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Biomedical subjects

B Weeke

Publications and source records attributed to B Weeke.

At least 91 records · Page 5Linked to original sources
PubMed1986

High-dose inhaled budesonide in treatment of severe steroid-dependent asthma.

Forty-five steroid-dependent asthmatic outpatients were treated twice daily for 51 weeks with a new inhalation steroid, budesonide (BUD), using a 750 ml spacer. During the initial 15 weeks the prednisone-sparing effects of a high daily dose (1600 micrograms) and a conventional dose (400 micrograms per day) were compared in a double-blind randomized trial including 50 patients. During the remaining 36 weeks 45 patients were treated openly with 1600 micrograms daily. All patients used other antiasthmatic drugs which were maintained throughout the study, except for inhalations of beta-2 agonists that could be used whenever needed. All patients but 2 were able to reduce the daily dose of oral prednisone. The mean daily dose decreased from 13.9 mg to 5.3 mg. Eighteen patients (40%) were able to discontinue oral prednisone. Adrenal gland function improved considerably as prednisone intake decreased. Oropharyngeal thrush frequency showed no change. No severe side effects were observed.

Administration, Oral↗
PubMed1985

Pharmacokinetics of theophylline and enprofylline in patients requiring a high or low dose of theophylline.

In patients requiring a high or low dose of theophylline the pharmacokinetics of theophylline and enprofylline were studied. The low-dose group took an average daily dose of 8.91 mg/kg body wt. and the high-dose group 24.75 mg/kg body wt. The average half-life of theophylline in the former was 7.11 h and in the latter 4.72 h. The average clearances (CL) of theophylline were 2.83 and 4.58 l/h, respectively. The daily oral intake of theophylline was negatively correlated with the theophylline t1/2 (r = -0.63). While the t1/2 of enprofylline was similar in the two groups, CL and volume of distribution (Vc) were slightly (about 30%) but significantly higher in patients requiring a high dose of theophylline. CL of enprofylline did not correlate with CL of theophylline, nor was the Vc of the two drugs correlated. Interindividual variability in t1/2 and CL was considerably lower for enprofylline than for theophylline.

Bronchodilator Agents↗
PubMed1985

Bambuterol: effects of a new anti-asthmatic drug.

Twenty-seven asthmatic outpatients were randomly treated with bambuterol 30 mg administered once daily before going to bed and sustained release terbutaline 10 mg twice daily in a 14 day, double blind cross over study. On all the parameters of bronchodilator effects, namely peak expiratory flow rate (PEF), use of extra beta-agonist puffs, asthma symptom score, and patient preference for one of the treatments, no statistically or clinically significant difference between the two treatments was found. No significant difference between treatments was observed in the number or severity of side-effects. Bambuterol administered once daily appears to be an effective anti-asthmatic treatment.

Adult↗
PubMed1985

The IgE and IgG subclass antibody response in patients allergic to yellow jacket venom undergoing different regimens of venom immunotherapy.

We developed a three-layer immunoradiometric assay for quantitation of IgG antibodies of all four subclasses to YJV. We studied the IgE and IgG subclass antibody response to YJV in 31 patients allergic to YJV who were undergoing three different kinds of venom immunotherapy. Group A received weekly single injections with alum-adsorbed venom, group B received weekly clustered injections with aqueous venom, and group C received fortnightly clustered injections with aqueous venom during the increasing dose phase of our study. All patients received alum-adsorbed venom during maintenance therapy. Results from the first 6 months of observation are reported. After 6 months of therapy the IgE antibody level rose significantly in group A, was unchanged in group B, and tended to fall in group C. The fall in IgE antibody level in group C correlated significantly to the pretreatment IgE antibody level. The IgG subclass antibody assays measured IgG antibodies of different subclasses in comparable units. No IgG2 or IgG3 antibodies to YJV were found. Before the start of immunotherapy, 23 patients had significant concentrations of IgG1 antibodies to YJV, and 14 had significant concentrations of IgG4 antibodies. In group A the IgG1 antibody level rose significantly after 6 months, and the IgG4 antibody level rose significantly after 3 months. In group B the IgG1 antibody level rose after 2 weeks and the IgG4 antibody level rose after 3 weeks. In group C the IgG1 antibody level rose after 2 weeks and the IgG4 antibody concentration rose after 8 weeks. When the maintenance dose was reached, the IgG1 antibody level in group C was significantly higher than that in group A. The possibility that IgG1 antibodies formed during venom immunotherapy take part in a feedback inhibition of the IgE antibody production is discussed.

Adult↗
PubMed1985

Sensitive glass microfibre-based histamine analysis for allergy testing in washed blood cells. Results compared with conventional leukocyte histamine release assay.

The new microfibre method for allergy testing is based on basophil histamine release after challenge with suspected allergens in samples of 50 microliter washed blood cells. Released histamine is bound to microfibres and measured after removal of interfering substances by washing. The microfibre method was compared with the conventional leukocyte histamine release assay in 18 allergic patients tested with 10 different allergens. It was found that the same individuals responded with histamine release to the same allergens in both assays, and the number of responders was almost identical. Also the dose-response curves and the cell sensitivity were almost identical, which further substantiated identity between the results obtained by the new microfibre method and the conventional assay. A comparison between the microfibre method and in vivo provocation tests showed good agreement when comparing the number of positive and negative responses in these test. The new method overcomes the problems in allergy testing, where only small amounts of blood are available and many tests have to be carried out.

Allergens↗
PubMed1985

Clinical and immunological aspects of a case of monoclonal hyper-IgE. Isolation of IgE-protein, estimation of basophil cell bound IgE and histamine release.

A case of monoclonal IgE type lambda with IgE levels about 1 mg/ml has been followed for 6 years. Except for a slight asthma no signs of malignancies, parasitic infestations or other known diseases compatible with hyper-IgE have been found. By the combination of fractional ammonium sulphate precipitation, gel filtration, chromatofocusing, and subtraction affinity chromatography the IgE protein was isolated in an immunochemically pure and homogeneous form. Immunofluorescence of bone marrow cells showed about 1% IgE plasma cells. The amount of basophil bound IgE was 42 ng/10(6) cells, and histamine release from basophils challenged with anti-IgE was not different from that in atopic control persons, indicating a within-allergic-patients normal amount of IgE receptors. The protein-A reactivity was 0.4% equivalent to well-known IgE myeloma proteins. No antigen specificity of the IgE protein was found. Only a few cases of asymptomatic hyper-IgE are known, and it cannot be ruled out that this represents a premyeloma condition, since a similar case terminated in a malignant lymphoma.

Aged↗
PubMed1985

Oral administration of grass pollen to hay fever patients. An efficacy study in oral hyposensitization.

Oral hyposensitization is still widely used in the treatment of allergic diseases, but controlled studies proving a beneficial effect are lacking. Fifty-eight hay fever patients were admitted to a double-blind placebo efficacy study in oral hyposensitization. An enterosoluble tablet containing timothy whole pollen or placebo was taken daily. Preseasonally, the actively treated patients received 4,315,000 PNU (880,260 AUR) and totally for 6 months 8,915,000 PNU (1,818,660 AUR). Such high doses have never been tried in similar studies. A new principle has been used - "the pollen count interval method" - in the evaluation of symptom and medication score. The study failed to prove any beneficial effect of oral hyposensitization measured by symptom score, medication score, nasal provocation test or skin prick test. There was no change in timothy specific IgE and IgG which could be caused by the treatment. The possibility that oral hyposensitization might be an effective treatment of hay fever in the future is discussed, but it is concluded that the present regimens cannot be recommended.

Administration, Oral↗
PubMed1985

Reproducibility of histamine skin prick test. Inter- and intravariation using histamine dihydrochloride 1, 5, and 10 mg/ml.

The reproducibility of skin prick test using histamine dihydrochloride 1, 5, and 10 mg/ml was tested by three nurses in five non-atopics in a double-blind trial. The variations day-to-day, within-day, between and for the same tester were calculated. Seventy-five percent of wheal reactions obtained by histamine 1 mg/ml were less than 15 mm2. With histamine 5 mg/ml there were only a few wheals less than 15 mm2 and none at all with histamine 10 mg/ml. The mean coefficient of variation of wheals greater than 15 mm2 was between 20-30%, in contrast to figures between 30-60% with wheals less than 15 mm2. No significant day-to-day or within-day variation was shown concerning histamine wheal areas. It is suggested that histamine dihydrochloride 10 mg/ml should replace histamine dihydrochloride 1 mg/ml as the positive reference in routine skin prick tests and biological standardization.

Adult↗
PubMed1985

Clustered immunotherapy with Yellow Jacket venom. Evaluation of the influence of time interval on in vivo and in vitro parameters.

To evaluate difference in clinical efficacy, side effects, in vivo and in vitro parameters, 25 patients allergic to Yellow Jacket were treated with clustered immunotherapy using either 7 or 14 days interval between clusters. Twenty-one patients completed the 6 months' treatment period and four were withdrawn due to adverse reactions (2 cases of anaphylactic shock). Sixteen patients were challenged by in-hospital sting and the clinical efficacy was complete. Local side effects were observed in the majority of patients, but only rarely limited the course of immunotherapy. Skin sensitivity estimated as the venom concentration eliciting a wheal equal to histamine HCl 0.1 mg/ml using intradermal test was significantly reduced after 6 months of treatment. Specific IgE showed an initial increase, thereafter declining to pretreatment levels. IgG subclasses were determined by a triple antibody assay. Only subclasses 1 and 4 showed response. Subclass 4 showed a steady increase contrary to subclass 1 which decreased after reaching maintenance dose. No unambiguous relation between either the absolute value or the change of IgG1 and IgG4 at the time of challenge was observed in the patients who tolerated a sting. Furthermore, the IgG response was not correlated to the cumulative dose of venom administered. No simple regulatory function of IgG subclasses in the skin and IgE response was found, and the occurrence of local side effects did not seem to be determined by IgG antibodies. We conclude that clustered immunotherapy with Yellow Jacket venom is highly effective and that the frequency of side effects is acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Serum aluminium in hyposensitized allergics.

The concentration of serum aluminium was examined in hyposensitized subjects receiving subcutaneous injections of solutions of allergens precipitated with or adsorbed to aluminiumhydroxide and in non-hyposensitized allergics. No correspondence between the serum values and the quantity of aluminium mediated with the injections was found. It was concluded that the investigation did not incriminate this type of treatment in causing rising serum concentrations of aluminium.

Adolescent↗
PubMed1985

Effects of enprofylline and theophylline on exercise-induced asthma.

Eight asthmatic out-patients with a history of exercise-induced asthma (EIA) were randomly treated with intravenously administered enprofylline 1.5 mg/kg b.wt., theophylline 5 mg/kg b.wt., and placebo immediately prior to a 6-min exercise provocation in this double-blind crossover comparison. A reduction in peak flow of more than 20% was seen in all patients after placebo pre-treatment. Mean plasma concentrations at the start of the exercise test were 3.3 mg/l and 13.2 mg/l after 20 min infusion of enprofylline and theophylline, respectively. The corresponding figures 25 min later were 2.3 and 11.7, respectively. Maximal fall in peak expiratory flow (PEF) after exercise in percent of pre-exercise PEF was 49% +/- 6% (mean +/- SEM), 39% +/- 6% and 24% +/- 5% after infusion of placebo, enprofylline, and theophylline, respectively. Theophylline produced a statistically significant better protection against EIA compared to enprofylline and placebo. Enprofylline produced a slight protection from EIA not statistically significantly different from placebo.

Adolescent↗
PubMed1985

Bronchial histamine challenge. A combined interrupter-dosimeter method compared with a standard method.

We compared the provocative concentration (PC) values obtained by two different methods of performing bronchial histamine challenge. One test was done on an APTA, an apparatus which allows simultaneous provocation with histamine and measurement of airway resistance (Rtot) by the interrupter method. The second test was a conventional tidal breathing method, with measurement of the FEV1. There was a high correlation between the PC20-FEV1 and the PC30-, PC40- and PC50-Rtot values. The correlation coefficients were 0.85, 0.71 and 0.70 (P less than 0.05) respectively. We further tested the reproducibility of the histamine challenge done on the APTA. When the PC30-Rtot values were compared, a correlation coefficient of 0.56 (NS) was found. For the PC40- and PC50-Rtot values the correlation coefficients were 0.65 (P less than 0.05) and 0.70 (P less than 0.02) respectively. We conclude that the APTA is useful for routine bronchial histamine challenge when 40-50% increase in basal Rtot is used as endpoint.

Adolescent↗
PubMed1985

Non-hereditary angioedema treated with tranexamic acid. A 6-month placebo controlled trial with follow-up 4 years later.

Ten patients with frequent attacks of non-hereditary angioedema were treated with tranexamic acid or placebo in a double blind manner, each period lasting 3 months. During the tranexamic acid period nine patients became symptom-free, or substantially improved, while one was unaffected (P less than 0.05). In four patients itching was a major accompanying complaint which was relieved in three. Diarrhoea and abdominal discomfort were more pronounced during tranexamic acid treatment (P less than 0.05), but only necessitated dose reduction in one patient. Four years later contact was obtained with eight of the nine responders and six were still taking tranexamic acid regularly, while in two patients the attacks were so infrequent that the drug was not taken regularly.

Adult↗
PubMed1985

Diagnosis and immunotherapy of mould allergy. I. Screening for mould allergy.

In order to screen for mould allergy, extracts of five common atmospheric moulds (Cladosporium, Alternaria, Penicillium, Aspergillus and Mucor) from various manufacturers were investigated in 130 patients (5-60 years old) with clinical symptoms indicating possible mould allergy. The patients were screened by skin prick test (SPT) and radioallergosorbent test (RAST). SPT seemed to be more sensitive than RAST as a diagnostic screening procedure (80% positive reactions to one or more species compared to 50%). With a partially purified, standardized preparation of Cladosporium herbarum more positive reactions were obtained than with crude extracts without evidence of any unspecific reactions. The difference between commercial and standardized extracts is most probably a result of a variation of both the biological potency of allergenic determinants and the allergenic composition. A considerable number of negative RAST reactions with standard discs were found in patients with positive skin reactions to partially purified Cladosporium, but RAST seemed to be more sensitive than SPT with the other commercial mould extracts. Based on the screening, a very convincing tendency to IgE-reactivity to other moulds was found in patients reacting to Cladosporium, the most common cause of mould allergy. The results confirm the inadequacy of most mould extracts used in diagnostic procedures and strengthen the value of using standardized extracts.

Adolescent↗
PubMed1985

Aluminium hydroxide adsorbed allergens used in modified RAST.

A method is described in which the conventional radioallergosorbent test (RAST) for determination of allergen-specific IgE in serum has been modified by displacing the solidphase sorbent by a gel of aluminium hydroxide (Al(OH)3). The optimum conditions for this new analysis (AlRAST) are determined, taking into account speed, costs and the ratio between responses of patients and normal individuals. The AlRAST fulfills the criteria for validity: it is specific and shows parallelism between serum dilution curves. The sensitivity and reproducibility are slightly lower than in the conventional RAST, but sufficient for most routine and screening procedures. The preparation of allergosorbents in AlRAST can be accomplished within 1 h, thus making it convenient for fast screening of patients against unusual allergen extracts, as well as for allergen standardization from dose-response curves. Further, it is possible to standardize aluminium hydroxide adsorbed extracts used for immunotherapy by using the products directly as allergosorbents in the AlRAST.

Allergens↗
PubMed1985

Identification and clinical significance of allergenic molecules of cat origin. Part of the DAS 76 Study.

Freeze-dried extracts from cat dander and the corresponding rabbit antibodies were used for establishing the CIE reference pattern for cat dander extracts. Anti-Cat Ag 1 and anti-cat albumin were used for identification of the corresponding antigens. CRIE on sera from selected groups of American and Danish cat-allergic patients demonstrated antigen-specific IgE binding to 10 of 15 cat dander antigens (Cat Ag 1 being the major allergen). Only minor differences were found between the two groups. Four of these allergens were serum proteins. Variable amounts of many of the 10 allergens were measured by QIE in saliva, serum, urine and three cat pelt extracts. However, extremely wide ranges for content of the serum allergens and the non-serum allergens were found. This was exemplified by an albumin/cat Ag 1 ratio between 1 and 400, smallest in cat dander. Immunoabsorption using anti-cat dander, anti-cat albumin and anti-Cat Ag 1 indicated that the anti-cat dander, anti-cat albumin, and the anti-Cat Ag 1 absorbed approximately 90%, 25%, and 56%, respectively, of the dander RAST activity, and 87%, 11%, and 45%, respectively, of the saliva RAST activity, confirming the major importance of Ag 1. It is concluded that cat allergenic extracts should contain only modest amounts of serum albumin and other serum-derived antigens and that any relevant standardization must include quantification of at least Cat Ag 1 and cat albumin.

Albumins↗