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Biomedical subjects

J Charpin

Publications and source records attributed to J Charpin.

At least 37 records · Page 2Linked to original sources
PubMed1988

[The role of alpha-amylase in baker's asthma].

We report a case of asthma in a baker provoked by an additive which is generally used in bread making, namely alpha-amylase, an extract of Aspergillus oryzae. Skin tests to alpha-amylase were positive in a concentration of 0.1 micrograms/ml. Specific IgE was detected to this enzyme. A provocation test to alpha-amylase was positive with a fall of the FEV1 of 42%. Provocation tests to flour gave a negative immediate and delayed reaction. Progress was made towards the disappearance of symptoms after several months of avoiding the allergen. This observation has enabled us to show the specificity of the allergy to alpha-amylase, a glycolytic enzyme, coming in the group of occupational diseases n. 63 (asthma due to lyophilised enzymes) whereas baker's asthma is at n. 66.

Adult↗
PubMed1988

[Prevention of infections in chronic bronchitis using vaccination and/or immunomodulation].

Polyvalent antimicrobial vaccines have been widely used in chronic bronchitis for nearly fifty years without their effect or mechanism of action always being well understood. The polysaccharide vaccines, in particular pneumococcal, are better defined chemically and in their mode of action. However, it does not seem that ordinary chronic bronchitis is a good indication for these vaccines. The immunomodulators, extracts of the cell wall of certain bacteria, are aimed at increasing the host's defence capacity in a non-specific manner. The addition of ribosomes may favour specific and non-specific immunomodulation. Certain vaccines have shown their efficacy in reduction of infective episodes in chronic bronchitis. However, other studies ought to be undertaken to obtain purified products which are not toxic and are yet more effective. Finally, it is necessary to have better knowledge of the mode of administration and of the doses administered corresponding to the optimal efficacy of the vaccines.

Adjuvants, Immunologic↗
PubMed1988

[Is there an urban factor in asthma and allergy?].

To evaluate if an "urban factor" could be responsible for an increase of asthma and allergic diseases in developed countries, we compared prevalence rates for these conditions in adults living in urban and rural settings. The urban group consisted of 4,008 adults, randomly selected from the 16 districts of the city of Marseille; the rural group consisted of 1,789 adults, representing 85% of the target population living in a small residential town, Trets. The protocol included, after a mass media information, home-visits by public health physicians. These physicians asked a short standardized questionnaire to all adults 18 to 65 years old. Then, in a subgroup of, hay-fever patients, they performed skin tests to grass pollens. The standardized prevalence rates of asthma and related symptoms, and hay fever, was very similar in both settings. Thus, this study does not support the hypothesis that there is a urban factor in asthma and allergic diseases. In the literature, several studies point out a higher prevalence of these diseases in an urban setting. But these studies have been performed several years ago, when there was a larger difference in air pollutants concentrations between urban and rural settings.

Adolescent↗
PubMed1987

Role of the quaternary ammonium ion determinants in allergy to muscle relaxants.

Anaphylaxis to muscle relaxants appears to be a very useful model to study the IgE-dependent mechanisms of mediator release in humans. The serum IgE binding sites of the drugs appeared to be the ammonium ion determinants. In patients allergic to suxamethonium, one of the most frequently used muscle relaxants for general anesthesia, significant histamine release could be obtained in each case with simple diammonium salts. The length of the chain linking the ammonium groups appears to play an important role. In fact, when the length was less than or equal to 4 A, no significant histamine release could be obtained, whereas the optimal length for histamine release appeared to be greater than or equal to 6 A. Furthermore, muscle relaxants with a rigid backbone between the ammonium determinants (such as pancuronium) are less active than flexible molecules (such as suxamethonium) in initiating mediator release. This study suggests that small divalent molecules can induce anaphylactic shock in sensitized patients and that the length and the flexibility of the chain bearing the haptenic determinants appear to be important factors in the elicitation of mediator release.

Drug Hypersensitivity↗
PubMed1987

Allergy to suxamethonium: persisting abnormalities in skin tests, specific IgE antibodies and leucocyte histamine release.

Twenty-one patients, who had previously experienced an anaphylactic reaction to suxamethonium during general anaesthesia, were selected for this study. Initially, skin tests with muscle relaxants were carried out in the twenty-one patients, detection of specific anti-choline IgE in nineteen, and leucocyte histamine release in seventeen. These three tests were then repeated between 1 year and 4 years after the initial evaluation. In the majority of patients, sensitization to the muscle relaxants persisted for more than 1 year after the anaphylactic reaction. Only three patients out of twenty-one (4%) had negative skin tests when retested 1-4 years later. A reduction in leucocyte histamine release was noticed in one of the seventeen retested patients (6%). Modifications of anti-choline IgE were observed in five of nineteen patients (26%). The persistence of sensitization to suxamethonium may result from repeated stimulation by occasional contacts with quaternary ammonium compounds. This study demonstrates the reliability of skin tests, leucocyte histamine release and detection of anti-choline IgE to diagnose allergic reactions to suxamethonium, even when they are performed a long time after the initial anaphylactic reaction.

Alcuronium↗
PubMed1987

Relationship between skin reactions to common allergens and non-specific bronchial reactivity in young healthy subjects.

In patients with respiratory symptoms, several studies have provided data supporting the hypothesis that there is a casual relationship between allergen exposure and variations in bronchial reactivity. In order to determine if this relationship holds when atopy is defined only on the basis of positive skin tests to common allergens, we compared bronchial reactivity in a group of twelve healthy subjects with positive skin tests and twenty-eight healthy subjects with negative tests. The two groups were comparable in terms of gender, age, smoking habits and family history of atopic diseases. The slopes of the dose-response curves, using airway conductance as an index of response, were similar in the two groups. Thus, in this healthy group of subjects, there was no relationship between skin and bronchial reactivity. It can be hypothesized that, if genetic factors determine bronchial reactivity, such reactivity might not be revealed until skin-test positive subjects have received repeated bronchial stimulation through inhalant allergens.

Adult↗
PubMed1987

Asthma without airway hyperresponsiveness to carbachol.

Generally, asthma is closely associated with hyperresponsiveness to bronchoconstrictor agents. However, we have observed three patients who initially had symptoms of asthma but no hyperresponsiveness. Responsiveness to carbachol was assessed by specific airway resistance (SRaw) measurement after bronchodilatators had been discontinued. The carbachol challenge was repeated 6-18 months later. Initially, no change in SRaw was observed after inhalation of 3 mg carbachol (cumulated dose). On the second occasion, carbachol responsiveness increased into the asthmatic range while the baseline values of SRaw were not different. Since we have used the SRaw measurement, the bronchodilatator effect of maximal inspiration is not the explanation for the failure to demonstrate hyperresponsiveness. These observations suggest that airway hyperresponsiveness is not a necessary condition for induction of asthma and symptoms of asthma may precede the appearance of airway hyperresponsiveness.

Adolescent↗
PubMed1987

[Pulmonary localization of Kaposi's sarcoma].

The authors describe a case of a 61 year old man suffering from Kaposi's sarcoma with pulmonary involvement associated with a hairy cell leukaemia. The numerous associations with Kaposi's sarcoma are reviewed and the circumstances of the unexpected appearance of this disease, placing it in the group of opportunistic diseases. The prognosis is totally different according to whether it is an isolated Kaposi's sarcoma without visceral localisation or to a form with polyvisceral involvement and associated with another neoplasm or immunodepression.

Humans↗
PubMed1986

[Anaphylactic complications due to suxamethonium].

A study was carried out on 36 patients who had presented with an anaphylactic reaction when they had been received anaesthetic induction agents including suxamethonium. After having been examined, they were assessed with various immunoallergic tests (skin tests, LHL, a search for specific anticholine IgE antibodies). They were compared with a group of 120 control patients with the same age, sex and professional characteristics. This study confirmed the part played by specific IgE antibodies in accidents involving suxamethonium. The specificity of the tests that could be used for the diagnosis was excellent. However, as far as sensitivity of the tests went, skin tests and LHL were more sensitive than the search for specific IgE antibodies. There was no statistical relationship between the limit for skin reactions and the degree of histamine release of the level of anticholine IgE antibody.

Adult↗
PubMed1986

Appearance of specific antibody-bearing cells in human bronchial mucosa after local immunization with bacterial vaccine.

The immune response to local in vivo inhalation of a lysed bacteria vaccine was assessed in surgical specimens of main-stem bronchi from patients who had undergone pneumectomy for cancer. The patient population included 22 subjects; 11 of these received the aerosol vaccine twice a day for 10 days prior to surgery, while the remaining 11 patients were used as controls and were not immunized. The submucous glands of immunized subjects showed significantly more cells than did those of the controls, i.e., 62 +/- 8 versus 37 +/- 7, respectively (P less than 0.05). The following five antigens were chosen for study by fluorescence assay: Streptococcus pneumoniae types II and III, Haemophilus influenzae, Streptococcus sp. strain D19, and Klebsiella pneumoniae. An immunization-dependent correlation was found between immunoglobulin A, immunoglobulin A-bearing cells, and specific antibody-bearing cells on the one hand and three of the five antigens (S. pneumoniae types II and III and Streptococcus sp. strain D19) on the other hand. This is the first time that a relationship has been established between bacterial immunization of the lower respiratory tract and local immunoglobulin production in humans.

Adolescent↗
PubMed1986

[Corticotherapy in asthma].

The author summarises the modes of action of steroids in asthma and then reviews the treatment of acute asthmatic attacks and long-term steroid treatment. In acute situations steroids are very effective but their onset of action is relatively slow, even when administered intravenously. In practice, beta-2 adrenergic drugs have to be added to steroids for the treatment of acute asthmatic attacks. In long-term treatment, steroids are very effective but the risks of the treatment must also be considered. The first rule is to try and use intermittent treatment, either with alternative steroids or with treatment 5 or 7 days every fortnight. Synthetic ACTH can be added to steroids. Aerosols now play an important role which should become important when the dosages of the puffs are increased. These methods will enable the long-term use of steroids with fewer side effects. This may either be obtained rapidly by beta-2 adrenergic drugs or more slowly with steroids when there are inflammatory lesions of the bronchial mucosa.

Acute Disease↗
PubMed1986

[Asthma and pollens].

Hay fever was well described by Blackley in 1973. The frequency of pollen asthma may be expressed as a percentage of general frequency of hay fever. The figure of Hagy and Settipane of 21% for students with a mean age of 17.9 years is quoted and ended with different results to the french study by Denis and Perdrizet of 6.5% in students with a mean age of 23 years. One may also express the frequency of asthma in subjects suffering from hay fever which vary greatly with the different plant families. The seasonal rhythm and the oculo-nasal accompaniment are very characteristic. The clinical "scores" of patients have been analysed in parallel with the atmospheric curves of pollen gathered. The current problems of hay fever are particularly: The problem of the penetration of the antigen into the bronchi, the methods of study are reviewed. Little pollen reaches the bronchi. In order to explain this paradox of pollen asthma vagal reflexes from the pharynx are involved and a possible penetration to the bronchi of fragments of pollen and above all aerosols containing allergens (Solomon). Why is it that certain patients have asthma and others only coryza? Perhaps the bronchial reaction is linked to different dose of antigen, to nasal obstruction which makes the subject breath with an open mouth, to different immunological phenomena more intensive in asthmatics than in the subject suffering from coryza (Kaliner) and the bronchial reactivity of certain subjects. In an inverse sense the allergy provokes or increased bronchial reactivity. Finally the early and delayed allergic responses to pollen are a model of what is an oedematous reaginic reaction then inflammatory.

Adolescent↗