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Biomedical subjects

Carsten Bindslev-Jensen

Publications and source records attributed to Carsten Bindslev-Jensen.

33 records · Page 2Linked to original sources
PubMed2004

Food allergy to apple and specific immunotherapy with birch pollen.

Conflicting results concerning the effect of specific pollen immunotherapy (SIT) on allergy to plant foods have been reported. The aim of this study was to investigate the effect of SIT using a birch pollen extract on food allergy with focus on allergy to apple. Seventy-four birch pollen-allergic patients were included in a double-blind, double-dummy, and placebo-controlled comparison of sublingual-swallow (SLIT) and subcutaneous (SCIT) administration of a birch pollen extract. Sixty-nine percent of these patients reported allergy to apple. The clinical reactivity to apple was evaluated by open oral challenges with fresh apple and a questionnaire. The immunoglobulin E (IgE)-reactivity was assessed by skin prick test (SPT), specific IgE, and leukocyte histamine release (HR). Forty patients were included in the final evaluation of the effect of SIT. The challenges were positive in 9 (SCIT), 6 (SLIT), and 8 (placebo) patients after treatment compared to 10, 4, and 10 patients, respectively, before SIT. The symptom scores to apple during challenges decreased in all groups, but only significantly in the placebo group (p = 0.03). As evaluated by the questionnaire, the severity of food allergy in general did not change and there were no differences between the groups. In spite of a significant effect on seasonal hay fever symptoms and use of medication and decrease in IgE-reactivity, SIT was not accompanied by a significant decrease in the severity of allergy to apple compared to placebo. Therefore, oral allergy syndrome (OAS) to apple should not be considered as a main criterion for selecting patients for birch pollen immunotherapy at present.

Adult↗
PubMed2004

A randomized, double-blinded, placebo-controlled oral challenge study to evaluate the allergenicity of commercial, food-grade fish gelatin.

BACKGROUND: Recent interest in the labeling of foods and food proteins derived from allergenic sources necessitates determination of the potential allergenicity of such food ingredients. Fish gelatin is extracted from the skin of fish species known to elicit allergic reactions in sensitized individuals. OBJECTIVE: To determine the allergenicity of fish gelatin by double-blinded, placebo-controlled food challenges (DBPCFC) in clinically fish-allergic individuals. METHODS: Thirty fish-allergic patients diagnosed according to the EAACI Guidelines were included (age 9-50 years). Skin prick tests (SPT) and Histamine Release tests (HR) were performed with fish gelatin and codfish, and codfish-specific IgE was measured. All patients underwent DBPCFC with a cumulative dose of 14.61 g fish gelatin. RESULTS: In all 30 patients SPT, HR, and specific IgE to codfish were positive. SPT and HR with fish gelatin were positive in 3/30 and 7/30, respectively. One patient showed mild reaction to placebo and no reaction to the active challenge. Two patients reported mild subjective reactions to active challenge. Upon re-challenge one of them described subjective symptoms again to the active challenge (7.61 g cumulated dose of fish gelatin) with no reaction to placebo, while the other experienced very mild subjective symptoms to placebo and nothing to the active. The proportion of truly sensitive patients was estimated to 0.03 in the total study group. CONCLUSION: None of 30 fish allergic patients reacted adversely to the ingestion of 3.61 g cumulative dose of fish gelatin. In this study fish gelatin presents no risk to fish-allergic patients at the doses typically used. Statistically, these results indicate that there is 95% certainty that 90% of fish-allergic consumers will not react to ingestion of a 3.61 g cumulative dose of fish gelatin.

Adolescent↗
PubMed2004

The diagnostic accuracy of the atopy patch test in diagnosing hypersensitivity to cow's milk and hen's egg in unselected children with and without atopic dermatitis.

BACKGROUND: Previous studies have suggested that the atopy patch test (APT) may make oral challenge superfluous in diagnosing children with food hypersensitivity. OBJECTIVE: To investigate the clinical relevance of APT in predicting hypersensitivity to cow's milk and hen's egg in 486 unselected children 3 years of age. METHOD: The children were examined by APT, skin prick (SPT), histamine release (HR), and specific IgE followed by oral challenge when hypersensitivity to cow's milk or hen's egg was suspected. RESULTS: Food hypersensitivity confirmed by oral challenge was 1.6% to hen's egg and 0.6% to cow's milk. No hypersensitivity to cow's milk or hen's egg was predicted by APT alone. CONCLUSION: APT could not predict food hypersensitivity not predicted by SPT, HR, or specific IgE. Thus, APT cannot be recommended in daily practice for the diagnosis of hypersensitivity to cow's milk and hen's egg in children 3 years of age.

Basophils↗
PubMed2004

An evaluation of the diagnostic value of different skin tests with egg in clinically egg-allergic children having atopic dermatitis.

Skin testing is a common diagnostic procedure in food allergy, but the final diagnosis of food allergy is based on the clinical response to food challenge. We studied the value of the skin prick-prick test (SPT), skin application food test (SAFT) and atopy patch test (APT) with fresh egg extract in diagnosing egg allergy. Ten clinically egg-allergic children with atopic dermatitis (AD; age 10 months to 8.4 yr, mean 3.4 yr) and 10 egg-tolerant children with and 10 without AD (age 2.4-11 yr, mean 5.5 yr) participated. In SAFT several false-negative reactions were seen, whereas all clinically egg-allergic children were positive in SPT and 40-60% in APT. In APT and in SPT false-positive reactions to egg were observed. In this study comprising a small number of patients including control subjects, neither SAFT nor APT with fresh whole egg extract were able to increase the diagnostic accuracy in detecting egg-allergic children with AD compared with SPT.

Child↗
PubMed2004

A comparative study of the allergenic potency of wild-type and glyphosate-tolerant gene-modified soybean cultivars.

A large proportion of soybean cultivars grown in the USA are now genetically modified varieties and concern has been raised about the safety of these products for consumers. A study of the impact on allergenic potency in soybeans, comparable except for the newly introduced gene (CP4 EPSPS), was performed using soybean-sensitized patients. The allergenicity of 18 different (10 GM and 8 WT) soybean extracts was examined blindly by the following three methods: A) Sera from patients with specific IgE against soybean were used to determine concentrations inducing 50% RAST inhibition; B) Histamine release induced by the extracts was examined using blood from sensitized patients; C) SPT was performed on sensitized patients with all 18 extracts. All three methods showed variations in the allergenic potency between the individual extracts but allergenic potential was not affected by presence of the transgene. By using standard in vitro methods and SPT for determination of allergenicity we were not able to detect any significant difference in the allergenic potency between GM and WT soybeans.

Food Hypersensitivity↗
PubMed2003

[Investigation of penicillin allergy. Procedures and retrospective statement of results for the period 1997 to 2001].

INTRODUCTION: We describe procedures in and findings of investigation for allergy to penicillin as it was performed at the Dermatological Department and the Allergy Centre of Odense University Hospital in the 5-year period 1997-2001 and compare history with findings on skin tests and systemic challenge. MATERIAL AND METHODS: Retrospective evaluation of findings in the investigation of penicillin allergy. A total of 109 patients with a history of reaction to treatment with penicillins and a negative specific IgE for penicillins G and V were successively skin prick tested, intracutaneously skin tested, challenged orally and by intramuscular injection. Further testing was cancelled when a positive result occurred. RESULTS: Fifteen of 109 (13.7%) had positive reactions on investigation. There was no correlation between the type and severity of cutaneous or systemic reactions to penicillin or presence of other allergies and test positivity or negativity. 20% of the test-positive developed severe systemic reactions (respiratory, cardiovascular) upon systemic challenge. DISCUSSION: 13.7% in a selected patient material with a history of penicillin allergy and negative specific IgE were found to have reaction to penicillin upon investigation. A high percentage of patients (20%) experienced systemic reactions to provocation. This finding has resulted in new procedures for the investigation of allergy to penicillin in our clinic.

Adult↗
PubMed2003

Threshold levels in food challenge and specific IgE in patients with egg allergy: is there a relationship?

BACKGROUND: Previously published articles described a relationship between food-specific IgE and the outcome of food challenge in children with egg allergy. These investigations defined different levels of predictive values in different study populations and thus pointed toward the possibility of a certain level of specific IgE to egg white predicting a positive outcome in food challenge. OBJECTIVE: The purpose of this study was to determine the utility of specific IgE in estimating threshold level to predict a positive outcome in food challenge. METHODS: Fifty-six children were evaluated for egg allergy by titrated oral challenges. Sera were analyzed for specific IgE to egg white in 56 patients by using the Magic Lite test and 32 of 56 patients also by the CAP test. Values of specific IgE to egg white were compared to the outcome of challenges and the threshold level. RESULTS: The diagnostic level of specific IgE predicting clinical reactivity in this population with greater than 95% certainty was identified as 10.8 standardized units/mL (Magic Lite) and 1.5 kilounits of allergen-specific IgE/L (CAP), respectively. We found no significant relationship between the specific IgE concentration (egg white) and the challenge threshold level. CONCLUSION: Although the specific IgE concentration correlated to a positive outcome in food challenge, there was no significant relationship between the quantification of specific IgE and the challenge threshold level. Therefore the standardized food challenge still remains the gold standard in the diagnosis of food allergy.

Child, Preschool↗
PubMed2003

Type I sensitization in adolescents: prevalence and association with atopic dermatitis. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS).

The prevalence of Type I sensitization and its relationship to atopic dermatitis were assessed in a cohort of 1501 8th grade schoolchildren (aged 12-16) in Odense, Denmark. The protocol included a questionnaire, a clinical examination, IgE measurements and skin prick tests. A history of atopic dermatitis was found in 21.3%, allergic asthma in 6.9% and allergic rhinitis in 15.7% of the adolescents. One or more positive specific IgE measurements (CAP FEIA) were found in 29.6% of the schoolchildren (inhalant allergens 28.4%, food allergens 8.5%, pityrosporum ovale 1.5%) and a considerable proportion were sensitized without clinical relevance. The association between atopic dermatitis and Type I sensitization was related to concomitant inhalant allergy. A clear association with atopic dermatitis was indicated only for the allergen pityrosporum ovale.

Adolescent↗
PubMed2003

Immunochemical and biological quantification of peanut extract.

Biological standardization of allergen extracts is one of the steps in the characterization of an extract. The gold standard for determination of biological potency is the skin prick test, but histamine release (HR) has been used as a convenient ex vivo method for analyzing a large number of samples. We describe the use of rabbit basophils as a tool in biological standardization. Using peanut as a model allergen, it is described how rabbits immunized for production of antiserum may become sensitized and their basophils used for histamine release experiments. It is also possible to use rabbit antiserum to passively sensitize basophils derived from naive rabbits, but the sensitivity of this method is so far 100-1000 times lower than the direct histamine release. The rabbit histamine release results are compared to an ELISA developed by means of the same antisera and by passive sensitization of human basophils using serum from a strongly sensitized peanut-allergic patient. The overall sensitivity of the methods were ELISA > HR-human cells > HR-sensitized rabbit cells > HR-passively sensitized rabbit cells. The use of rabbit basophils for biological standardizations will allow for the use of rabbit antisera.

Animals↗
PubMed2002

Factors affecting the determination of threshold doses for allergenic foods: how much is too much?

BACKGROUND: Ingestion of small amounts of an offending food can elicit adverse reactions in individuals with IgE-mediated food allergies. The threshold dose for provocation of such reactions is often considered to be zero. However, because of various practical limitations in food production and processing, foods may occasionally contain trace residues of the offending food. Are these very low, residual quantities hazardous to allergic consumers? How much of the offending food is too much? Very little quantitative information exists to allow any risk assessments to be conducted by the food industry. OBJECTIVE: We sought to determine whether the quality and quantity of existing clinical data on threshold doses for commonly allergenic foods were sufficient to allow consensus to be reached on establishment of threshold doses for specific foods. METHODS: In September 1999, 12 clinical allergists and other interested parties were invited to participate in a roundtable conference to share existing data on threshold doses and to discuss clinical approaches that would allow the acquisition of that information. RESULTS: Considerable data were identified in clinical files relating to the threshold doses for peanut, cows' milk, and egg; limited data were available for other foods, such as fish and mustard. CONCLUSIONS: Because these data were often obtained by means of different protocols, the estimation of a threshold dose was very difficult. Development of a standardized protocol for clinical experiments to allow determination of the threshold dose is needed.

Allergens↗
PubMed2002

Contact allergy and allergic contact dermatitis in adolescents: prevalence measures and associations. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS).

The aims of this cross-sectional study were to establish the prevalence measures of contact allergy and allergic contact dermatitis in 8th grade schoolchildren (aged 12-16 years) in Odense, Denmark, and to examine the associations with atopic dermatitis, inhalant allergy and hand eczema. Contact allergy to a standard series allergen was found in 15.2% of schoolchildren. The point prevalence of allergic contact dermatitis was 0.7% and the lifetime prevalence 7.2%, predominantly in girls. The most common contact allergens were nickel (8.6%) and fragrance mix (1.8%). Nickel allergy was clinically relevant in 69% and fragrance allergy in 29% of cases. A significant association was found between contact allergy and hand eczema while no association was found between contact allergy and atopic dermatitis or inhalant allergy. In the future this cohort of schoolchildren will be followed with regard to the course and development of atopic diseases, hand eczema and contact dermatitis. Key words: school-

Administration, Inhalation↗
PubMed2002

Nickel sensitization in adolescents and association with ear piercing, use of dental braces and hand eczema. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS).

The prevalence of nickel allergy (sensitization) and the associations with ear piercing, use of dental braces and hand eczema were assessed in a cohort of 1,501 8th grade schoolchildren (aged 12-16 years) in Odense, Denmark. Nickel allergy was found in 8.6% and was clinically relevant in 69% of cases. Nickel allergy was found most frequently in girls and the association with ear piercing was confirmed. Application of dental braces (oral nickel exposure) prior to ear piercing (cutaneous nickel exposure) was associated with a significantly reduced prevalence of nickel allergy. In adolescents a significant association was found between hand eczema and nickel allergy. A follow-up study of this population is planned in order to assess the course and development of contact dermatitis, hand eczema and atopic diseases in adulthood and after choice of occupation.

Adolescent↗