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Biomedical subjects

J F Soothill

Publications and source records attributed to J F Soothill.

At least 37 records · Page 2Linked to original sources

Prospective study of cancer in patients with hypogammaglobulinaemia.

Among 377 patients with primary hypogammaglobulinaemia, mainly common variable immunodeficiency (CVID), 316 patients survived the first 2 years after diagnosis and were the subject of a study of cancer incidence. Among the 220 patients with CVID, there was a 5-fold increase of cancer due mainly to large excesses of stomach cancer (47-fold) and lymphomas (30-fold). The excess of stomach cancer is probably related to the high frequency of achlorhydria in CVID. 3 of the 7 patients with stomach cancer and CVID survived for 5 years or longer.

Adolescent↗

Infant feeding and subsequent risk of atopic eczema.

An attempted controlled trial of exclusively breast fed neonates with atopic parents, to assess the effectiveness of breast feeding in preventing atopic allergy, was not successfully achieved. Analysis of the data as an observational study, however, provided evidence that breast feeding offers some protection against eczema in genetically vulnerable infants. Feeds of soya preparations were associated with eczema as often as cows' milk based feeds.

Age Factors↗

A dietary management of severe childhood migraine.

We describe in detail a dietary treatment which has been shown to be effective in most children with severe migraine. Potential adverse nutritional and allergic effects are outlined; because of the diet should be undertaken only in those ill enough to justify it. In the first stage very few foods are given, and if the child responds to this oligoantigenic diet, foods are reintroduced one by one at weekly intervals. In this way foods causing symptoms are identified and eliminated. Research is urgently needed to establish simpler empirical diets and diagnostic tests.

Adolescent↗

Combined oral and nasal beclomethasone diproprionate in children with atopic eczema: a randomised controlled trial.

In a double blind, placebo controlled, crossover trial in 26 children with severe atopic eczema those receiving four weeks' treatment with combined oral plus nasal beclomethasone diproprionate improved significantly more than those receiving placebo. No adverse effects were observed, but 24 hour urinary cortisol excretion was slightly reduced. This combination may provide effective treatment in refractory atopic eczema with relatively little of the danger associated with systemic administration of prednisolone and other traditional corticosteroids.

Administration, Intranasal↗

A controlled trial of hyposensitization with adsorbed tyrosine Dermatophagoides pteronyssinus antigen in childhood asthma: in vivo aspects.

Continuing study for a second year and further analysis of a double-blind placebo controlled trial, already briefly reported, of injections of tyrosine-adsorbed, glutaraldehyde-modified Dermatophagoides pteronyssinus antigen in fifty-one children with perennial asthma and positive bronchial challenge to the antigen, confirms that the patients receiving the treatment reduced their symptomatic medication more than controls, without deterioration of symptoms. Some became symptom-free, when off all treatment. A double-blind placebo controlled trial of continuing treatment for a second year gave evidence of deterioration when the treatment was stopped. Within the treatment group, the improvement was associated with loss of late (6 hr) reaction to bronchial provocation with the antigen, but was not associated with change of immediate (20 min) reaction in lungs or skin. Those who improved in the placebo group did not lose their late reaction. There was a trend for similar benefit from active treatment in the control group, during the second year, though less than in the original active group, and only one lost his late reaction. Only one of the six children with very severe early onset asthma improved. Local reactions to either active or placebo (tyrosine) were seen in half the patients; these were mild and did not influence the treatment. Systemic symptoms occurred shortly after four active injections and after two placebo injections; only one patient stopped the treatment.

Adolescent↗

In vitro investigations in asthmatic children undergoing hyposensitization with tyrosine-adsorbed Dermatophagoides pteronyssinus antigen.

Successful hyposensitization to Dermatophagoides pteronyssinus in perennial childhood asthma was associated with a slight mean rise of serum IgG antibody to the mite antigen in contrast to a placebo group in whom this antibody fell slightly. No relationship was detected between the effect on asthma and the magnitude of this change. Nor was there any consistent effect on IgE or IgA antibody. There was a wide range of total serum IgE and IgE, IgG and IgA antibody to D. pteronyssinus before treatment; this level did not predict the effect of treatment. Some patients lacked IgA antibody. IgE antibody to timothy grass pollen was raised in some but not others. These levels did not change systematically during the study and improvement occurred in those who had this antibody as well as IgE antibody to D. pteronyssinus. IgG and IgE antibodies to D. pteronyssinus were significantly correlated in the pre-treatment samples. Lymphocyte thymidine uptake was lower after 8 weeks of treatment than in the control group, not only after stimulus with D. pteronyssinus antigen, in vitro, but also with antigen from Candida albicans. This was not a serum effect. The late bronchial provocation response was lost only in those with serum IgA less than the log mean for age.

Adolescent↗

Food allergy: the major cause of infantile colitis.

Forty six children presented with colitis between 1977 and 1981, and all 8 of those below the age of 2 years had food allergic colitis which resolved completely after exclusion of certain foods. In most of the 8 the onset was soon after starting foods other than breast milk. The most common offending food was cows' milk protein, but soya (3 cases) and beef (1 case) were also implicated. A history of allergy in the child or family was common as were blood eosinophilia, high concentrations of serum IgE, and positive IgE antibodies. Colonoscopic appearances were distinctive and biopsies showed a noticeable increase in eosinophils and IgE-containing cells in the lamina propria. We suggest that food allergy is the major cause of colitis in infancy and that an exclusion diet is the treatment of choice.

Adolescent↗

Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment.

93% of 88 children with severe frequent migraine recovered on oligoantigenic diets; the causative foods were identified by sequential reintroduction, and the role of the foods provoking migraine was established by a double-blind controlled trial in 40 of the children. Most patients responded to several foods. Many foods were involved, suggesting an allergic rather than an idiosyncratic (metabolic) pathogenesis. Associated symptoms which improved in addition to headache included abdominal pain, behaviour disorder, fits, asthma, and eczema. In most of the patients in whom migraine was provoked by non-specific factors, such as blows to the head, exercise, and flashing lights, this provocation no longer occurred while they were on the diet.

Abdomen↗

Absence of cytochrome b-245 in chronic granulomatous disease. A multicenter European evaluation of its incidence and relevance.

The heme-containing protein cytochrome b-245 has been proposed as a primary component of the microbicidal oxidase system of phagocytes that normally generates superoxide-free radicals but when defective is associated with chronic granulomatous disease. We measured this cytochrome in granulocytes from 27 patients with chronic granulomatous disease and from 64 members of their families. It was undetectable in all 19 of the men in whom the defect appeared to be located on the X chromosome. Female relatives who were heterozygous carriers had reduced concentrations of the cytochrome and variable proportions of cells that were unable to generate superoxide; these two characteristics were closely related (r = 0.93 in the 16 mothers and 0.85 in all 24 carriers, P less than 0.001). In contrast, in all eight patients (seven women) with a probable autosomal recessive inheritance the cytochrome was present but nonfunctional. The properties tested, including midpoint potential, carbon monoxide binding, and organelle distribution, were normal, but the cytochrome did not undergo reduction on cellular stimulation. Thus, absence or malfunction of the cytochrome b-245 may be the causal molecular defect in chronic granulomatous disease, implicating it in the microbicidal oxidase system.

Adolescent↗

Immunological studies in asthmatic children undergoing antigen provocation in the skin, lung and nose.

In children with perennial asthma, dual (immediate and late) reactions in the skin to D. pteronyssinus and Timothy grass pollen were more frequent with high doses of antigen and were associated with large immediate reactions. The frequency of dual bronchial or nasal reactions was not related to the size of the immediate reaction and dual reactions were commonly elicited to the lowest antigen dose which would elicit an immediate reaction. Serum IgG, IgA, IgM or IgE concentrations, IgE or IgG antibodies to the antigens and defective yeast opsonization did not differ in children with dual or immediate only reactions in skin, nose or lung. In five patients undergoing bronchial provocation tests with D. pteronyssinus there was no fever, no fine crepitations in the lungs and no significant change in the levels of C3.

Adolescent↗

Phorbol myristate acetate stimulated NBT test: a simple method suitable for antenatal diagnosis of chronic granulomatous disease.

When endotoxin was compared with phorbol myristate acetate (PMA) for stimulation of phagocytes in the nitroblue tetrazolium (NBT) test, both methods discriminated between affected patients with X-linked chronic granulomatous disease (CGD) and controls, but only the PMA NBT test distinguished female carriers of CGD. Endotoxin provided no stimulation of normal fetal blood whereas PMA was an effective stimulator. Our results indicate the superiority of the PMA NBT test for diagnosis of patients and carriers of CGD and should allow accurate antenatal diagnosis of the disease.

Adolescent↗

Genetic differences in immune exclusion and partial tolerance to ingested antigens.

The effect of feeding ovalbumin was studied in CBA, C3H, SWR/J and A inbred strains of mice. In non-immune animals differences were observed in their abilities to absorb intact antigen and eliminate it from their circulation. Following oral immunization, C3H mice were able to absorb significantly less ovalbumin than controls, however no evidence for immune exclusion was found in the other strains. Oral tolerance could be induced in all strains tested but in CBA and SWR/J mice oral immunization had to be continual, via the drinking rather than a single daily gastric intubation. The results suggest that genetic differences exist in the handling of antigen by the gut. If similar differences exist in man they may underly differences in susceptibility to food allergy.

Administration, Oral↗