Search PubMed⌕ Search

Biomedical subjects

B Niggemann

Publications and source records attributed to B Niggemann.

At least 127 records · Page 7Linked to original sources
PubMed1997

Prevalence of latex-specific IgE antibodies in atopic and nonatopic children with type I diabetes.

OBJECTIVE: The potential induction of allergic sensitization to latex from insulin vial tops stimulated an investigation of the prevalence of specific IgE antibodies to latex in serum and the relationship to atopic disease in children with diabetes. RESEARCH DESIGN AND METHODS: In a cross-sectional study, serum samples of 112 children with type I diabetes (age: 15 [5-18] years; diabetes duration: 6 [1-14] years; median [range]) were investigated for total IgE, IgE screening for inhalational and nutritional allergens, and specific IgE antibodies to latex. RESULTS: Specific IgE antibodies for inhalational and/or nutritional allergens was found in 42 (38%) children (atopic group). Seven children (6%) exhibited specific IgE antibodies (0.61 [0.40-3.84] kU/I) to latex in serum although none reported clinical symptoms of latex allergy. All latex-sensitized children were found in the atopic group. This prevalence of latex sensitization of 17% (7/42) in atopic children with diabetes is comparable with the frequency described in atopic children without diabetes. These seven patients had higher serum total IgE antibody levels (328 [113-1,000] kU/I) than atopic patients without latex sensitization (n = 35; 124 [24-857] kU/I; P < 0.05) or patients without atopy (n = 70; 33 [2-339] kU/I; P < 0.001). No differences in age or diabetes duration were observed between either group. CONCLUSIONS: Sensitization to latex is found exclusively in children with atopic sensitization and appears to be related to atopic disease and not to frequent contact to latex through insulin injections. However, atopic patients may be at risk for reactions secondary to latex from insulin vials and syringes.

Adolescent↗
PubMed1996

Suppression of the proliferation and migration of oncogenic ras-dependent cell lines, cultured in a three-dimensional collagen matrix, by flavonoid-structured molecules.

The effects of 7-hydroxycoumarin, genistein and quercetin on two ras-oncogene-driven tumour cells (rat breast adenocarcinoma and human bladder carcinoma) were investigated using cellular (proliferation and migration) and molecular targets (p21ras GTPase activity and intracellular amount of p21ras protein). All three compounds inhibited the growth of both cell lines. Genistein was the most effective substance. Furthermore, 7-hydroxycoumarin and genistein affected the motile machinery of both cell lines because major fractions of the cells were slowed down or stopped locomotion. The phorbol ester, phorbol 12-myristate 13-acetate (PMA), a well-known tumour promoter, increased the locomotion behaviour of the cells; the time of migration, the velocity and the distance of migration increased under the control of PMA. 7-Hydroxycoumarin decreased the relative amount of intracellular p21ras, and concomitantly a PMA-induced decrease of p21ras GTPase activity could be partially antagonized by 7-hydroxycoumarin. Because of the low toxicity and the mode of action evaluated, it is likely that the best role for these substances may be adjuvant therapy of some malignancies following surgery. Profiles directed to migration and proliferation inhibition make these drugs exceptional candidates for chemopreventive strategies in tumours diagnosed as having increased ras oncogene levels.

Adenocarcinoma↗
PubMed1996

Pulmonary function in children with homozygous alpha1-protease inhibitor deficiency.

UNLABELLED: Alpha1-protease inhibitor (alpha1-PI) deficiency is a well-recognized cause of emphysema in adults; however, the natural history of this disorder in children is unclear. Because of the paucity of data in the paediatric age group, we performed whole body plethysmography, spirometry, and diffusing capacity, in a cohort of 17 homozygous (PiZZ phenotype) children (9 females, 8 males; mean age +/- SEM 13.4 +/- 0.9, range 7-18 years) and in 17 normal schoolchildren (13.5 +/- 0.9, 7-18 years), using a matched-pair design. Blood was drawn for determination of serum alpha1-PI levels, PI phenotype, and standard biochemical tests of liver function. Among the PiZZ subjects, 12 were detected during diagnostic workup of prolonged neonatal icterus, and 5 by routine testing in paediatric patients. None had chronic respiratory symptoms except for an 18-year-old PiZZ girl with a history of recent onset of exertional dyspnoea. All were non-smokers. The Wilcoxon test was used for statistical analysis. As expected, serum alpha1-PI levels were lower in the PiZZ group (16% of the control value). A few patients had slight elevations of their liver enzymes. As for the pulmonary function parameters, differences between groups were not significant. Individual data showed no consistent abnormality in lung function except for signs of mild expiratory obstructive airway disease with hyperinflation (elevated TGV/TLC ratio) in the only symptomatic 18-year-old subject (0.63, control subject 0.49). This was unresponsive to bronchodilators. For her, augmentation therapy with intravenous infusion of alpha1-PI may be considered. CONCLUSION: Our study confirms the absence of pulmonary function abnormalities in the vast majority of children with homozygous alpha1-PI deficiency. Serial measurements of lung function may help to distinguish those individuals who require treatment with alpha1-PI from those who do not.

Adolescent↗
PubMed1996

The role of circulating food antigen-specific lymphocytes in food allergic children with atopic dermatitis.

In this study we evaluated antigen-specific in vitro responses of peripheral blood lymphocytes to lipopolysaccharide (LPS)-depleted food allergens in children who reacted to food challenge (cow's milk or hen's egg) with a deterioration of their atopic dermatitis (AD). Some of the children showed immediate symptoms (urticaria, bronchial asthma or gastrointestinal symptoms) as well. The proliferation of casein-stimulated lymphocytes from children reacting to cow's milk (age 0.7-5.9 years) was significantly higher (P < 0.01) than the proliferation of lymphocytes from 15 children with AD without milk allergy (age: 2.1-9.1 years). Twenty-eight T-cell clones (TCC) were established from the blood of three children sensitized to cow's milk and hen's egg who reacted to double-blind, placebo-controlled oral food challenge both with a deterioration of AD and with immediate symptoms. Surprisingly, 16 of 28 casein- or ovalbumin-specific TCC were CD8+. All TCC produced high amounts of IFN-gamma upon stimulation with concanavalin A. In addition, 75% of the CD4+ TCC and 44% of the CD8+ TCC secreted IL-4. Our results indicate that: (i) food-specific proliferation of blood lymphocytes can be detected in patients with clinically relevant food allergy with LPS-depleted allergens in vitro and (ii) circulating food-specific lymphocytes are CD4+ and CD8+ T cells with the capacity of producing both type 1 and type 2 cytokines.

Animals↗
PubMed1996

Sensitivity and allergy to latex in atopic and non-atopic children.

To study the sensitivity and allergy to latex in children, we investigated sera of 306 atopic and 303 non-atopic children (median age 4.5 years) for specific IgE to latex. In patients with specific IgE to latex, a questionnaire was sent to families and provocation tests were carried out. 60/306 atopic children (20.8%) and 1/303 non-atopic children (0.3%) showed specific IgE to latex in serum. The proportion of atopic, latex-sensitized and provocation positive children was 12/48 (25%). Specific IgE to latex was significantly higher (p < 0.03) in symptomatic compared to non-symptomatic patients. Specificity of a positive history was 92%, sensitivity 50%. Atopic dermatitis tended to be more prevalent among the 12 provocation positive atopic children (75%) compared to 36 provocation negative children (58%). There was a tendency that children of the symptomatic group underwent surgical interventions more frequently compared to non-symptomatic children. In conclusion, latex sensitization and latex allergy seem to have occurred more often in atopic children than previously known. Risk factors for the development of a sensitization to latex are atopy and the clinical diagnosis of atopic dermatitis; risk factors for a clinically manifest allergy to latex are an elevated specific IgE to latex, a positive history upon contact to material containing latex and probably frequent operations. Provocation tests should be performed to plan avoidance measures in latex-allergic children especially before surgical interventions.

Adolescent↗
PubMed1996

Domestic fungal viable propagules and sensitization in children with IgE mediated allergic diseases.

In order to study the possible relationship between domestic fungal exposure and sensitization to fungi, the homes of 20 children with allergic diseases (mainly bronchial asthma) were inspected for visible fungal growth and airborne viable fungal propagules were sampled. Inclusion criterion was sensitization to at least one of the tested fungi as shown by proof of specific IgE in serum. Twelve of 19 homes (63%) revealed a considerable amount of viable fungal propagules and/or visible fungal growth. Penicillium, Cladosporium, Aspergillus, Mycelia sterilia and yeasts were most prevalent. There was no clear-cut relationship to serologically proven sensitization.

Adolescent↗
PubMed1996

Comparison of three immunoassays for diagnosing sensitization to latex in children with spina bifida.

As natural rubber latex (latex) has become more widespread in our environment, physicians have become increasingly aware of the problem of possible allergic reactions. Many fatal and near-fatal incidents have been reported (mainly during surgery) (1-3) and data has been published on groups frequently exposed to latex, such as patients with spina bifida (4-9), healthcare professionals (10-12) and occupationally exposed persons (13). The incidence of latex allergy in children seems to be increasing (14). Tests are therefore needed which can reliably detect sensitization to latex. Our aim was to compare the diagnostic accuracy of three commercial immunoassays for measuring specific IgE in serum to latex.

Adolescent↗
PubMed1996

Relevance of serum ECP measurements for monitoring acute asthma in children.

To evaluate the role of serum eosinophil cationic protein (ECP) concentration as a monitoring parameter in acute bronchial asthma, 11 children (mean age 10.2 years) were studied during an acute exacerbation of their disease. Under an appropriate anti-inflammatory therapy, FEV1 increased significantly at day 1 (p < 0.05), day 14 (p < 0.05), day 28 (p < 0.03), and day 56 (p < 0.03) compared to baseline values at referral to hospital. Serum ECP concentration decreased in the group of patients significantly at day 28 (p < 0.02) and day 56 (p < 0.04). However, considering the individual serum ECP time courses, most of the patients did not show a uniform pattern of continuously decreasing values. From our data, we conclude that measuring serum ECP concentration during acute asthma episodes in children may play a role in some patients, whereas in others--probably those without acute eosinophil inflammation--monitoring by serum ECP concentration is of limited value.

Acute Disease↗
PubMed1996

[Echinococcosis of the heart].

Human disease caused by echinococcus granulosus is rare in Northern Europe, but is seen increasingly due to migration of labour and of tourism to endemic areas e. g. Southern Europe and the Middle East. Echinococcosis of the heart occurs in only 0.5 to 2% of cases of echinococcosis. Diagnosis is difficult because of the long latency between infection and manifestation of disease, and also because symptoms are unspecific. It is a diagnosis "to think of". Apart from a thorough history serological tests and medical imaging (ultrasound, X-rays, computed tomography) are used in the diagnosis of echinococcosis. Surgery is the preferred therapy, if not feasible medical treatment with benzimidazoles (Albendazole and Mebendazole) is effective. We describe a case of echinococcosis of the heart as the only manifestation of the disease: a 34-year-old male Turkish patient came in severe cardiac shock due to cardiac tamponade to the emergency department. Immediate heart surgery revealed a pericardium filled with cysts of echinococcus granulosus, infiltrating the left ventricle of the heart (Figure 1). The cysts were removed and the patient was put on a 2-year course of Mebendazole. The patient is free of relapse for more than 6 years now and he is considered to be cured.

Adult↗
PubMed1996

Risk factors for latex allergy in patients with spina bifida.

OBJECTIVE AND METHODS: In order to study risk factors for latex allergy in patients with spina bifida, we investigated 165 patients with spina bifida (mean age 9 years). Besides answering a questionnaire, patients underwent skin-prick testing and determination of specific serum IgE to latex as well as a screening test for specific IgE to environmental allergens. A total of 80 patients (49%) were sensitized to latex according to the presence of specific IgE to latex. RESULTS: Skin-prick tests (SPT) with high ammonia latex milk were performed in 81 of our patients with spina bifida and were positive in 36 patients (46%). Concordance of SPT with specific IgE in serum was good. Nineteen out of 165 patients suffered from a clinically relevant latex allergy: five patients had a history of systemic reactions to latex (e.g. severe bronchospasm, anaphylactic reactions), mostly during surgery. Fourteen patients reported clinical symptoms while inflating a balloon; all these 19 patients were sensitized to latex. Number of operations ranged from one to 26 (mean 5 operations). Concentration of specific IgE to latex in serum correlated well with increasing numbers of operations. Some 32/76 patients (41%) with spina bifida who were sensitized to latex showed an atopic disposition, while 21 out of 81 latex-negative patients (26%) were atopic. Of 300 consecutive sera (mean age of patients 9 years) sent to our laboratory for routine determination of specific IgE, 144 (48%) were positive in terms of specific IgE to environmental allergens, of which 247144 (17%) were sensitized to latex. CONCLUSIONS: From our data we conclude that in order to minimize risk of severe systemic clinical reactions, all patients with spina bifida should be screened for their individual risk of latex allergy to plan preventive measures before operations. Main risk factors for latex allergy seem to be: more than five operations, atopic predisposition, history of clinical symptoms while inflating a balloon, and a sensitization with a CAP-class of > or = 4.

Adolescent↗
PubMed1996

[Comparison of serum concentrations of once and twice daily administration of ultra-retard theophylline in school children with bronchial asthma].

It was the aim of our study to find out whether once-daily administration of an ultra-retard preparation is meaningful also during childhood if compared to twice-daily application. To this end we examined 11 children (6 girls, 5 boys) between 7 and 16 years of age (median 12 years) who were suffering from bronchial asthma. The same theophylline daily dose was administered for 10 days each either as a single dose in the evening (20.00 hrs) or subdivided into two single doses (9.00 and 20.00 hrs). Dosage was according to age between 11 and 24 mg/kg body weight and day. The median values of blood serum concentration of theophylline of the once-daily or twice-daily administration in the "steady state" did not show any significant difference in the course of the 24-hour observation. The maximum effective concentration was attained after 12 hours in case of the once-daily application and after 8 hours with the twice-daily application. Summing up, our data indicate that good control of asthma bronchiale can be achieved even with once-daily administration of an ultra-retard preparation also in childhood. With both regimens the blood serum concentrations showed a satisfactorily low variability over 24 hours.

Adolescent↗
PubMed1995

Two cases of pulmonary tuberculosis presenting with unilateral pulmonary hyperinflation in infancy.

UNLABELLED: Two infants with recurrent obstructive symptoms attracted attention because of massive radiologically detected unilateral pulmonary hyperinflation. Further diagnostic procedures including bronchoscopy, revealed a pulmonary tuberculosis with lymph nodes encroaching on the bronchi. Steady improvement of clinical symptoms and hyperinflation was noted under combined antituberculotic therapy including systemic steroids. CONCLUSION: Our two cases demonstrate that the differential diagnosis of unilateral pulmonary hyperinflation and wheezing in infancy should consider valvular stenosis by encroaching lymph node due to pulmonary tuberculosis.

Bronchi↗
PubMed1995

Individual time-courses of ECP and EPX during allergen provocation tests in asthmatic children.

To study the time-course of eosinophil cationic protein (ECP) and eosinophil protein X (EPX) during bronchial allergen provocation, we investigated 32 asthmatic children sensitive to house-dust mites as well as 6 non-atopic young adult controls. In all subjects, allergen challenges were performed with house dust mite extracts of Dermatophagoides pteronys-sinus or Dermatophagoides farinae. Blood samples were taken at regular intervals during the 24-h observation period. The individual time-courses of ECP and EPX revealed different characteristic groups of patterns: (1) an isolated early serum peak of both mediators during or within the first 60 min after provocation (2) an early plus a late peak (3) an isolated late peak 12 h after provocation (4) an isolated late peak 24 h after provocation, and (5) no significant variation during the 24-h observation period. The early peak could be due to short-term changes in eosinophil activation, while late peaks may reflect eosinophil proliferation, recruitment, subsequent priming and enhancing of the propensity to release their proteins. ECP and EPX showed a corresponding parallel time-course in nearly all challenges, with EPX-concentration exceeding that of ECP. There was no correlation between ECP/EPX serum concentrations and clinical parameters such as lung function data. From our results we conclude that the striking groups of time-courses of ECP/EPX serum concentration indicate different uniform patterns of eosinophil activation during allergen challenge-but do not predict clinical outcome of provocation. The role of the eosinophil in early asthmatic reactions remains to be established in further studies.

Adolescent↗