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Biomedical subjects

L Guilloux

Publications and source records attributed to L Guilloux.

At least 19 recordsLinked to original sources

Prevalence of muscle relaxant sensitivity in a general population: implications for a preoperative screening.

BACKGROUND: Muscle relaxants (MR) are responsible for 59% of peroperative anaphylactic reactions. A major issue would be to determine whether a systematic preoperative screening in the general population should be recommended. OBJECTIVE: The purpose of the study was to evaluate the prevalence of muscle relaxant sensitivity in a sample of the general population and to assess the role of possible risk factors. METHODS: Two hundred and fifty-eight subjects, aged 20-40 years, visiting a health care centre for a check-up were evaluated. Protocol included a questionnaire (occupation, symptoms of atopy, previous surgery, history of drug allergy), skin-prick tests to four commercial muscle relaxants and measurement of specific IgE against quaternary ammonium ions. Atopy was evaluated by skin-prick tests to common inhalant allergens and by a Phadiatop test. RESULTS: Of the study group, 9.3% had either a positive skin test to one or more muscle relaxant or a presence of specific IgE to quaternary ammonium ions. No risk factor was identified in the studied group. CONCLUSION: Since the rate of MR sensitivity is much higher than the anticipated rate of peroperative reactions due to allergy, a systematic preoperative screening for MR allergy should not be recommended for adults in a general population.

Adult↗

Cross-reactivity between terrestrial snails (Helix species) and house-dust mite (Dermatophagoides pteronyssinus). II. In vitro study.

Epidemiologic and in vitro data have shown that the association of house-dust mite (HDM) allergy and snail allergy in the same patients was due to cross-reactivity between HDM and snail allergenic components. However, the cross-reacting allergen(s) have not yet been identified. In vitro reactivity of seven patients' sera to the various extracts and hemolymph of four different Helix snail species was analyzed by IgE detection and immunodots and Western blots. Cross-reactivity between snails and Dermatophagoides pteronyssinus was assessed by immunodot and ELISA inhibition in two patients. Heterologous inhibition of the snail immunodot and ELISA was observed in one serum. Western blotting showed a specific binding on all four snail species extracts; molecular weights of snail allergens ranged from < 21 to 200 kDa. Marked individual differences were observed in the seven sera under study; most sera demonstrated IgE recognition of multiple bands, illustrating that no single allergen is responsible for cross-reactivity between snail and mite. These results confirm that cross-reactivity exists between snails of the Helix genus and HDM. This cross-reactivity, involving more than a single allergen, may be of clinical significance in atopic patients allergic to D. pteronyssinus. The identity of the cross-reacting allergens remains to be determined. Potential candidates include the thermostable minor allergens of D. pteronyssinus, tropomyosin and hemocyanin.

Animals↗

Prevalence of latex sensitization in subjects attending health screening: implications for a perioperative screening.

BACKGROUND: Because latex is a common allergen, the rate of latex sensitization may be high in the general population. A major issue would then be to determine whether a systematic preoperative screening in the general population should be recommended. OBJECTIVE: The purpose of the study was to evaluate the prevalence of latex sensitization in a sample of the general population and to assess the role of possible risk factors. METHODS: The subjects were 258 people, aged from 20 to 40 yr, visiting a health care centre for a check-up. The protocol included: a questionnaire (occupation, symptoms of atopy, use of latex goods and possible reactions, history of previous surgery), a skin-prick test, and a CAP RAST to latex. Atopy was evaluated by a skin-prick test to common allergens and a Phadiatop test. RESULTS: Some 6.6% of the study group had either a positive skin test or a positive RAST to latex. These subjects had a four-fold higher prevalence of symptoms when wearing gloves. The rate of latex sensitization was higher by fivefold in subjects with a history of reactions to latex goods and by fourfold in atopic subjects. CONCLUSIONS: Because the rate of latex sensitization is much higher than the anticipated rate of perioperative reactions due to latex allergy, a systematic preoperative screening for latex allergy should not be recommended for adults.

Adult↗

Hypersensitivity to banana in latex-allergic patients. Identification of two major banana allergens of 33 and 37 kD.

BACKGROUND: Allergy to banana often occurs in patients sensitized to latex. The spectrum of IgE-mediated responses to latex allergens is more and more documented but banana allergens and epitopes shared by these two allergens have not yet been characterized, even though the existence of cross-reacting IgE antibodies has been demonstrated. OBJECTIVE: The purpose of this study was to assess the relationship between banana hypersensitivity and latex allergy in a population of 19 latex-allergic patients and to identify allergenic components in banana and the common structures shared with latex. METHODS: The in vivo study was conducted in our outpatient department in patients with well-documented latex allergy. Clinical histories were evaluated and skin prick tests were performed with banana and latex extracts. IgE responses from 19 patients were investigated by means of CAP RAST assay and SDS PAGE immunoblotting. Epitopes shared by banana and latex were investigated by means of immunoblotting experiments. RESULTS: Eight of 16 patients (50%) reported symptoms after eating bananas and banana skin prick tests were positive in 5 of 14 patients (36%). Banana RAST results were positive in 12 of the 19 patients (63%). In immunoblot experiments, 17 of the 19 patients (89%) exhibited specific banana IgE antibodies and 16 allergenic components were identified with molecular weights ranging from 17 to 128 kD. Two were considered as major allergens: 33 kD was detectable in 15 of 19 sera (88%) and 37 kD in 13 of 19 sera (76%). Inhibition studies by preincubation of two individual sera with banana or latex extract demonstrated the complete disappearance of IgE binding on banana blotted allergens. CONCLUSION: This study confirms the "latex-fruit syndrome" already described by Blanco et al. Two major allergens were revealed in banana at 33 and 37 kD and the presence of more than ten common components with latex was observed.

Allergens↗

Hypersensitivity to latex and Ficus benjamina allergens.

BACKGROUND: Association between allergy to Ficus benjamina and Hevea brasiliensis, two botanically unrelated plants, was suspected in consequence of two clinical observations. Symptoms were rhinitis and asthma. This study was undertaken to assess the in vivo and in vitro cross-reactivity between Ficus benjamina and Hevea brasiliensis allergens. METHODS: The two patients were asked about use and contact with latex devices and relationship between symptoms and Ficus benjamina exposure. Skin prick tests were performed with Ficus benjamina, Hevea brasiliensis extracts and common allergens. Double-blind nasal and bronchial challenge tests were done using the rinse fluid from a brand of latex gloves. Total and specific IgE antibodies to Ficus benjamina and Hevea brasiliensis were determined. In vitro cross-reactivity was investigated by means of CAP RAST and immunodot inhibition experiments. RESULTS: We observed that for the first patient the primary phenomenon is probably allergy to latex followed by allergy to Ficus benjamina. For the second patient, allergy to Ficus benjamina was diagnosed (improvement related to the avoidance of exposure to Ficus benjamina allergens) and positivity to latex skin prick tests may be due to the cross-reacting allergens. In vitro assays showed specific IgE antibodies to both allergens and cross-reactivity was confirmed in the two cases by reciprocal inhibition of the two extracts. CONCLUSION: The increasing risk of sensitization to widely used latex devices and extensive exposure to Ficus species in households and offices indicates increased allergenic risk from this newly recognized cross-reactivity.

Adult↗

Histamine release assay and radioimmunoassay for the detection of IgE antibodies against neuromuscular blocking drugs.

It is well established that muscle-relaxant drugs may be responsible for anaphylactoid reactions during anaesthesia. In the present work we evaluated in 41 patients who had experienced anaphylactoid reactions during general anesthesia, the value of different radioimmunoassays (RIAs) and of an histamine release assay (HRA). The RIA was performed with different solid phases as PAPPC (para amino phenyl phosphoryl choline), morphine, TMA (trimethylamine) and TEA (triethylamine). The results were expressed as the percentage of 125I anti-human IgE adsorbed onto the solid phase. The sensitivity was estimated respectively at 95, 82, 93 and 64%. The results were significantly in accordance with those obtained with QAS-RIA (from Guéant) but a weak correlation was seen with Phadebas Rast succinylcholine (r = 0.85 and 0.53 respectively). The HRA gave with the NMBD incriminated a sensitivity of 88%. The correlation between HRA and IDR for the drug involved was 89% and 43% for the other NMBDs. The PAPPC RIA was apparently the most efficient test to screen sera for the presence of IgE antibodies whatever the NMBDs involved in anaphylaxis. An advantage is that this solid phase is commercially available and therefore this RIA can be used routinely with a high sensitivity, allowing the comparison of the results obtained by different laboratories.

Anaphylaxis↗

A new radioimmunoassay using a commercially available solid support for the detection of IgE antibodies against muscle relaxants.

It is well established that muscle-relaxant drugs may be responsible for anaphylactoid reactions during anesthesia. In this study, we developed an in vitro test with a commercially available solid phase for the detection of specific IgE directed to the tertiary or quaternary ammonium groups of neuromuscular-blocking drugs. The solid-phase complex was P-aminophenylphosphoryl-choline (PAPPC) immobilized on agarose, and an RIA was performed with an antihuman IgE labeled with 125I. The results, expressed as the percentage of 125I-labeled anti-IgE linked to the solid phase, were at 0.41 +/- 0.19 for 34 control sera from nonallergic healthy adults, with an upper limit estimated at 1%. The values obtained with the sera of 31 allergic patients ranged from 0.6% to 41% with a sensitivity of 97%. The specificity and the positive predictive value of the PAPPC RIA were 97% and 94%, respectively. These results were compared with results of other RIAs with morphine, trimethylamine, triethylamine immobilized on epoxy-activated Sepharose, and choline hydrochloride immobilized on Sepharose (quaternary ammonium Sepharose RIA) and with Phadebas RAST succinylcholine and Phadebas RAST alcuronium. The PAPPC RIA appears to be the most efficient test to screen sera for the presence of IgE antibodies directed to neuromuscular-blocking drugs. One major advantage is that this solid phase is commercially available and ready to use. This advantage will improve the accuracy in the comparison of the results with results from different laboratories.

Anaphylaxis↗

Evolution of sensitivity to Hymenoptera venom in 200 allergic patients followed for up to 3 years.

Duration of venom immunotherapy still remains questionnable, since some patients outgrow their sensitivity. Two hundred venom-allergic patients (4 to 82 years; mean +/- SD, 37.3 +/- 14.2 years) who were first observed with systemic reactions (SRs) were investigated yearly for up to 3 years. Among these patients, 72 were allergic to honeybee venom, 83 to yellow jacket venom, and 45 to both yellow jacket and Polistes venom. At each visit patients had skin tests and RAST to venom. All patients had the same semirush protocol and a monthly maintenance dose of 200 micrograms. After 1 year of treatment, 19% of bee venom-allergic subjects and 35% of vespid venom-allergic individuals had a negative skin test and RAST to the corresponding venom. The percentage of negativation of tests increased after 3 years to 30.5% in bee venom-allergic patients and to 54% in vespid venom-allergic individuals. This rapid and relatively important negativation of skin tests and RAST may be due to a monthly maintenance dose of 200 micrograms; 76 patients experienced a field sting without any SR, two patients had a severe SR, and three patients had a mild SR. Although we tried to define parameters that might predict the abolition of venom sensitivity before starting immunotherapy, we could not find any parameter except venom species. Children and adults behave similarly in terms of evolution of venom sensitization. Mean serum venom-specific IgG levels were significantly lower in patients who had lost their sensitivity.

Adolescent↗

[Specific IgG and immunotherapy].

The authors discuss about the functions and the evolution of total specific IgG antibodies and specific antibodies of the IgG1 and IgG4 isotype during desensitization treatment.

Allergens↗

[A simple test for the detection of respiratory allergy to current pneumallergens].

Phadiatop is a new in vitro test used for screening patients with allergic respiratory diseases. This test, based on the RAST procedure, is performed with a paper disc to which a balanced mixture of relevant inhalant allergens has been coupled. One hundred and one adults ranging in age from 18 years to 73 years and 38 children (4 months to 15 years) were studied. We found a good correlation between this new test and total IgE (adults: 74.3 p. 100, children: 68.4 p. 100), specific IgE (adults: 91.1 p. 100, children: 100 p. 100) and skin test (adults: 79.2 p. 100, children: 97.1 p. 100). There was a high correlation between clinical atopy assessment and the result of Phadiatop, its efficiency was 83 p. 100 in adults and 97 p. 100 in children.

Adolescent↗

[Sequential analysis of specific IgE and IgG titres as a function of the cumulated doses of venoms injected in allergies to Hymenoptera and correlation with specific IgE, clinical manifestations and skin tests].

The numbers of IgE and specific IgE in ten desensitized to wasp-venom patients are retrospectively analysed, in order to study their variation according to the cumulated dose of administered venom during the desensitization (mean-time 18.4 months). Our results allow to find after a latency period, a growth of the specific IgE number, then their gradual decrease, while the specific IgE number gradually rises to reach a deal-level.

Adult↗

[In vitro exploratory methods in immuno-allergology].

The authors discuss different in vitro tests that provide evidence for: involvement of atopy in clinical symptoms (eosinophilia, total IgE titre, histaminemia); the identification of the responsible allergen (specific IgE, basophil degranulation, and release of histamine); following the course of hyposensitization treatment (specific IgG).

Allergens↗

[Allergy to Thyrophagus putrescentiae and Lepidoglyphus destructor in a population of young asthmatic adults].

In the present work a study has been made of the prevalence of allergy to two storage mites, Tyrophagus putrescentiae and Lepidoglyphus destructor in a population of 105 young adults in the east of France. Combination of skin tests and specific IgE measurements shows that 43.10% of the subjects were sensitive to Tyrophagus and 44.95% to Lepidoglyphus. Interpretation of skin tests remains uncertain, particularly concerning the source of the allergen used and it is most often also necessary to measure the specific serum IgE. As in many studies, most sensitization was found amongst farmers. In contrast, no difference was seen between rural and city dwellers, subjects who were in contact with small animals and those in contact with food for livestock if they were not farmers, not between declared asthmatics who lived in a humid place and those who lived in an environment that was drier. Certainly these mites appeared in the present study to be much more ubiquitous than supposed previously and the fact that they seemed to be carriers of allergens and antigens that were different from those of Dermatophagoides raises the question as to whether the need for hyposensitization treatment for them has been under-estimated.

Acari↗

[Allergy to Tyrophagus putrescentiae and Lepidoglyphus destructor in a population of young adult asthmatics].

The goal of this work was the study of the prevalence of allergy to two mites, Tyrophagus putrescentiae and Lepidoglyphus destructor in a population of 105 young asthmatic men from East of France. The association of skin tests and specific IgE shows that 43.10% are allergic to Tyrophagus and 44.95% to Lepidoglyphus destructor. The significance of skin tests is doubtful and depends on the laboratories which provide the allergens. Therefore, specific IgE has to be performed. As in other studies it has been observed that farmers are very often sensitized. But, nose difference has been noticed between people living in town or in country, between those having contacts with pets or not, feeding the cattle or not (except for the farmers). In the same way, no difference has been noticed between the asthmatics living in a wet country and/or wet house and those living in a dry area.

Adolescent↗

Blotting methods applied to investigations of the mitogenic activity of phytohaemagglutinin (PHA).

PHA polypeptides were separated by SDS-polyacrylamide gel electrophoresis and transferred to nitrocellulose filters which were then cut into identical discs and used to perform blastogenic stimulation on cultured human peripheral blood lymphocytes. This method offers the following advantages: the high resolution of SDS-polyacrylamide gel electrophoresis, the sensitive immunochemical identification of the polypeptides involved in the mitogenic responses of lymphocytes, the determination in the same experiment of the molecular weight, antigenicity and biological activities of the proteins.

Collodion↗