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Biomedical subjects

B Przybilla

Publications and source records attributed to B Przybilla.

At least 145 records · Page 8Linked to original sources
PubMed1988

Trends in allergic contact sensitization.

A standard patch test series was tested for 7 years (1977-1983) in a total of 11,962 patients. The annual frequency of positive reactions to the compounds tested was assessed for the total and for males and females separately. During the observation period, there were significant increases in positive reactions in the total group from 6.2% to 12.7% for nickel sulphate, from 5.3% to 7.0% for balsam of Peru and from 3.8% to 6.5% for potassium dichromate, reflecting significant changes in both sexes. The frequency of positive reactions to wool alcohols, formaldehyde, neomycin sulphate, paraben mix and gentamycin sulphate significantly increased, while that of positive reactions to clioquinol, mercuric chloride and turpentine peroxide significantly decreased in either males or females, sometimes leading to significant changes in the total group.

Allergens↗
PubMed1988

Eicosanoid release in polymorphous light eruption: selective UV-A-induced LTB4 generation by peripheral blood leukocytes.

The biochemical basis of ultraviolet-induced cutaneous inflammation in polymorphous light eruption (PLE) is not known. We investigated the potential role of eicosanoids--derivatives of arachidonic acid--as mediators of inflammation in this common disorder. 13 patients were investigated, in whom skin lesions could be experimentally reproduced by repeated UV-A but not UV-B irradiation. Peripheral blood leukocytes of these patients were irradiated with UV-A or UV-B, and the release of leukotriene B4 (LTB4), LTC4 and prostaglandin E2 (PGE2) was measured. Cells from PLE patients, but not healthy controls, released selectively high amounts of LTB4 in response to UV-A. The UV-A-induced LTB4 release was light-dose-dependent. This phenomenon was not observed with UV-B. The selective UV-A-induced release of LTB4 could play a major role in the pathophysiology of cutaneous inflammation in PLE.

Adult↗
PubMed1988

Polymorphous light eruption: eliciting and inhibiting wavelengths.

In 38 patients with polymorphous light eruption (PLE) photoprovocation tests were performed by applying 100 J/cm2 of UV-A to the extensor side of the upper arm on three consecutive days. Test sites were divided into four areas by covering the patients' skin with Schott glass filters WG 320, WG 335, WG 360, and GG 385 (or GG 395). In 17 patients typical skin lesions could be provoked in at least one test field. 10 patients reacted either at all test sites or at shorter wavelengths (simultaneously higher doses) only. In the remaining 7 patients test reactions did not occur underneath filters with lower cut-off points, whereas skin lesions were induced by radiation deprived of the shorter wavelengths passing through these filters. This observation suggests an inhibitory effect of shorter wavelengths in these cases.

Humans↗
PubMed1988

[The basophilic histamine liberation test as a diagnostic method in Hymenoptera venom allergy].

In 181 patients with systemic reactions to hymenoptera stings as a result of immediate-type allergy to bee or wasp venom confirmed by history, skin testing and demonstration of hymenoptera venom-specific IgE antibodies on radioallergosorbent testing (RAST), in vitro histamine release from peripheral basophilic granulocytes following stimulation with bee or wasp venom was evaluated. Suspensions of washed peripheral leukocytes at a density of 2 x 10(6)/ml were incubated with four different concentrations of hymenoptera venoms. Histamine was measured by spectrofluorometry, and histamine release was calculated as a percentage of the total histamine content. Tests performed with peripheral leukocytes obtained from 18 non-allergic individuals served as controls. In both bee venom allergy and wasp venom allergy the corresponding allergen induced concentration-dependent histamine release. Upper normal limits of histamine release were defined for the venom concentrations used. When these were used as reference values the basophil histamine release test exhibited a specificity of 94% and a sensitivity of 82% in the diagnosis of bee venom allergy, and a specificity of 83% and a sensitivity of 68% in the diagnosis of wasp venom allergy. Since there was no relevant significant correlation between the results of the basophil histamine release test on one hand and the severity of sting reactions and the prick test and RAST results on the other, it seems that the histamine release test determined additional parameters of sensitization. Thus, the method is a valuable adjunct to the in vitro methods available for the diagnosis of hymenoptera venom allergy.

Adolescent↗
PubMed1988

[Epicutaneous testing with a standard series. Results in 12,026 patients].

From 1977 to 1983, 12,026 patients were given patch tests with a standard series of substances. A total of 4,494 (37.4%) had positive patch-test reactions to one or more allergens; the average number of positive reactions was 1.85. The most frequent reactions were due to nickel sulphate (positive reactions in 9.2% of those tested), fragrance mix (8.9%), balsam of Peru (6.3%), cobalt chloride (4.7%), potassium dichromate (4.3%) and wool alcohols (4.3%). Women showed significantly more positive reactions than men to nickel sulphate, cobalt chloride, wool alcohols, and parabens and significantly fewer positive reactions than men to potassium dichromate, PPD mix, and epoxy resin. Younger patients showed significant more positive reactions to nickel sulphate and cobalt chloride; middle-aged patients reacted more to potassium dichromate, paraphenylendiamine, formaldehyde and thiuram mix; elderly patients reacted to balsam of Peru, wool alcohols, caine mix, neomycin sulfate, benzocaine, colophony, clioquinol, mafenide, parabens, and gentamycin sulfate.

Adult↗
PubMed1987

[Pseudo-allergic drug reactions: pathophysiology and diagnosis].

The symptomatology of allergic diseases may be imitated by non-immunological, so-called "pseudo-allergic" reactions. Phenocopies of any type of allergic reaction may occur. Pseudo-allergic drug reactions may be caused by the active components as well as by additives. Anaphylactoid pseudo-allergic reactions are of special clinical interest. Their pathomechanism has not been conclusively elucidated yet. Based on clinical and experimental data, we discuss some hypothetic mechanisms of a few compounds, always keeping in mind the possibility of allergic mechanisms not yet identified. For the diagnosis of pseudo-allergic drug reactions we need provocation tests, as skin tests are not possible, and routine in-vitro assays are not available.

Analgesics↗
PubMed1987

[Rush hyposensitization with Hymenoptera venoms. Tolerance and results of therapy].

During 290 courses of rush hyposensitization with bee or wasp venoms performed on an in-patient basis there were systemic anaphylactic side effects in 38% before the maintenance dose of 100 micrograms was reached. These reactions were usually mild, occurred mostly at higher venom doses (threshold doses greater than or equal to 1 microgram in about 75%) and were more frequent (P less than 0.05) in patients with a history of a full shock due to stings than in individuals with milder symptoms. Furthermore, systemic anaphylactic side effects occurred more often (P less than 0.01) in bee venom allergic patients with a greater sensitivity in the prick test (threshold less than 10 micrograms/ml) than in those being less reactive; no such dependence was found in wasp venom allergy. RAST results were not correlated to the occurrence of systemic anaphylactic side effects. Evaluation of the therapeutic effect was performed by 163 sting challenge tests, which caused only local sting reactions in 80%. Compared to prior stings improvement of symptoms was achieved in 95% of 157 patients with a history of systemic reactions. Individuals with more severe challenge reactions were older (P less than 0.05) than those with merely generalized skin symptoms. Furthermore, there was a correlation between the occurrence of systemic challenge reactions and systemic anaphylactic side effects during rush hyposensitization as well as between a history of more severe sting reactions and symptoms exceeding generalized skin symptoms at challenge. Thus, hyposensitization with hymenoptera venoms induces partial or complete protection in a high percentage of patients. The course of rush hyposensitization as well as the therapeutic effect depend to some degree on the original intensity of hypersensitivity.

Adolescent↗
PubMed1987

Allergy to local anesthetics: comparison of patch test with prick and intradermal test results.

The interrelation between immediate and delayed hypersensitivity reactions to local anesthetics is poorly understood. Especially, the relevance of positive patch test reactions to local anesthetics with regard to the compatibility of injected local anesthetics is unclear. We therefore subjected 104 patch test-positive probands to prick and intradermal tests with seven local anesthetic agents. All prick tests were negative. Only 14 patients showed positive reactions in intradermal tests: 11 with the ester local anesthetic procaine, one with the amide local anesthetic butanilicaine, and two with both. Procaine yielded both immediate and delayed reactions; butanilicaine, only immediate reactions. All other local anesthetics showed negative reactions. It is concluded that in patients with positive patch test reactions to local anesthetics and negative history of anaphylactoid reactions, positive skin test reactions to intradermal application are rare and that, therefore, the risk of anaphylactic reactions to injection anesthesia with amide local anesthetics, except butanilicaine, appears low in these patients.

Adult↗
PubMed1987

Nonsteroidal antiinflammatory drugs induce UV-dependent histamine and leukotriene release from peripheral human leukocytes.

The effect of UV-A radiation on the in vitro release of vasoactive mediators from human peripheral leukocytes incubated with different nonsteroidal antiinflammatory drugs (NSAIDs) was studied in the newly developed photo basophil histamine release test (PBHRT). Washed peripheral leukocytes were incubated with 10(-6) to 10(-3) M of various NSAIDs and exposed to 1-100 J/cm2 UV-A. Maximum histamine release was 4% with acetylsalicylic acid, 10% with benoxaprofen, 20% with thiophene, 28% with diclofenac, 39% with tiaprofenic acid, 40% with carprofen, 55% with ketoprofen and not demonstrable with indoprofen. Maximal reactions occurred at UV-A doses of 25 or 50 J/cm2. Leukotriene B4 (LTB4) generation in the supernatants of cells treated with UV-A or NSAID alone was below or close to the detection limit (145 pg/ml). On the contrary, UV-A irradiation of cells incubated with NSAID led to marked LTB4 generation (up to 1,000 pg/ml). The results indicate that many NSAIDs can induce photosensitization in vitro, the PBHRT being a promising new method for identification of possibly phototoxic compounds. Release of vasoactive mediators like histamine or leukotrienes may be involved in the in vivo development of phototoxic or photoallergic side reactions.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1987

Phototoxicity of non-steroidal anti-inflammatory drugs demonstrated in vitro by a photo-basophil-histamine-release test.

The phototoxic activity of the non-steroidal anti-inflammatory drugs (NSAID) acetylsalicylic acid, benoxaprofen, carprofen, diclofenac, indoprofen, ketoprofen, tiaprofenic acid, and of thiophene, a heterocyclic ring structure of the tiaprofenic acid molecule, was evaluated in vitro by a newly developed photo-basophil-histamine-release test (PBHRT) performed with human leukocytes. Cell suspensions incubated with 10(-6) to 10(-3) M of the test compounds were exposed to 1 to 100 J/cm2 UVA. Maximum photo-basophil-histamine-release was 4% with acetylsalicylic acid, 10% with benoxaprofen, 20% with thiophene, 28% with diclofenac, 39% with tiaprofenic acid, 40% with carprofen, 55% with ketoprofen, and not demonstrable with indoprofen. These results indicate that many NSAID can exert phototoxic effects, thus confirming clinical observations as well as other in vitro experiments. The PBHRT seems to be a promising new method for the identification of phototoxic compounds.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1987

[Photosensitizing properties of nonsteroidal antirheumatic drugs in the photopatch test].

The non-steroidal anti-inflammatory drugs, aspirin, carprofen, diclofenac, ketoprofen, piroxicam, and tiaprofenic acid, were tested in a standard photopatch test series. The routine irradiation dose was 15 J/cm2 UV-A; in most patients additional test series were exposed to non-erythematogenic doses of UV-B and a combination of UV-B and UV-A. In the photopatch test, there were reactions to tiaprofenic acid in 43 of 175 (24.6%), to carprofen in 21 of 86 (24.4%), to aspirin in 7 of 76 (9.2%), to piroxicam in 7 of 84 (8.3%), to diclofenac in 5 of 75 (6.7%), and to ketoprofen in 2 of 53 (3.8%). In 16 patients positive photopatch test results did not start to develop until after the 3rd test day (between day 7 and day 34). In some cases there were positive reactions within the non-irradiated control series. Most of the positive photopatch test reactions could be elicited by UV-A alone; in some cases, however, combined irradiation with UV-B plus UV-A was necessary to yield positive results; only rarely did positive reactions occur exclusively with UV-B. The high incidence of positive photopatch test reactions to non-steroidal anti-inflammatory drugs is a possible indication of a phototoxic action. However, in some cases a photoallergic pathomechanism seems probable with regard to the development of reactions after the 3rd test day, a high UV-sensitivity in the photopatch threshold test, and the results of the histological evaluation of test reactions in some patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Sulfite hypersensitivity].

Sulfites are widely used as preservatives and antioxidants in foods and drugs, often without specification. Sulfite can lead to severe hypersensitivity reactions, asthma being obviously the most frequent symptom, but also urticaria, angioedema, or other anaphylactoid symptoms may occur. Furthermore, allergic leukocytoclastic vasculitis and exacerbation of an atopic eczema have been observed. The pathomechanisms of sulfite hypersensitivity have not yet been completely elucidated. Asthmatic reactions have been attributed to reflectory activation of the parasympathetic system by the irritating effect of sulfites, possibly enhanced by a deficiency of sulfite oxidase. Besides this pseudo-allergic mechanism, for at least some cases of sulfite hypersensitivity an IgE-mediated immediate-type allergic reaction has to be considered. The diagnosis of sulfite hypersensitivity is based on provocation testing, which must be done with extreme caution.

Anaphylaxis↗
PubMed1987

Environmental influences on UVB erythema.

In 31 volunteers the superficial skin temperature of one forearm was either raised or lowered by a warm or cold water bath. Immediately afterwards the individual minimal erythema dose (MED) for monochromatic light of 300 +/- 5 nm (UVB) was determined on both arms. Compared to the control forearm, a warm water bath significantly lowered the MED (p less than 0.001), whereas a cold water bath had no influence on the light sensitivity. In 14 volunteers the MED for polychromatic UVB was determined on the lower back with and without a continuous cold air flow 5 min before and during the UVB exposure. The continuous cold air flow significantly increased the MED (p less than 0.05). Environmental factors such as warm water or cold air have modulating effects on UVB erythema. These interactions should be considered when dealing with the effects of natural sun exposure or phototherapy.

Adolescent↗
PubMed1986

[Total IgE levels in the serum in dermatologic diseases].

A total of 2,951 determinations of total IgE serum levels in dermatologic patients revealed significantly elevated geometric mean values in 18 of 25 diagnostic groups. The highest IgE concentrations (geometric mean greater than 100 kU/l) were found in atopic diseases (atopic eczema, extrinsic asthma, allergic rhinitis), scabies, ichthyosis vulgaris and diseases of the prurigo group. Furthermore, total IgE was elevated in acute, chronic, and physical urticaria, in patients with immediate-type allergies, in various kinds of eczema, in patients with characteristic features of atopy (typus atopicus), in psoriasis, in pyogenic skin infections, and alopecia areata. The range of individual IgE values was wide: in all diagnostic groups individual IgE levels beneath the normal adult geometric mean of 14 kU/l were found; the maximum concentrations were 340-47,000 kU/l, thus exceeding the upper limit of 100 kU/l for individual values. Knowledge of the patient's clinical condition is a prerequisite for the diagnostic interpretation of an individual total IgE serum level.

Adolescent↗