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Biomedical subjects

J Brasch

Publications and source records attributed to J Brasch.

At least 19 recordsLinked to original sources
PubMed2000

Iontophoresis of nickel elicits a delayed cutaneous response in sensitized individuals that is similar to an allergic patch test reaction.

Wearing of patch test chambers for 1-2 days is uncomfortable for patients. Allergen application by iontophoresis avoids this, but it is unknown so far whether iontophoresis itself interferes with the delayed immune response. We compared the effects occurring 48 h after iontophoresis with distilled water, 0.9% NaCl, and 0.01 M NiSO4 in normal volunteers and in nickel-sensitized patients (total n=36). Visual assessment was performed and transepidermal water loss (TEWL), stratum corneum hydration, cutaneous blood flow, and immunohistopathology were determined. After iontophoresis with nickel sulfate, only individuals sensitized to nickel reacted with a positive clinical response, increase in cutaneous blood flow, decline in epidermal CD-1a-positive cells, increase in epidermal proliferation (Ki-67-positive cells), pronounced infiltration of cells positive for CD4, CD11, or CLA, and cellular activation (expression of ICAM1, HLA-DR). Iontophoresis with distilled water or saline did not result in such reactions in volunteers with or without nickel sensitization, and the latter also tolerated nickel iontophoresis without significant skin reactions. We conclude that the delayed cutaneous response to nickel induced via iontophoresis is specific and similar to a positive patch test reaction. Iontophoresis may therefore be considered as an alternative to patch testing.

Adult↗
PubMed1999

[Trichophyton tonsurans var. sulfureum subvar. perforans in Tinea gladiatorum].

This is the first report on an isolation of Trichophyton tonsurans var.sulfureum subvar.perforans in Germany. In our patient, the strain had caused typical tinea corporis, which was most likely acquired during a wrestling competition. Based on the macroscopic and microscopic morphology and on the physiologic properties occurring under various growth conditions, the identification of Trichophyton tonsurans and the particular characteristics of its var.sulfureum subvar.perforans are described. Partial 18S and 23S nuclear ribosomal RNA sequences and the internal transcribed spacer region I sequences of our strain were completely identical with those of a Trichophyton tonsurans reference strain. The epidemiology of Trichophyton tonsurans var.sulfureum subvar.perforans and a possible association of this variety with tinea in wrestlers (tinea gladiatorum) have not yet been investigated.

Adult↗
PubMed1999

Lack of sialidase activity in Candida albicans and Candida glabrata.

Because several micro-organisms having close contact to animal hosts and man produce sialidase (EC 3.2.1.18) as a tool for adhesion and invasion, we investigated two Candida species for the presence of this enzyme. Two sensitive assays, a fluorometric test with 4-methylumbelliferyl-alpha-D-N-acetylneuraminic acid and a radiometric test with 3H-labelled sialyllactitol as sialidase substrates, were applied to detect sialidase activity. None of 40 Candida albicans and 10 C. glabrata strains grown in three different media exhibited sialidase activity, but the positive control Ophiostoma stenoceras produced sialidase under comparable conditions. Our surprising negative findings are divergent from an earlier positive report, which may be due to strain selection or bacterial contamination. These results indicate that sialidase is probably of no relevance in cutaneous or mucosal candidoses.

Candida↗
PubMed1999

The association between size of test chamber and patch test reaction: a statistical reanalysis.

A recent study by Brasch and co-workers reported on the association between size of test chamber and patch test reaction. The investigators interpreted their data on 495 patients as having conclusively shown that standard preparations of fragrance mix, wool wax alcohols, Kathon CG and formaldehyde led to more positive test reactions when large Finn Chambers were used for patch testing. We have scrutinized the statistical aspects of this study and conclude that the authors should have adopted a statistical approach suitable to analyse dependent samples. After explaining the correct methodological way of dealing with quadratic contingency tables formed by 2 dependent samples, we reanalyze the data accordingly and compare the results to those of the original paper. Based on this reanalysis, the conclusions are more complex: the reaction pattern for the fragrance mix and wool wax alcohols is significantly different between small and large test chambers; however, this discrepancy arises primarily from changing weak positive reactions with small chambers to strong positive reactions with large chambers. For formaldehyde, no relationship between chamber size and patch test reaction was found in the data, while for Kathon CG, statistical evidence is borderline that more positive test reactions are yielded by large test chambers than by small ones.

Adult↗
PubMed1999

Reproducibility of irritant patch test reactions to sodium lauryl sulfate in a double-blind placebo-controlled randomized study using clinical scoring. Results from a study group of the German Contact Dermatitis Research Group (Deutsche Kontaktallergie-Gruppe, DKG).

Reading of doubtful patch test reactions can be improved by comparing them to defined negative, allergic and irritant controls. For the latter, an irritant patch test is needed that gives sufficiently reproducible results. In our double-blind, placebo-controlled, randomized study, we have analysed the synchronous reproducibility of patch tests with 0%, 0.0625%, 0.125%, 0.25%, 0.5% and 1.0% sodium lauryl sulfate (SLS). Tests and readings were done according to ESCD guidelines. 139 patients (75 women, 64 men) 18 to 77 years old were tested. The % of positive patients as well as the % of reproducible positive reactions increased with rising concentrations of SLS to a maximum of approximately 90% and 85%, respectively, with 1% SLS. Time courses of reactions were also related to the concentration of SLS: with 1% SLS, plateau-type time courses were most common (65%), followed by decrescendo- (23%) and crescendo-type reactions (12%). With 1% SLS, very similar mild to moderate reactions were obtained on days 2 and 3. The reaction threshold and reproducibility of tests were not related to age and sex of patients or to their own assessment of skin irritability. We conclude that 1% SLS is appropriate for an irritant patch test that gives sufficiently reproducible results.

Adolescent↗
PubMed1998

[Differentiated contact allergy lists serve in quality improvement].

Through cooperation between the German Contact Dermatitis Research Group (DKG) and the Information Network of Departments of Dermatology (IVDK), results of standardized patch tests performed by the participating centres are centrally recorded in Germany. For this study, data from 24 departments of dermatology (19678 patients) were evaluated retrospectively and separately for 1995 and 1996. With decreasing frequency, nickel, fragrance mix, balsam of peru, and thimerosal yielded positive reactions most often; surprisingly high numbers of positive reactions were also seen with amerchol L-101 and palladium. Differentiated lists of allergens were compiled for 1995, referring to subgroups of patients (defined by gender, age, localization of eczema, geographical region, occupation, sensitization) and particular problems. In men, percentages of positive reactions were markedly lower for nickel, fragrance mix and balsam of peru than in women. Younger patients reacted more often to thimerosal and older ones to topical medical preparations. Medical allergens were also often positive in patients with leg eczema, whereas occupational allergens were found more frequently in patients with hand eczema. A comparison of positive reactions obtained in distinct geographical regions was problematic because of differences between test populations. The spectrum of allergens found in office workers was similar to that of the whole test population. Patients with positive reactions to nickel and fragrance mix had more positive reactions to unrelated allergens than the total test population. Sex- and age-adjusted frequencies of sensitization revealed a decrease in reactions to nickel and an increase in reactions to mercury allergens from 1995 to 1996. The clinical relevance of mercury reactions was often not apparent. Differentiated lists of allergens can be used to improve the quality of diagnostic and prophylactic procedures in allergic contact dermatitis.

Adolescent↗
PubMed1998

[Tinea caused by Trichophyton equinum].

We report on the first human infection with Trichophyton equinum in Germany, which was transmitted from an infected pony to a 12-year old girl. Trichophyton equinum was identified by its morphology, dependency on nicotinic acid, hair perforation, and enzyme production. A noteworthy new observation was the development of white pleomorphic tufts on the surface of thalli grown on potatoe-dextrose agar. The girl's tinea was non-inflammatory and responded promptly to topical treatment, whereas the pony's strongly inflammatory lesions persisted for months. In supernatants of cultures supplemented with different nutrients, enzyme patterns were measured for Trichophyton equinum that correspond to other species of dermatophytes more pathogenic for humans. Therefore, a lack of enzymes is apparently not the explanation for the rarity of human infections with Trichophyton equinum. More likely, predisposing factors of the host are necessary in combination with a close contact to infected horses. Treatment of infected humans appears to be no major problem.

Animals↗
PubMed1998

Genotype and phenotype of N-acetyltransferase 2 (NAT2) polymorphism in patients with contact allergy.

We investigated whether patients with contact allergy differed from non-contact-allergic, non-atopic controls with regard to genotype and phenotype of the polymorphic enzyme N-acetyltransferase 2 (NAT2). 55 contact-allergic patients recruited from the Information Network of Departments of Dermatology (IVDK) were compared to 85 controls from among local health care personnel. NAT2 activity was calculated from HPLC analysis of the ratio of the caffeine metabolites 5-acetylamino-6-formylamino-3-methyluracil (AFMU) and 1-methylxanthine (1MX) in the urine. NAT2 genotype was determined by polymerase chain reaction (PCR). A statistically significantly increased proportion of rapid acetylators was found in contact-allergic patients. This may have 2 possible implications: acetylation may enhance contact sensitization; or NAT2 status may be a genetic marker for contact sensitizability.

Acetylation↗
PubMed1997

[Hormones, fungi and skin].

It is indicated by some epidemiological and clinical observations, that steroidal hormones may belong to those factors that are capable to influence the clinical courses of mycotic infections in man. Several fungal species, including pathogenic ones, are able to produce or metabolize steroidal hormones, or their growth can be affected by such hormones. Since, on the other hand, the steroid-responsive human skin is also capable to synthesize and convert steroidal hormones, the relationship between pathogenic fungi and host may be influenced by hormonal mediators in dermatomycoses.

Dermatomycoses↗
PubMed1997

[Dermatophytes do not produce sialidase in vitro].

Sialidase (EC 3.2.1.18) is a pathogenicity factor of many microorganisms, and may also play a role in adhesion of dermatophytes to the epithelia of their hosts by the hydrolytical cleavage of terminal, negatively charged sialic acids of glycoconjugates on the cell surfaces, thus allowing fungal lectins to bind to the subterminal sugars. Therefore, 116 strains of seven species of dermatophytes were investigated for sialidase production. Two highly sensitive, quantitative sialidase assays were applied to cell homogenates and culture supernatants from seven different media of the fungi, but were always negative for sialidase activity. However, sialidase activity was always detected in Ophiostoma stenoceras used as a positive control cultivated in parallel; the enzyme was inducible by sialylated mucins. A sialidase-dependent pathomechanism for dermatophytes appears unlikely based on the results presented.

Animals↗
PubMed1997

More positive patch test reactions with larger test chambers? Results from a study group of the German Contact Dermatitis Research Group (DKG).

Test chambers of various sizes are commercially available for patch testing. Therefore, we asked the question whether the size of patch test chambers may affect allergic patch test reactions. A total of 495 patients were double tested synchronously with small and large Finn Chambers containing standard preparations of fragrance mix, wool wax alcohols, Kathon CG and formaldehyde. Double tests in 217 patients who had reacted with at least 1 allergic, questionable, or irritant reaction to 1 of these allergens were statistically evaluated. For each of the 4 allergens, a significantly higher number of stronger reactions was seen with the large chambers as compared to the small ones. It is concluded that large test chambers may be useful for detection of weak sensitizations to particular contact allergens.

Adult↗
PubMed1997

Patch test results in schoolchildren. Results from the Information Network of Departments of Dermatology (IVDK) and the German Contact Dermatitis Research Group (DKG)

Our aim was to explore the current spectrum of contact allergens in schoolchildren, as a basis for diagnosis and prevention of allergic contact dermatitis. Results of patch tests in children 6-15 years old, performed in the years 1990-1995 by 22 centres of the German Contact Dermatitis Research Group and filed by the Information Network of Departments of Dermatology, were analysed and evaluated retrospectively, including epidemiologic data. Children with positive tests (62 out of 156 boys and 108 out of 260 girls tested) had a higher frequency of allergic contact dermatitis and a lower frequency of atopic dermatitis than patch test negative ones. 16 distinct allergens elicited positive reactions in > or = 1% of the children tested. Reactions to nickel sulfate occurred in 15.9% of all children tested, but in 25.0% of girls 14/15 years old, and in only 4.5% of boys 6-13 years old. Double-sensitizations with cobalt salts, potassium dichromate and palladium were seen. Mercury compounds were found in 2nd place (thimerosal: all children: 11.3%; 6-13 years old: 14.3%; 14/15 years old: 8.0%), followed by fragrance allergens. We conclude that contact allergy in children is related to their sex and age. Prophylaxis against nickel, mercury, and fragrance allergy needs to be improved. A shortened standard series may be sufficient for testing children.

Adolescent↗
PubMed1997

Influence of epidermal permeability barrier disruption and Langerhans' cell density on allergic contact dermatitis.

Previously, we have showed that artificial epidermal permeability barrier disruption leads to an increase in epidermal Langerhans' cell (LC) density within 24 h. We now asked if this is accompanied by an enhancement of allergic contact dermatitis. Barrier disruption was induced by acetone on the upper arms in 6 volunteers with known sensitization to nickel, fragrance mix, or p-phenylenediamine. Twenty-four hours after this treatment the relevant allergen was applied without occlusion or with Finn chambers. Twenty-four hours after application of the allergen, clinical grading and transepidermal water loss (TEWL) measurements were performed and biopsies were taken. Immunohistochemical stainings for LCs (anti-CD1a, Leu6) and for epidermal proliferation (Ki-S3) were performed. Open applications of the allergens after acetone pretreatment resulted in strong allergic test reactions. TEWL, which showed a 70% recovery 24 h after acetone treatment, was increased again 4-fold by the allergic test reactions. LC density, which was increased by 80% 24 h after acetone-induced barrier disruption, was further enhanced 2.4-fold in total. Epidermal proliferation showed a 6-fold increase after open application of the allergens. Under patch test conditions after acetone pretreatment very strong bullous reactions were observed. We conclude that the increase in epidermal LC density induced by epidermal permeability barrier disruption is accompanied by an enhanced response in allergic contact dermatitis.

Acetone↗
PubMed1996

[Oral exposure testing in non-aspirin-induced analgesic intolerance].

Although intolerance reaction to analgesics are not uncommon, there is still a lack of standardized procedures to diagnose the problem. We retrospectively analyzed results of scratch tests as well as oral challenges with analgesics in order to evaluate risk and diagnostic relevance of these procedures. In 1987-1992 a total of 650 patients with supposed intolerance to drugs were tested by oral challenge. Among them were 98 patients with a positive history of intolerance to non-aspirin analgesics. In 56 patients the intolerance could be verified by oral challenge. In order of decreasing frequency, the most likely agents were propyphenazone, diclofenac, metamizole, ibuprofen, carbamazepine, indomethacin, phenazone (antipyrine), and paracetamol (acteaminophen). Oral provocation showed clear dose-response relationships. For propyphenazone, the half-effective provocation dose was the same for all symptoms (cutaneous, nasal, bronchial, anaphylactoid). Scratch testing was not of diagnostic significance. Standardized test protocols starting with low dose oral challenges are suitable and helpful in minimizing the risk of severe side effects.

Administration, Oral↗
PubMed1996

Dermatophytes contain a novel lipid-like leukocyte activator.

In the early phase of dermatophytosis, neutrophils are regularly detected microscopically in the infected skin. Although neutrophil recruitment may at least in part occur indirectly by complement activation, we asked whether dermatophytes might release chemoattractants for neutrophils. We cultivated various strains of different dermatophytes and tested fungal extracts for the presence of neutrophil chemotactic activity. As a result, we detected neutrophil chemotactic activity only in diethylether extracts, but not in aqueous extracts. We purified this lipid-like leukocyte activator (LILA) to apparent homogeneity by reversed-phase high performance liquid chromatography and found that purified LILA does not show ultraviolet absorption at wavelengths > 210 nm. Biologic studies revealed that LILA is as effective as formyl-methionyl-leucyl-phenylalanine in eliciting neutrophil chemotaxis, degranulation, and activation of the respiratory burst. Desensitization experiments in chemotaxis and degranulation with leukotriene B4, platelet-activating factor, or 5-oxo-eicosanoids revealed that LILA does not cross-desensitize with any of these other lipid-like attractants and thus possibly acts via a distinct as yet postulated neutrophil receptor. It is hypothesized that LILA, similarly to formylated methionyl peptides in bacteria, represents a dermatophyte- and possibly fungus-specific lipid compound that allows the host phagocytes to specifically recognize fungal infection. This system would be similar to the recognition of bacteria by phagocytes via N-formylated methionyl peptides, which represent a characteristic and unique system to identify bacteria.

Arthrodermataceae↗
PubMed1996

[LILAs (lipid-like leukocyte activators) isolated from Saccharomyces cerevisiae induce calcium mobilization in human neutrophilic granulocytes[].

Recently, we isolated some new and functionally identical panchemotactic factors (Lipid-like leucocyte activators = LILAs) from Candida albicans, Saccharomyces cerevisiae and various dermatophytes, which are chemotactic for human neutrophilic and eosinophilic granulocytes as well as for monocytes. In order to answer the question, whether human neutrophilic granulocytes express a specific receptor for LILA, we now investigated the mobilisation of the intracellular second messenger calcium within human neutrophils which were stimulated with LILA. Furthermore, LILA-mediated activation of neutrophils was subjected to desensitisation experiments with the well known neutrophil activators 5-oxo-eicosatetraenoic acid, leukotriene B4, platelet activating factor, C5a, Interleukin-8, and N-for-myl-methionyl-leucyl-phenylalanin (FMLP). The intracellular calcium concentration was measured by use of the fluorescence indicator FURA-2/AM. As a result we were able to show a significant dose-dependent increase in the intracellular calcium concentration after stimulation of human neutrophils with LILA. The desensitisation experiments revealed no cross-desensitisation between LILA and the well known stimuli. Our results show that LILA induces an intracellular calcium signal in addition to its panchemotactic activities. Therefore, calcium may act as second messenger in LILA-stimulated activation of neutrophils. Since LILA-mediated activation was maintained in the desensitisation experiments, LILA-specific receptors may be present on human neutrophils.

Calcium↗
PubMed1996

Dynamic patterns of allergic patch test reactions to 10 European standard allergens. An analysis of data recorded by the Information Network of Departments of Dermatology (IVDK).

Insight into the dynamic time courses of patch test reactions may be useful for patch test evaluation. To put this to the proof, we have analysed the time courses of allergic patch test reactions that were filed between 1990 and 1994 by the Information Network of Departments of Dermatology in Germany (IVDK). Based on reaction strength at days 1 to 3, each allergic patch test was assigned to 1 of 5 distinct dynamic reaction patterns: crescendo, plateau, decrescendo, crescendo/decrescendo, or decrescendo/ crescendo. The frequencies of these patterns were determined for those 10 standard allergens yielding the highest numbers of allergic reactions (n between 180 and 1240), and dynamic patterns were classified as type 1 (crescendo or plateau patterns) or type 2 (other patterns). Influences of population characteristics upon the classification of patterns were evaluated by logistic regression analyses. Different frequencies of reaction patterns were found for distinct allergens. For all 10 allergens, type-1 patterns were significantly more often observed for allergic reactions assessed as clinically relevant. For 5 allergens, female sex of patients was associated with a lower frequency of type-2 patterns. A history of atopic dermatitis and the age of patients were only weakly associated with a certain classification of reaction patterns in some of the allergens. In a comparison of reaction patterns obtained with different allergens in the same population, we found that nickel sulfate elicited type 1 reaction patterns more often than fragrance mix. We conclude that the dynamic reaction patterns should be taken into account in the evaluation of patch tests. The relation of type-1 patterns to clinical relevance of the reaction needs further attention.

Adult↗