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Biomedical subjects

J M Kelso

Publications and source records attributed to J M Kelso.

At least 37 records · Page 2Linked to original sources
PubMed1996

Monospecific allergy to swordfish.

BACKGROUND: Fish allergy is a relatively common and potentially fatal condition. Most fish allergic subjects are allergic to multiple fish species. We encountered a patient clinically allergic only to swordfish. OBJECTIVE: To characterize the in vivo and in vitro IgE antibody responsiveness of this patient solely allergic to swordfish. METHODS: Prick skin tests, as well as immunoassay and protein immunoblotting for IgE antibody were performed using commercial fish extracts and fresh swordfish. A more typical multiple fish-allergic subject and a subject not allergic to food were also studied for comparison. RESULTS: The multiple fish-allergic subject demonstrated IgE antibody to a 13-kD protein in all fish tested (probably Gad c 1 and its analogues in other fish). The swordfish-allergic subject did not recognize this 13-kD band but did demonstrate IgE directed against a 25-kD band only in swordfish. The negative control showed no IgE binding to either the 13 or 25 kD bands. CONCLUSIONS: It is possible to be allergic to a single fish species, such as swordfish, and such monospecific allergy may be due to the presence of species-specific allergens, in this case a 25-kD allergen in swordfish.

Adult↗
PubMed1996

Skin test results in related and unrelated persons with allergic rhinitis.

BACKGROUND: First degree relatives of patients with allergic rhinitis are at increased risk of having the disorder. It is not yet clear whether or not two such related persons with allergic rhinitis are more likely to be skin test positive to the same specific allergic extracts than unrelated persons with allergic rhinitis. OBJECTIVE: To determine whether or not first degree relatives (parent and child or full siblings) with allergic rhinitis are more likely to be skin test positive to the same allergen extracts than unrelated persons with the disease. METHODS: A retrospective chart review of Allergy Clinic patients was performed. Skin test results for 12 common aeroallergen extracts were compared in 32 pairs of genetically related subjects and 32 pairs of age-matched and sex-matched unrelated subjects, all with allergic rhinitis. The percent of concordant results (both members of a pair skin test positive or both negative) and discordant results (one member of a pair positive and the other negative) were calculated and compared for related and unrelated groups. Also, the expected rates of positive concordance (both skin tests positive) based on the prevalence of skin test positively in the two groups were calculated and compared with the corresponding observed rates. RESULTS: Results were concordant in 242 of 384 skin tests (63%) in related pairs versus 233 of 384 skin tests (61%) in unrelated pairs (P = .28, not significant). The expected and observed rates of positive concordance were not significantly different in the related (P = .38) or unrelated (P = .49) groups. When the groups were subdivided into parent-child pairs and sibling pairs, a similar lack of significant differences between the groups was found. CONCLUSIONS: It is concluded that first degree relatives, both with allergic rhinitis, are no more likely to be skin test positive to the same allergen extracts than unrelated persons with this disease. Further, it seems appropriate to advise patients with allergic rhinitis that their first degree relatives who also have the disorder will not necessarily have the same specific allergies.

Adolescent↗
PubMed1995

Oral allergy syndrome successfully treated with pollen immunotherapy.

BACKGROUND: Some patients with allergic rhinitis have oral allergic reactions to fresh fruits and vegetables. This phenomenon has been termed "oral allergy syndrome" and is proposed to be due to cross-reacting allergens in the foods and pollens. METHODS: We report a patient with allergic rhinitis and oral allergy syndrome treated with pollen immunotherapy. Prior to immunotherapy, eating any fresh fruit or vegetable caused immediate itching and swelling of his tongue and throat. Prick skin test titration with pollens and foods was performed before and after 13 months of immunotherapy. Specific IgE immunoassay was performed with the same extracts on serum obtained before and after 7 and 13 months of immunotherapy. IgE immunoblots were performed on the same extracts separated by polyacrylamide gel electrophoresis using sera from the same time periods. RESULTS: After 1 year on immunotherapy, the patient's allergic rhinitis symptoms resolved, and he was able to eat fresh fruits and vegetables without reaction. Skin testing and specific IgE immunoassay demonstrated a marked reduction in sensitivity to not only the pollens but the foods as well. Immunoblots revealed that the intensity of IgE binding to most components of the extracts, some common to pollens and foods, declined during immunotherapy. CONCLUSIONS: These results support the notion that oral allergy syndrome is due to cross-reacting allergens in foods and pollens and may be amenable to treatment with pollen immunotherapy.

Adult↗
PubMed1994

Extractable latex allergens and proteins in disposable medical gloves and other rubber products.

BACKGROUND: IgE-mediated sensitization to rubber proteins is being reported with increasing frequency in health care workers. To explore the relative importance of various sources of allergen exposure, we measured the total rubber allergen and protein levels in extracts of disposable rubber gloves and compared the allergen levels with those in extracts of other medical and consumer rubber products. METHODS: Rubber allergens were measured by inhibition immunoassay with a rubber glove extract as the solid-phase allergen and pooled plasma from five rubber-sensitized health care workers as the IgE antibody source. Proteins were measured by Ninhydrin assay. RESULTS: Among 71 lots of gloves tested, the extractable allergen and protein levels were significantly correlated and were appreciably higher in powdered gloves than in powder-free gloves. Allergen levels varied 3000-fold among gloves from different manufacturers and were higher in examination gloves than in surgical or chemotherapy gloves. Measurable allergen was found in 11 of 24 lots of "hypoallergenic" gloves tested. Allergen levels in toy balloons were comparable to those in powdered gloves; much lower allergen levels were measured in condoms and anesthesia rebreathing bags. CONCLUSIONS: The allergen content of disposable rubber gloves varies widely and is higher in powdered gloves than in powder-free gloves and higher in examination gloves than in surgical gloves. Hypoallergenic gloves may contain substantial amounts of IgE-binding proteins. Gloves and toy balloons appear to be more important sources of rubber allergens than the other rubber products tested.

Allergens↗
PubMed1993

Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gelatin.

BACKGROUND: Allergic reactions to measles, mumps, and rubella (MMR) vaccine are rare; some have been attributed to allergy to trace quantities of egg proteins. We report a 17-year-old female who had an anaphylactic reaction to MMR vaccine. A primary vaccination with MMR at age 15 months had been uneventful. She is not allergic to eggs; however, ear and throat pruritus and tongue swelling develop after she eats gelatin. MMR vaccine contains gelatin as a stabilizer. METHODS AND RESULTS: Prick skin tests were positive to 1:10 wt/vol dilutions of MMR vaccine and gelatin but negative to egg. By immunoassay, her serum IgE antibodies were elevated to both MMR vaccine and gelatin, but not to isolated MMR antigens. IgE binding to the gelatin carrier could be inhibited in a dose-dependent fashion by addition of not only MMR vaccine but also gelatin from a variety of animal sources. Immunoblotting confirmed the presence of IgE antibodies to multiple gelatin components as well as to MMR vaccine components. CONCLUSIONS: We conclude that the patient has an anaphylactic sensitivity to gelatin, and that her anaphylaxis to MMR vaccine was caused by the gelatin component. This sensitivity may explain other cases of MMR anaphylaxis.

Adolescent↗
PubMed1991

Common variable immunodeficiency: the disorder and treatment.

A case of common variable immunodeficiency, a relatively rare disorder, is presented. This case was complicated by the presence of an anti-IgA antibody in the patient's serum and a history of a possible anaphylactic reaction to a prior intravenous infusion of gamma-globulin. Common variable immunodeficiency is actually a heterogeneous group of demonstrable immunoglobulin deficiencies that have in common low levels of most immunoglobulin isotypes, the inability to form antibodies to antigen, an absence of gross defects in cell-mediated immunity, and the presence of recurrent bacterial infections. The history of immunoglobulin deficiency and its treatment is reviewed. Although the primary therapy for common variable immunodeficiency is gamma-globulin replacement, ancillary measures such as early treatment of infections with antibiotics are also important. Intravenous gamma-globulin replacement therapy is preferred to intramuscular replacement therapy in these patients because intramuscular doses must be limited in volume to minimize local pain and take 2 to 14 days to achieve maximal blood levels, during which time in situ degradation of up to 50% of the administered dose can occur. Five intravenous gamma-globulin preparations are currently available in the United States. The potential adverse effects of intravenous gamma-globulin infusion and the precautions currently taken to ensure safety during administration of this product are discussed.

Adult↗
PubMed1991

Diagnostic performance characteristics of the standard Phadebas RAST, modified RAST, and pharmacia CAP system versus skin testing.

Results from three in vitro assays for allergen-specific IgE, the standard Phadebas radioallergosorbent test (PhRAST), modified RAST (mRAST), and the new Pharmacia CAP System (CAP) were compared with skin prick testing (SPT) results in 104 patients with allergic rhinitis and/or asthma and 24 nonatopic controls. Five allergens were evaluated: cat, Dermatophagoides pteronyssinus, Alternaria, June grass, and short ragweed. Using SPT results as the reference standard, the PhRAST had the lowest sensitivity (62%) and highest specificity (99%). The CAP achieved higher sensitivity (74%) with comparable specificity (96%) while the mRAST had even higher sensitivity (90%) but lower specificity (87%). The overall frequency of positive results in controls was 0% for PhRAST, 1.7% for CAP, and 3.3% for mRAST. If the threshold for a positive mRAST was raised to greater than or equal to class 2, this assay achieved performance characteristics similar to the CAP. If the results of these in vitro tests are used as the sole guide to the prescription of environmental control and immunotherapy in unselected patients with rhinitis and asthma, the performance characteristics of the CAP make it the preferred test.

Adolescent↗
PubMed1990

Effect of inhaled methacholine on inspiratory flow.

One hundred consecutive outpatients with symptoms suggestive of asthma who came to the Pulmonary Function Laboratory for a methacholine challenge test were studied. In addition to the forced expiratory maneuvers, forced inspiratory maneuvers were performed before and after the maximal response to methacholine. In 24 patients, the methacholine challenge suggested that they had asthma (forced expiratory volume in 1 s [FEV1] decrease greater than or equal to 20 percent). Six of these 24 patients also had a decrease in maximal forced inspiratory flow (FIFmax) greater than or equal to 20 percent and nine had a decrease in forced inspiratory flow at 50 percent of vital capacity (FIF50) greater than or equal to 20 percent, suggesting that bronchoconstriction can cause decreased inspiratory as well as expiratory flows. In 76 patients, the methacholine challenges were "negative" (FEV1 decrease less than or equal to 20 percent), suggesting that they did not have asthma. Nevertheless, in 11 of these 76 patients the FIFmax decrease was greater than or equal to 20 percent, and in 14 patients the FIF50 decrease was greater than or equal to 20 percent, suggesting that intermittent central airway obstruction is responsible for these patients' symptoms.

Administration, Inhalation↗
PubMed1990

Anaphylactoid reaction to ethanol.

We studied a 14-year-old boy who developed a pruritic rash and facial swelling after ingestion of beer or wine. A blinded challenge with purified ethanol was positive demonstrating ethanol itself to be the offending agent. An IgE-mediated reaction to ethanol or one of its metabolites as a hapten is possible, or the reaction may involve unusual metabolism of ethanol with accumulation of acetaldehyde and/or direct mast cell degranulation.

Adolescent↗
PubMed1982

Effects of insulin on wound healing in diabetic mice.

In the present study wound healing was examined in normal C57B1/6 male mice, diabetic mice, non-treated; and in diabetic mice treated with insulin. Small dermal wounds were made in the ears of the mice 40 h after the initial injection of insulin or vehicle alone. All animals were biopsied 8 h later. The wounds were examined by light and electron microscopy and wound components (capillaries, fibroblasts, PMN's oedema, collagen) were quantitated by lineal point analysis. The non-treated, diabetic mice demonstrated in inability to heal wounds when compared to controls; whereas, diabetic mice given a multidose insulin regimen demonstrated a response similar to controls. Insulin treatment of diabetic mice reduced the mean level of hyperglycaemia when compared to the non-treated diabetic mice. There was no detectable difference in the healing response with duration of diabetes in either the insulin-treated or non-treated diabetic mice. Although there was a mild reduction in hyperglycaemia, these data support the hypotheses that insulin is a necessary component of an adequate wound healing response.

Animals↗
PubMed1981

The effect of antisera to insulin, 2-deoxyglucose-induced hyperglycemia, and starvation on wound healing in normal mice.

Wound healing was examined in normal C57BL/6 male mice treated with antiserum to insulin or 2-deoxyglucose (2-DG) and in mice starved for 33 h. Hyperglycemia was induced after antiserum or 2-DG treatment; the blood glucose was lowered in the starved mice when compared with controls. Small dermal wounds were made in the ears of the mice 1 h after the initial injection of antisera or 2-DG. The starved group were wounded after 25 h of fasting. All animals were biopsied 8 h later. The wounds were examined by light microscopy and wound components (capillaries, fibroblasts, PMNs, collagen, and edema) were quantitated by lineal point analysis. Mice treated with antisera to insulin and mice starved for 33 h had an impaired healing response; the mice treated with 2-DG had a response similar to controls. These results suggest that hyperglycemia, per se, or the production of any toxic metabolites from high blood glucose levels could not alone induce the poor healing response. The depressed response in the antiserum-treated and starved mice may be due to the decreased availability of insulin to the wound tissues. These data support the hypotheses that insulin is a necessary component for an adequate wound healing response. In addition to a role in glucose transport and metabolism, insulin may also promote cellular growth.

Animals↗