accident, and the second a month or 6 weeks afterwards. At first, we evaluate the sequential study of the liberation of the mediators of anaphylaxis, plasma histamine, serum tryptase, urinary methylhistamine and, more recently, leucotriene E4. The second study is devoted to reactions that are mediated by IgE, essentially, specific serum IgE, tests of activation of basophils by flow cytometry, measurement of leucotriene C4 and skin tests. A study on 16 subjects has evaluated and validated the protocol and shown a significant level of correspondence of results between the sequential measurement of mediators on one hand and on the other the search for IgE-mediated reactions every time that there was an anaphylactic reaction.
Adolescent↗
[Importance of the urinary leukotriene E4 level. Preliminary study].
Post-anesthesia anaphylactic reactions or those seen during drug provocation tests with a systemic clinical reaction may be confirmed by the sequential release into blood of plasma histamine, tryptase and leukotriene C4 and into urine of urinary methylhistamine and leukotriene E4.
Acetaminophen↗
[Predictive value of the allergologic profile in anesthesia and resuscitation].
The allergic history to anaesthetics in general and especially to synthetic myorelaxants, poses few etiological diagnostic problems in practice, because of on one hand the excellent collaboration between Anesthetists and Allergologists in the CHU at Angers and on the other because of the great sensitivity of skin testing. Why then have a predictive history for myorelaxants? The results of a study at the CHU at Angers on 15 patients showed sensitivity to anaesthetics in general (myorelaxants 86%, Diprivan) and/or an antibiotic, latex were very encouraging. One 15 new general anaesthetics a single minor incident was seen: the 15 patients had benefited from a predictive history.
Adolescent↗
[Specific immunotherapy using allergens apropos of specific immunotherapy by the sublingual route].
The present number of publications an allergen specific immunotherapy (ITa) by clinically controlled tests, double blind, is objective proof of the value of this treatment in the allergy pathologies mediated by IgE. The mechanisms of action of Ita are better understood, taking account of the intervention of TH2 and TH1 cells with the respective involvement of cytokines IL4-IL5, favouring the synthesis of IgE and interferon gamma (IFN gamma) slowing the synthesis of IgE. Adjuvants of bacterial origin influence the balance TH2/TH1 by blocking the production of TH2 cells. Ita by the sublingual route (SLIT) has been the objective of double blind clinical studies, with favourable results and good tolerance, of a number of allergens, pollens (grass, ragweed, parietaria, olive) and D. pteronyssinus mites. Application of this technique of SLIT to foods and drugs reveals more a mechanism of customisation than induction of cellular acticity, of a mucosal secretory IgA and an oral tolerance with systemic response, mechanisms that are involved in SLIT. Taking into account the restrictions of ITa, SLIT allows inclusion of other allergic patients, such as children receiving injections and subjects who are not inclined to observe and comply with treatment.... The different techniques used for classical ITa by the subcutaneous route are also useable for SLIT with a very good tolerance, apart from some transitory digestive problems. SLIT is no longer a technique of the future, but already one of the present time, currently used and which gives a renewal of value in the form of therapy that is ITa for IgE-mediated allergy pathology.
Administration, Sublingual↗
Thirteen cases of allergy to human seminal plasma.
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Adolescent↗
[Does the pork/cat syndrome constitute a predisposition to heparin allergy?].
Observations are reported of two heparin-allergic patients (in one case, urticaria and in the other urticaria and asthma). These two patients show a curious association of the pork/cat syndrome, previously described (1, 2), that is an association of sensitivity to cat epithelia and pork meat. Since the heparins used nowadays are of porcine origin, the question is raised of a possible causal link that may exist between these 2 allergies. It seems that the possibility of association of these two allergies is much more likely than chance encounter.
Adult↗
[Contribution of flow cytometry to allergologic diagnosis].
The technique of Flow Cytometry for activation of basophils (TAB), expressed as the marker CD63, is at present one of the pathways of research applied to drug allergy. In this work are reported the results of TAB of Pneumoallergens and Hymenoptera venoms. TAB can define better than total IgE the atopy of the subject: in effect the fluorescence of the basophils is emphasized in comparison with non-atopic subjects. This hypothesis has been confirmed by a study of three groups of subjects. With regard to drug allergy, it is important to study patients in whom the observations have been documented very objectively by clinical history and positive skin tests to the drug, compared with a negative reference to the same drug. So, TAB has been shown to be very useful in diagnosis of allergy to certain drugs, such as the Myorelaxants.
Allergens↗
[Chronic rhinitis, or the consequences of gluttony].
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Adult↗
[Immunobiologic diagnosis of food allergy].
Food allergy is becoming more frequent, with 6% of asthmatics reporting an isolated food allergy, and 5 to 6% of atopic dermatitis patients also have either a single or multiple true food allergy. There is value in immuno-biological diagnosis by: Measurement of total serum IgE. Measurement of mono-allergen-specific IgE, following a measurement by a multi-allergen of the Trophatope type. A study of elimination of foods for 2 or 3 months followed by their re-introduction. Oral provocation tests in a hospital environment under clinical control and subsequent measurement of the mediators: Plasma histamine, tryptase, and urinary methylhistamine, to give proof of responsibility of the food allergen. Nowadays, it is perfectly possible to include in diagnosis the new technologies of the test of activation of basophils/or lymphocytes by means of flow cytometry.
Animals↗
[Histamine liberation in vitro or histamine release (HR). Study of the threshold of positivity in allergy to hymenopteran venoms].
The technique of histamine release in vitro (HR) is only usable in diagnosis of hymenoptera venom allergy. The allergen extracts that are supplied for clinical (skin tests) or biological diagnosis contain significant amounts of histamine, falsify the results, especially HR, and reduce significantly the correlation between HR and other biological or cutaneous tests. Dialysis of the allergen extracts significantly improves the sensitivity and specificity of the technique and lowers the threshold of positivity of HR from 30% to 12%. Correlation of HR with other diagnostic parameters:clinical history, specific IgE and skin tests is very significantly improved.
Animals↗
[Anaphylactic or anaphylactoid reactions to paracetamol. Report of 3 cases].
Anaphylaxis to paracetamol exists and perhaps nowadays diagnosis is not confined to clinical evidence of: The repeatability of clinical symptoms. Skin tests. Provocation tests. But also by immuno-biological evidence. Application of the test of Activation of basophils by Flow Cytometry and measurement of leukotriene C4 have been nowadays largely validated and constitute irrefutable proof of the responsibility of the drug as the origin of the clinical symptoms.
Acetaminophen↗
[Allergy to mosquitoes and use of new immunobiological parameters].
With regard to an observation of anaphylaxis after a mosquito bite, we have shown by new immunobiological parameters and clinical investigations: Skin tests, specific IgE, Tests of Activation of basophils by flow cytometry (on basophils and total blood) and measurement of Leucotriene LTC4, the objective reality of the mechanism of IgE-dependent hypersensitivity (HS). This observation is correlated with rare work in support of true IgE-mediated allergy to mosquito 9 authors having used skin tests, PK in 1984 and immunoblot.
Adult↗
[Immuno-biological diagnosis of food allergy].
Food allergy is becoming more frequent, with 6% of asthmatics reporting an isolated food allergy, and 5 to 6% of atopic dermatitis patients also have either a single or multiple true food allergy. There is value in immuno-biological diagnosis by: Measurement of total serum IgE. Measurement of mono-allergen-specific IgE, following a measurement by a multi-allergen of the Trophatope type. A study of elimination of foods for 2 or 3 months followed by their re-introduction. Oral provocation tests in a hospital environment under clinical control and subsequent measurement of the mediators:-Plasma histamine, tryptase, and urinary methylhistamine to give proof of responsibility of the food allergen. Nowadays, it is perfectly possible to include in diagnosis the new technologies of the test of activation of basophils/or lymphocytes by means of flow cytometry.
Adolescent↗
[Cross-reactivity between cow's milk and goat's milk].
Tolerance of LC may be explained by a great intra and interspecific genetic diversity that leads to a great variety of proteins. In contrast, industrial treatment (UHT sterilisation) introduces configural modifications that may provoke a very great structural homology between the proteins of the two milks. Casein is in high concentration in both milks and shows some homology of the AA sequences between both and it makes a common allergen for a cross- reaction. It has been observed that a good IgE inhibition in vitro does not automatically form a clinical cross-allergenicity. Therefore there may exist an immunological crossed reaction between LC and LV without production of a real crossed allergenicity.
Animals↗
[When the fluoro-immuno-enzymatic (FEIA) measurements turn out to be more sensitive than radioimmunologic (RIA) measurements. Application to the measurement of serum tryptase].
The measurement of Tryptase by the Fluoro-Immuno-Enzymatic (FEIA) method is nowadays possible on the Pharmacia CAP system (automatic UniCAP). This measurement is more comprehensive as it measures the release of serum tryptase from both the tissue mastocytes (MCTC) as well as the mucosal mastocytes (MCM). Technically the measurements are comparable with those made by the method of radio-immunology (RIA), are absolutely reproducible and surprisingly at 100%. It has also been possible to evaluate the two techniques of FEIA and RIA on negative and positive pools. This new FEIA technique for serum tryptase is applicable: to anaphylactic and/or anaphylactoid accidents at the time of induction of anesthesia, in general conditions such as haemorrhagic recto colitis (RCH), Crohn's disease, and mastocytosis. Finally these measurements can be used during nasal and bronchial provocation tests, as the measurements may be made on nasal and bronchial lavage liquids. The sensitivity and the very good reproducibility of this new technique of FEIA for tryptase is of very great interest and avoids use of radio-active isotopes.
Anaphylaxis↗
[Comparison of the measurements of total IGE using the CAP-RIA technique and the UNICAP-FEIA technique].
The contribution of a new method of measurement of total IgE by the Fluoro-Enzymo-Immuno-assay (FEIA) with the assistance of Pharmacia UNICAP automation is very reliable since, when compared with the measurement by the CAP SYSTEM RIA on 144 patients who were clinically allergic (84 with a raised and 60 with a normal IgE titre) the result of a comparative study between the two techniques is statistically highly significant. The two methods were also compared by age groups and these results were also statistically highly significant.
Adult↗