Infant feeding and atopy.
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Biomedical subjects
Publications and source records attributed to J F Soothill.
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A placebo-controlled double-blind crossover trial of oral sodium cromoglycate was undertaken in thirty children with atopic eczema, employing the dosage and administration schedule recommended by the manufacturers. No difference was detected between the effects of 4 weeks' treatment with sodium cromoglycate and placebo.
The postweaning IgE and IgG antiovalbumin antibody responses were greater in rat pups which had received a cows' milk-based supplementary feed than in litter mates which had not. This effect was antigen non-specific and might be similar to that of supplementary feeds in the development of atopy in human infants. The total IgE concentration was similar in the two groups. Supplementary feeds did not increase the low values of IgE antiovalbumin in rats suckled by mothers immunised to ovalbumin.
In newborn English Infants, the predominant faecal bacteria were coliforms and bacteroides, as shown by Gram film, culture, and gas-liquid chromatography, whether they were bottle fed or exclusively breast fed. This contrasted with bifidobacterial predominance in faeces from breast-fed Nigerian infants. Presumably environmental factors other than exclusive breast feeding are also important for establishing the flora. No differences were detected between the flora of infants of atopic and non-atopic controls.
Most (18/21) children with perennial asthma gave dual (immediate and late) responses to bronchial provocation with two of Dermatophagoides pteronyssinus, and either timothy grass pollen or cat fur. Most (19/21) also showed dual responses to skin prick tests, only half (11/21) gave dual responses in the nose, mainly with timothy grass pollen, and these were associated with allergic rhinitis. Only two children gave dual responses in lung, skin and nose to both antigens, and only two gave immediate reactions without late reactions in all positive tests; most showed different patterns of response according to the organ tested or the antigen used for provocation. Our results suggest that local factors may be important in determining the pattern of allergic response in a 'target' organ, and that dual responses are strongly associated with the patient's symptoms.
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Twenty-six 8-year-old children who had had respiratory syncytial virus (RSV) bronchiolitis in infancy and their paired controls underwent skin and blood tests to assess the role of immunodeficiency and atopy in the pathogenesis of RSV bronchiolitis and the wheezing that may follow it. There was no difference between patients and controls in prevalence of atopy; positive results of prick tests to common antigens; eosinophil counts; yeast opsonisation defect; C2 deficiency; IgG, IgA, IgM, and IgE concentrations; or IgE antibody to dermatophagoides, timothy-grass pollen, and cat fur. Those of the children who had had RSV bronchiolitis and who continued to wheeze had a slightly higher mean eosinophil count and levels of IgE antibody to dermatophagoides than those who did not wheeze. Exercise-induced bronchial lability, though higher in patients than controls, did not correlate significantly with eosinophil counts or IgE concentrations. The genetic factors predisposing to RSV bronchiolitis and postbronchiolitic wheezing may differ from those predisposing to atopic asthma, though exclusive breast feeding may protect against both.
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T lymphocyte mobility is low in patients with low neutrophil mobility. Thymocytes move comparably with normal mature T lymphocytes. Histamine accelerates T lymphocyte mobility in healthy subjects, patients with defective lymphocyte mobility and thymocytes. Ascorbic acid increases lymphocyte mobility of healthy subjects and thymocytes. Inhibition of mobility of T- or Tmu-depleted T lymphocytes by complexed IgG casts doubt on previous reports that the T gamma cells do not move.
T cells may either increase or decrease in vitro proliferation of marrow pre-B cells from patients with acute lymphatic leukaemia after withdrawal of successful treatment. There is less proliferation when T cells are removed by E rosetting, and repletion of T cells restores proliferation. When additional T cells from the patients were added to the patients' marrows, proliferation was increased more effectively than with T cells from healthy subjects; there was no evidence of an allogeneic effect. In contrast, normal T cells stimulated with concanavalin A suppress proliferation. There was no evidence of differentiation into B cells.
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In a study designed to confirm our preliminary report of associations between HLA-B12, atopy, and relapse following cyclophosphamide treatment in steroid-responsive nephrotic syndrome (SRNS), we again found a higher incidence of HLA-B12 in SRNS children (44%) than we did in controls (24%). The association of HLA-B12 with short time-to-relapse after cyclophosphamide treatment of SRNS was also confirmed, but that with atopy in SRNS children was not, though we observed a similarly high incidence of atopy in them as before.
36 parents of infants who had died suddenly did not differ in frequency of atopic symptoms, immediate skin tests, IgE, IgE antibody, immunoglobulin G, A, and M, or yeast opsonisation, from 36 matched controls, although atopy was common (about half had atopy in both groups.
The factor in sera of patients with cystic fibrosis (CF) and their parents which agglutinates Proteus vulgaris has characteristics similar to those of IgG antibody to this organism. Sera of patients without CF who have P. vulgaris infections agglutinate the organism similarly. At present there are too many false-positives in a control population for the test to be widely useful for heterozygote identification.
Four patients with defective yeast opsonisation and protracted diarrhoea are reported. Plasma infusions improved the opsonising function in all 4 and the diarrhoea in 3. This immunological abnormality was assessed in 100 sequential patients with chronic diarrhoea associated with various gastrointestinal disorders; 52 with protracted diarrhoea and failure to thrive of undetermined cause, 26 with 'toddler diarrhoea', 8 with coeliac disease, 5 with chronic inflammatory bowel disease, and 9 with miscellaneous disorders. 23% of the patients with protracted diarrhoea of undetermined cause had defective opsonisation, a greater proportion (P less than 0.05) than that in 'toddler diarrhoea' or the remaining patients, in whom the frequency (4%) was similar to that (5%) in healthy populations. We suggest that yeast opsonisation be tested in children with protracted diarrhoea, as plasma infusions can be an effective form of treatment.
Healthy adults (parents, neighbours, and hospital staff) in close contact with children with leukaemia were found to have a high incidence of positive latex agglutination antiglobulin tests (probably an IgM antiglobulin antibody). This may explain a previous report of a high incidence of IgM anti-EB virus antibodies in parents of leukaemic children, which our results did not confirm (IgM antiglobulin, reacting with IgG anti-EB virus, could have been misinterpreted as IgM anti-EB virus). The antiglobulin antibody probably represents a nonspecific response to an infective agent. Other hospital staff, including those exposed to nonleukaemic children with infections, had a much lower incidence of the antibody, and it may represent a response to the leukaemic process itself, rather than to the infections to which such children are prone. Some leukaemic children have a similar antibody.