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Biomedical subjects

F Ruëff

Publications and source records attributed to F Ruëff.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Induction of penicillin tolerance in therapy of neurosyphilis in penicillin allergy].

Pharmacologically or immunologically induced hypersensitivity to penicillin is frequent. Immunological, i.e., allergic, hypersensitivity reactions are among the most important side effects and can lead to severe and life-threatening reactions. All types of allergic reactions have been described secondary to penicillin therapy. Immediate type hypersensitivity reactions, the symptoms of which range from urticaria and angioedema to respiratory and cardiovascular symptoms, and finally to life threatening full anaphylactic shock are particularly dangerous. This case-report demonstrates that in a patient allergic to penicillin, in whom there is a vital indication to administer this compound, the drug can be given safely after tolerance induction.

Aged↗
PubMed1999

[Tryptase, a marker for the activation and localization of mast cells].

The serine protease tryptase (ECNr. 3.4. 21.59), which is almost exclusively expressed in mast cells, is released by mast cell degranulation in an enzymatically active form together with other mediators, e.g. histamine, into the extracellular space and the circulation. The capability of the enzyme to directly stimulate several cell types as well as to cleave polypeptide hormones and to activate pro-enzymes suggests a role for tryptase in inflammatory and tissue-remodeling processes. Therefore, in the skin, a role of tryptase is suggested not only in mastocytosis and immediate type hypersensitivity reactions, but also in other inflammatory diseases, degenerative or neoplastic conditions as well as in wound healing, where an accumulation and/or activation of mast cells is found. Extracellular tryptase may be superior to histamine as a parameter for the onset and course of immediate type reactions and as an indicator for the activation of mast cells in other conditions. Its absence during histamine-liberating reactions may suggest basophil activation. In addition, tryptase has been shown to be a sensitive and specific marker for the localization of mast cells in tissues.

Biomarkers↗
PubMed1999

IgE binding of the recombinant allergen soybean profilin (rGly m 3) is mediated by conformational epitopes.

BACKGROUND: Soybean proteins are constituents of a number of food products and represent a panel of potential allergens. Thus far, little is known about the molecular characteristics of soybean allergens. OBJECTIVE: The aim of this study was to identify the soybean profilin by PCR-based complementary (c)DNA cloning and to elucidate its allergenic characteristics. METHODS: Highly degenerate profilin-specific primers were used to identify, by means of PCR, 2 soybean profilin isoforms (GmPRO1 and GmPRO2) by using soybean cDNA as a target. One isoform (GmPRO1) with a length of 394 bp corresponding to 131 amino acid residues was subcloned and expressed in fusion with the maltose-binding protein. Moreover, 3 overlapping recombinant soybean profilin fragments comprising amino acid residues 1-65, 38-88, and 50-131 were also prepared as maltose-binding protein fusion proteins. IgE-binding reactivity of the recombinant proteins and the cross-reactivity of soybean profilin with birch profilin was studied by immunoblotting, enzyme-linked allergosorbent assays (EASTs), and competitive inhibition experiments by using serum samples from 13 soybean-sensitized subjects. RESULTS: Results of immunoblot analysis, EAST, and EAST-inhibition experiments indicate the presence of profilin in soybean extract. The recombinant soybean profilin (rGly m 3) was recognized by IgE in 9 (69%) of the 13 sera tested. Only the full-length rGly m 3 was able to bind with IgE antibodies, whereas the 3 soybean profilin fragments did not show significant binding reactivity, indicating that the IgE binding to rGly m 3 depends on the integrity of a conformational structure, which was not present in the overlapping profilin fragments. The rGly m 3 cross-reacted with birch pollen profilin (Bet v 2), and the IgE binding to Bet v 2 could be inhibited by rGly m 3. CONCLUSIONS: rGly m 3 represents a new soybean allergen with well-characterized primary sequence, and its IgE-binding reactivity is mediated by conformational epitopes.

Adolescent↗
PubMed1999

Mastocytosis associated with severe wasp sting anaphylaxis detected by elevated serum mast cell tryptase levels.

A markedly elevated serum level of mast cell tryptase (77.6 microg/L; 95th percentile in normals 13.5 microg/L) was detected in a patient treated for 5 years with wasp venom immunotherapy because of severe anaphylaxis following a wasp sting. Retrospective analysis of stored serum samples taken during the course of immunotherapy revealed that the tryptase level had been elevated for at least 3 years. Despite several dermatological examinations, skin changes of mastocytosis had been missed. Re-examination of the patient revealed sparse macules on the thorax and thighs; Darier's sign was negative. Histologically, mast cell accumulation in these lesions was demonstrable. No signs of systemic mastocytosis were detected. The most appropriate diagnosis was telangiectasia macularis eruptiva perstans. Even in patients with highly elevated tryptase levels, mastocytosis may go undiagnosed. As mastocytosis predisposes to severe anaphylaxis, the condition should be looked for in patients with such reactions by clinical examination and measurement of serum tryptase levels.

Adult↗
PubMed1999

Delayed contact hypersensitivity to non-steroidal anti-inflammatory drugs.

Several non-steroidal anti-inflammatory drugs (NSAIDs) are available for topical treatment of acute soft tissue trauma or degenerative musculoskeletal disorders; the NSAID bufexamac is mainly used for therapy of chronic inflammatory skin diseases. In order to assess the occurrence of contact allergy to NSAIDs in 371 consecutive patients presenting for diagnosis of presumed contact allergy, patch tests were performed with a standard series and additionally with a series of NSAIDs, comprising acetylsalicylic acid, bufexamac, diclofenac, etofenamate, felbinac, flufenamic acid, ibuprofen, indomethacin, and piroxicam. 17 individuals (4.6%) exhibited delayed hypersensitivity to one of the NSAID preparations: 12 patients (3.2%) had patch test reactions to bufexamac, 2 (0.5%) to etofenamate, 2 (0.5%) to indomethacin, and 1 patient (0.3%) to flufenamic acid. These patch test results corresponded well to the individual history in 11 individuals (including 10 patients with reactions to bufexamac), and in 2 patients the clinical relevance of the reactions was probable. In view of the high frequency of allergic contact reactions to bufexamac, we propose to test this drug particularly in patients with atopic eczema or other chronic eczematous diseases.

Adolescent↗
PubMed1999

[Desensitization of allergy to hymenoptera venoms].

Hyposensitization (immunotherapy) of hymenoptera venom allergy has been practised for 70 years. About 20 years ago the use of ineffective whole-body extracts was abandoned, as effective therapy with preparations of bee venom and wasp venom became available. The diagnosis of hymenoptera venom allergy is based on history, skin tests and determination of venom specific IgE-antibodies in the serum. Only rarely other tests are needed (histamine or leukotriene release tests, immunoblot, specific IgG antibodies). To achieve a definite diagnosis, all findings have to be considered carefully, as "false positive" and "false negative" results can occur in all test systems. Hyposensitization is indicated in all patients with systemic IgE-mediated immediate type reactions, only in children with exclusive skin symptoms it may not be needed. Contraindications of hyposensitization are to be considered. Allergen preparations for subcutaneous injection are available as aqueous preparations or as aluminium hydroxide-adsorbed depot extracts. Various rush or conventional treatment protocols are used to reach the maintenance dose of usually 100 micrograms venom/four weeks. The most frequent side effects are large local reactions, which are observed in almost all patients. Systemic anaphylactic side effects also occur in up to 40%, in most cases the symptoms are mild. To identify patients who are not protected by the usual maintenance dose, a sting challenge test with a living insect should be performed. By this, about 80 to 100% of the patients are found to be protected from systemic symptoms, and in those still reacting an increased dose of 200 micrograms (or even higher) eventually induces protection. Hyposensitization may be stopped if it lasted at least for 3 to 5 years, if systemic side-effects did not occur and if the patient has tolerated a sting challenge or a field-sting without systemic symptoms. In patients intensely exposed to hymenoptera or in those with an increased risk of severe reactions, longer treatment has to be considered.

Anaphylaxis↗
PubMed1998

Natural rubber-latex allergy in patients not intensely exposed.

Immediate-type allergy to natural rubber latex (NRL) is common in highly exposed groups, particularly in health-care workers and patients with spina bifida. The occurrence of NRL allergy was investigated in subjects not belonging to such risk groups. A total of 493 patients presenting with various diseases for allergologic evaluation was studied. A questionnaire-based history was taken, skin prick tests with NRL milk and common aeroallergens were done, and NRL-specific serum IgE antibodies were measured. A total of 317 subjects (64.3%) was atopic. There were skin prick test reactions to NRL in 80 (16.2%) and NRL-specific IgE in the serum in 79 (16.0%) subjects; both were found in 25 patients (5.1%). Altogether, NRL sensitization was found in 134 patients (27.2%). By history and/or challenge tests, 13 subjects (2.6%) were diagnosed as having clinically relevant NRL allergy. In five of these, anaphylactic reactions had occurred during dental procedures, and in four during general anesthesia; 10 subjects reported immediate-type reactions to NRL products in daily life. All patients with clinically relevant NRL allergy had a skin prick test reaction to NRL milk (sensitivity 100%). Nine had specific IgE antibodies in the serum (sensitivity 69.2%); respective specificity was 86.0% or 85.4%. Nine of the 13 patients (69.2%) with NRL allergy were atopic. Despite exclusion of those at risk, many patients had clinically relevant allergy to NRL, and many of these had had severe reactions. NRL allergy is an important health issue also beyond the known risk groups.

Adolescent↗
PubMed1997

[Latex allergy].

Explore the source record for details and available documents.

Condoms↗
PubMed1997

National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK).

Sensitization rates to contact allergens vary between centers and are influenced by sex and age. Eliminating the latter 2 factors by standardization of data by age and sex, the present analysis addresses possible differences between centers remaining after elimination of these confounders, and analyzes other factors which might influence rates, e.g., the MOAHL index. Overall standardized rates were well within the range reported in previous studies and may be regarded as representing the rates of the "patch test population" in Central Europe (e.g., nickel sulfate 12.9%, fragrance mix 10.5%, balsam of Peru 7.3%, thimerosal 5.6%). For this analysis, data of those departments which contributed more than 2000 patients, or of those with extreme proportions concerning sex, age and occupational cases were selected. Patients from these 10 departments differed considerably with regard to the items of the MOAHL index and with regard to standardized rates. The items of the MOAHL index proved to be suitable for describing different patch test populations and for explaining some differences between centers. Only 'atopic dermatitis' seems to have little influence on (standardized) rates. Face dermatitis is not yet represented in the MOAHL index, but should be included, together with age > 40 years, in an extended index (acronym: MOAHLFA). Regional allergen exposure (with striking differences between East Germany, West Germany and, to a lesser extent, Austria) seems to have a great influence on the sensitization pattern observed in a department. In addition, sociological factors may influence sensitization rates, which is exemplified by high rates of nickel allergy in a socially defined subgroup. Future studies should focus on these factors, as well as on factors concerning patch test practices and quality control.

Adult↗
PubMed1975

[Clinical aspects of Crohn's disease. Report of experience at the Munich surgical university hospital 1954-1974].

Crohn's regional ileitis, which is differentiated into acute, chronic uncomplicated and chronic complicated forms, is seen to have a high complication rate in the long run. It is the fistulae to sections of the intestine which are not primarily diseased, the fistulae to the bladder, vagina and retroperitoneal space, fistulae opening on the abdominal wall and perianal fistulae which make the primary condition a serious disease. In the chronic stage, an adequate resection of the intestine in good time can lead to healing. Detour anastomoses which leave behind the affected section of the intestine gives poor results.

Acute Disease↗