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Biomedical subjects

J Pepys

Publications and source records attributed to J Pepys.

At least 91 records · Page 5Linked to original sources

Allergy to a tetracycline preparation-a case report.

Immediate asthmatic and urticarial reactions were provoked in an affected subject by ingestion of a commercial combination of three tetracylines. No reactions were elicited by the tetracyclines given separately or prepared together as a powder; this was perhaps due to tachyphylaxis, since a test with the commercial preparation 2 months later elicited the reactions again. No reactions were elicited by the blue coating of the commercial preparation or by tartrazine.

Adolescent↗

Radioallergosorbent test (RAST) studies with insolubilized polysaccharides.

Polysaccharide preparations from Aspergillus fumigatus and Candida albicans when used with some human sera were found to fix complement and precipitate with specific antibodies present in the sera. Precipitins consisted predominantly of IgG with traces of IgM and IgA. Following insolubilization of the fungal polysaccharide preparations with the N-carboxyanhydride of L-leucine, reactivity with serum precipitins was retained and reaction with IgE antibodies was demonstrated using the radioallergosorbent test (RAST). Results showed that for A. fumigatus and C. albicans at least, polysaccharide-specific IgE antibodies probably occur in sera from some hypersensitive individuals. We suggest that chemical methods of the type described which induce polymerization or cross-linking will be useful for detecting IgE antibodies in the RAST. Such an approach could be used with a variety of polysaccharide preparations which cannot be coupled to polysaccharide solid supports by the usual methods.

Antibodies, Fungal↗

Asthma due to inhaled chemical agents--fumes from 'Multicore' soldering flux and colophony resin.

Four patients with occupational asthma associated with exposure to soldering flux or hot-melt glue containing pine resin (colophony) were subjected to occupational type inhalation challenge testing. All four gave immediate bronchial reactions to inhalation of the fumes, varying from one breath to 3 min of exposure. The clinical history and provocation test reactions suggest hypersensitivity to colophony fumes.

Adult↗

Bacterial precipitins and their immunoglobulin class in atopic asthma, non-atopic asthma, and chronic bronchitis.

In a study of groups of patients with atopic (extrinsic) asthma, non-atopic (intrinsic) asthma, and chronic bronchitis, no difference could be detected in the numbers having precipitating antibodies against species specific antigens from Staphylococcus aureus or Streptococcus pneumoniae compared to suitably matched control subjects. Precipitating antibodies against species specific antigens from Haemophilus influenzae, demonstrated in this investigation by double diffusion in agar gel, were found much more frequently in patients with chronic mucopurulent or obstructive bronchitis (50%) than in either asthmatic subjects (6%) or normal controls (6%) (P = less than 0.0005). While the precipitating antibody demonstrated in these patients against the extracts of Str. pneumoniae and Staph. aureus was in the IgG class alone, IgM and IgA antibody were detected against the species specific but not the non-species specific antigens of H. influenzae. These results underline the importance of H. influenzae as an infecting agent in chronic bronchitis and suggest that the finding of precipitins against the species specific H1 and H2 antigens of this bacterium denotes infection either concurrently or in the recent past. There is no evidence to suggest from this study that infection with Staph. aureus, Str. pneumoniae or H. influenzae is any more common in asthmatics as a group compared to controls or between patients with the non-atopic (intrinsic) and atopic (extrinsic) form of the disease.

Adolescent↗

Hyposensitisation.

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Desensitization, Immunologic↗

Cystic fibrosis--immunological reactions to A. fumigatus and common allergens.

Immunological studies of forty-three patients with cystic fibrosis showed that positive prick tests to at least one common allergen were obtained in 70%, to multiple allergens in 28% and to A. fumigatus in 50%. Specific IgE antibodies against these allergens were found in the appropriate subjects. In spite of this evidence of type 1, IgE, sensitization none of the patients had a history of infantile eczema. Intracutaneous tests with A. fumigatus extract gave types 1 and 3 reactions in sixteen patients (37%), only seven of whom were among the sixteen (37%) who gave positive precipitin tests. Raised levels of total serum IgG and IgA were found as compared with healthy controls and asthmatic subjects. No differences were found in total serum IgM and IgD levels. The high incidence of allergy to A. fumigatus in cystic fibrosis is confirmed.

Aspergillosis↗

Asthma due to inhaled chemical agents--the macrolide antibiotic Spiramycin.

One year after starting work in the pharmaceutical industry a 35-year-old non-atopic maintenance engineer developed attacks of sneezing, coughing and breathlessness. These occurred at home during the evening and early morning, never at work during the day. His employment involved contact with a wide variety of chemical agents including the macrolide antibiotic spiramycin. Inhalation challenge tests carried out in hospital with gradually increasing quantities of spiramycin reproduced his symptoms and led to the development of late asthmatic reactions, during which the FEV1 fell by 25% and the FEV1/FVC ratio by 15%. No change occurred in the single breath CO transfer factor nor were crepitations heard over the lung fields which remained normal on chest X-ray. The patient showed positive immediate skin prick tests to spiramycin and developed blood eosinophilia during the late asthma attacks. Inhalation of sodium cromoglycate either before, or before and hourly after the provocation challenge for 6 hr, failed to prevent the late asthma, although its onset was further delayed. On leaving the pharmaceutical industry the patient's symptoms improved but did not finally clear until his wife, who had worked in a clerical capacity in the same factory also ceased her employment.

Asthma↗

Effect of sodium cromoglycate on asthmatic reactions to environmental temperature changes.

Immediate asthmatic reactions, with falls in FEV1 of 16-42.5% were elicited by exposure in a cold room at 3 degrees C in five out of eight subjects with histories of asthma provoked by falls in environmental temperature. In four of the subjects pretreatment by inhalation of sodium cromoglycate gave complete inhibition of the asthmatic reaction in two, partial inhibition in one and had no effect in one case.

Administration, Intranasal↗

RAST, skin and nasal tests and the history in grass pollen allergy.

A comparison of the RAST (Phadebas), skin prick test, nasal test and a history of hay fever was made in 141 subjects, eighty-seven being prick test positive, with three concentrations of extracts of Sweet vernal (Anthoxanthum odoratum), Cocksfoot (Dactylis glomerata), Meadow fescue (Festuca elatior), Rye (Lolium perenne), Timothy (Phleum pratense), Meadow (Poa pratensis). In adequate concentration any of the species extracts would have sufficed for skin tests, with Cocksfoot pollen the most potent. Correlations found were: positive RAST/prick test, 98%; positive prick test/RAST, 89%; positive RAST/nasal test, 75%, and the higher the RAST the closer the correlation and the higher the nasal sensitivity; nasal test positive/RAST negative, 17%; positive history/RAST, 91%; positive history/prick test, 92%.

Asthma↗

Extrinsic allergic alveolitis due to rat serum proteins.

In a research assistant with recurrent episodes of extrinsic allergic alveolitis on exposure to rats, typical systemic and pulmonary reactions on inhalation and positive reaction on prick testing were elicited only by tests with rat serum; precipitins were present against rat serum and rat pelt, but not rat fur, and were also present against rat urine, which may contain large amounts of serum protein and which may have been a main source of antigenic exposure.

Adult↗

An analysis of skin prick test reactions in 656 asthmatic patients.

Of 656 asthmatic patients referred specifically for allergy assessments, 544 (84 percent) gave positive immediate skin prick tests to at least one of 22 common allergens used routinely. Comparison of these skin test positive patients with the 102 (16 percent) who were skin test negative showed a number of significant differences. The majority of the skin test positive patients (52 percent) were less than 10 years old at the time of onset of the asthma, whereas, of the skin test negative patients, 56 percent were aged over 30 years at the time of onset. Seventy per cent report rhinitis compared with 48 per cent of the skin test negative patients, and 29 per cent reported infantile eczema compared with 9 per cent. Symptoms attributed to house dust, pollens, and animals were noted two to three times more frequently by the skin test positive patients, while corticosteroid drugs had been used more commonly by the skin test negative patients (45 percent compared with 35 percent). No significant differences were observed with the other factors studied, namely, history of urticaria or angio-oedema, family history of "allergic" disease, and awareness of sensitivity to foods, aspirin or penicillin. Prick test reactions in the skin test positive patients were most commonly seen to house dust or the acarine mite, Dermatophagoides farinae (82 percent), followed by pollens (66 percent), animal danders (38 percent), foods (16 percent), Aspergillus fumigatus (16 percent), and other moulds (21 percent). There was a highly significant association of positive history with positive prick test for all allergens studied.

Adrenal Cortex Hormones↗