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Biomedical subjects

M Forsbeck

Publications and source records attributed to M Forsbeck.

At least 19 recordsLinked to original sources

Mercury-specific lymphocytes: an indication of mercury allergy in man.

In this study, 18 patients with oral lichen planus (OLP), adjacent to amalgam fillings, were tested in vitro with an optimized lymphocyte proliferation test, MELISA (memory lymphocyte immunostimulation assay) and with a patch test. Twenty subjects with amalgam fillings but without oral discomfort and 12 amalgam-free subjects served as controls. The results show that patients with OLP have significantly higher lymphocyte reactivity to inorganic mercury, a corrosion product of amalgam, compared to control groups. Removal of amalgam fillings resulted in the disappearance of oral mucosal changes, thus indicating a causal relationship. Positive responses to phenylmercury (phenyl-Hg), a bactericidal agent in root fillings and in pharmaceutical preparations, were also noted in the oral lichen group but not in the control groups. Thus, low-grade chronic exposure to mercury may induce a state of systemic sensitization as verified by Hg-specific lymphocyte reactivity in vitro.

Adolescent↗

Lymphocyte transformation test for diagnosis of isothiazolinone allergy in man.

The lymphocyte transformation test (LTT) has been used for evaluation of in vitro lymphocyte responses in 18 patients with dermatitis and positive patch tests to 200 ppm of a combination of 5-chloro-2-methylisothiazolinone and 28methylisothiazolinone (MCI) in nine patients with dermatitis unrelated to MCI and in seven subjects without skin diseases. Two workers sensitized by occupational exposure to a formulation containing 1,2-benzisothiazolin-3-one (BIT) were also studied. Lymphocytes from nine patch-test-positive patients proliferated vigorously to MCI in vitro. Lymphocytes from the remaining nine patients were not stimulated. Lymphocytes from two BIT-sensitized workers responded to BIT in vitro. The lymphocyte proliferation to isothiazolinones indicates the presence of memory cells in the patients' blood and confirms immunologic reaction to the inducing agent. To establish clinical relevance of LTT results, 12 MCI patch-test-positive patients underwent "use test" with lotion containing 15 ppm MCI. Four of five LTT-positive patients were use-test-positive, whereas seven of seven LTT-negative patients were use-test-negative. LTT-positive and lotion-positive patients responded to 100 ppm or lower concentrations of MCI on patch testing, whereas seven of eight LTT-negative and lotion-negative patients responded to 200 ppm only. In the case of MCI, proliferation was due to the chlorinated component, indicating that this part contains an allergenic epitope. Finally, MCI-specific lymphocyte proliferation was observed only in patients with MCI-positive skin test, but not in nine patients with dermatitis induced by other agents, or in seven subjects without skin diseases. Thus, the lymphocyte transformation test is able to distinguish between irritant and allergic skin responses. It may also be valuable in establishing the clinically relevant patch-test concentration of allergens with irritative properties.

Adult↗

Side-chain-specific lymphocyte responses in workers with occupational allergy induced by penicillins.

Eight workers with clinically diagnosed or suspected occupational allergy caused by penicillins were studied by the lymphocyte transformation test (LTT) and by skin test. The majority of the workers handled bacampicillin, some of them had been in contact with benzylpenicillin and one worked with azidocillin only. Six workers had eczema and 2 workers suffered from rhinitis only. Lymphocytes from workers with bacampicillin-induced symptoms responded to this drug in vitro by an increased 3H-thymidine incorporation and by lymphoblastogenesis. Bacampicillin-specific allergy had been confirmed by positive patch test in 5 workers. Lymphocytes from bacampicillin-allergic workers did not respond to other penicillins such as benzylpenicillin or azidocillin in vitro. However, such penicillins were antigenic in vitro since lymphocytes from an azidocillin patch test positive worker proliferated on exposure to azidocillin in vitro. The findings at the cellular level were further supported by the specificity of the skin test. Thus, bacampicillin patch test positive workers had a negative skin reaction to benzylpenicillin. In conclusion, these data suggest the role of penicillin side chains in the sensitization process underlying occupational allergy to penicillins. LTT can be used as a tool for studying antigenic specificities involved in a sensitization process leading to penicillin allergy.

Ampicillin↗

The lymphocyte transformation test for diagnosis of drug-induced occupational allergy.

Twenty-five workers with clinically diagnosed or suspected occupational hypersensitivity caused by contact with bacampicillin, alprenolol, and/or quinidine were studied by the lymphocyte transformation test and by skin tests. Ten healthy exposed workers, 16 job applicants, and seven healthy nonexposed laboratory workers served as control subjects. Lymphocyte transformation was measured by 3H-thymidine uptake into DNA and by counting of lymphoblasts on cell smears. Lymphocytes from workers with contact eczema or with eczema in combination with conjunctivitis and rhinitis responded to offending drugs in vitro as demonstrated by an increased 3H-thymidine incorporation and by the presence of lymphoblasts in the cultures. In vitro proliferative responses were reproduced during a 4-year period. Drug-specific allergy was confirmed by positive patch test in most workers with eczema. In addition, bacampicillin-specific lymphocyte proliferation was also observed in workers with suspected bacampicillin hypersensitivity but with negative skin tests. They suffered mostly from eczema in combination with conjunctivitis and rhinitis or from conjunctivitis/rhinitis only. Lymphocytes from most control subjects did not respond in vitro to bacampicillin, alprenolol, or quinidine. Weak proliferative responses to bacampicillin were observed in two of the 16 job applicants. The exquisite specificity of drug-induced lymphocyte responses is demonstrated. Thus, lymphocytes from a quinidine-sensitive worker did not respond in vitro to the quinidine stereoisomer, quinine. Furthermore, lymphocytes from a bacampicillin-sensitive worker responded to some penicillins, such as pivampicillin and ampicillin, but not to others, such as benzylpenicillin or pivmecillinam. These data suggest the role of N-acylamido side chain in the sensitization of lymphocytes from this particular donor. In conclusion, lymphocyte transformation test can be used for the detection of offending agents in occupationally sensitized workers. Furthermore, lymphocytes from such individuals may serve as a model for study of specificity of cellular reactions underlying drug-induced hypersensitivity.

Adult↗

Buckwheat allergy: health food, an inhalation health risk.

Thirteen out of 28 persons (14 men and 14 women) employed in a company which imports, prepares and distributes plant products used in spices and as ingredients in so-called health food, had developed work-related symptoms in the form of rhinitis, conjunctivitis, asthma, itch or urticaria. The symptoms occurred in connection with specific work operations, especially in the grinding and packaging of buckwheat. Seven out of 25 examined persons (28%) had at least one positive allergy test (prick test or RAST) against buckwheat. Furthermore, one person had positive RAST against extract from castor-oil bean. The correlation between positive allergy tests and work-related symptoms is significant. Fourteen persons were also patch tested. All were negative except one person who had a positive patch test against nickel. The nickel allergy was diagnosed before this study was done and had no relation to the work. The levels of airborne dust in the breathing zones of the workers when they performed dust-forming work were around and below 5 mg/m3. When buckwheat flour was packaged, the airborne dust levels were about 1-2 mg/m3. Thus, exposure to comparatively low levels of buckwheat dust may induce a definite risk of rapidly ensuing allergy. It is also obvious that persons without atopic stigmata, such as an earlier history of allergy or the occurrence of allergic diseases in relatives, risk becoming allergic. A conclusion is that health food could be a danger, when it is inhaled.

Adolescent↗

Atopic hand dermatitis: a comparison with atopic dermatitis without hand involvement, especially with respect to influence of work and development of contact sensitization.

A group of 77 patients with atopic hand eczema were compared with 136 atopic dermatitis patients without hand manifestations. Age distribution was identical in the two groups, peaking at 25-39 years of age. Both groups were dominated by female patients. No differences existed between them with respect to atopic heredity, occurrence of other atopic manifestations, or distribution of serum IgE values. The fingers represented the predilection sites for hand involvement. Patients with hand lesions changed jobs more frequently (p less than 0.001) than those with unaffected hands, and change from a wet or unclean occupation was more common (p less than 0.001) than from a dry one. Change of work entailed improvement in the skin status of both groups. Prevalence of positive patch test reactions was high and statistically identical in both groups. Occurrence of positive responses did not explain the development of hand affliction; in only 3 patients did the test result correspond to exacerbation of the hand eczema. The number of positive reactions was high in patients with low serum IgE levels, while high levels were associated with fewer positive patch test reactions.

Adult↗

Contact eczema produced by a beta-adrenergic blocking agent (alprenolol).

In a pharmaceutical industry, several cases of allergic contact eczema caused by the beta-adrenergic blocking agent alprenolol (Aptin) have appeared. This report deals with 12 men and two women who developed eczema during work with the substance. In 13 of the 14 cases, the induction time for sensitization was less than 1 year. The skin reactions were very florid. After healing they could be reproduced by very small quantities of the substance. In one case, eczema could also be produced after ingestion of Aptin tablets. All the cases were transferred to other work within the factory. An intensive programme was implemented to remove dust from the working areas. Despite this, isolated new cases still appear. Some employees in contact with the substance also experienced mucous membrane symptoms. These symptoms could not be shown to have an allergic aetiology, but were considered to be irritant reactions. Alprenolol must be considered a very strong contact allergen.

Adult↗

Comparison between 24- and 48-hour exposure time in patch testing.

A pilot study was performed to compare the results obtained by leaving the test substances recommended by ICDRG on the backs of the patients for 24 and 48 h, respectively. The Pirilä chamber test method was used. We got different results between the two methods of application time as reported, and intend to continue the study.

Humans↗

Immediate reactions to patch tests with balsam of Peru.

Closed patch tests with balsam of Peru gave rise to nine immediate reactions among 121 patients with different dermatoses and to 10 reactions among 57 patients with chronic urticaria. Among compounds of balsam of Peru, cinnamic aldehyde, cinnamic acid benzoic acid and benzaldehyde also gave the same reactions. The reactions could not passively be transferred with serum from patients. They were abolished by antihistamine given before testing, and by pretreatment with compound 48/80. Balsam of Peru and cinnamic aldehyde did not provoke new symptoms when given orally to patients.

Balsams↗

Patch testing, tuberculin testing and sensitization with dinitrochlorobenzene and nitrosodimethylanilini of patients with atopic dermatitis.

Cell-mediated immunity was studied in patients with atopic dermatitis. 113 patients were patch tested with ten contact allergens. The frequency of positive reactions to patch testing with "common contact allergens" was found to be lower in patients with "high IgE values" than in those with IgE less than or equal to 1000 U/ml. A larger number of patients with severe dermatitis reacted negatively to PPD and were more difficult to sensitize with DNCB and NDMA as compared with the patients with mild dermatitis. The results of this investigation support the findings of earlier workers that patients with atopic dermatitis show disturbances in the cell-mediated immune system and these disturbances appear to be correlated to the degree of severity of the dermatitis.

Adolescent↗

Immunoglobulin E (IgE), an aid in the classification of occupational dermatoses?

During an 18-month period determinations of immunoglobulin E(IgE) in serum were made on all (631) new patients referred to the Department of Occupational Dermatology, Karolinska Sjukhuset, Stockholm. The mean for the entire series was 238 units/ml (U): 280 U for the 323 men and 196 U for the 308 women. The IgE values for the different age groups, clinical diagnoses and sexes are presented. About 20% of the patients with normal IgE (less than 250 U) had a history of atopy. On the other hand about 30% of the patients with pathological IgE value (greater than 1000 U) had no such history. No explanation of this rise of IgE without concurrent atopy was discovered despite detailed laboratory tests. Our impression is that the IgE value has a prognostic significance and that, especially for the question of choice or change of occupation in cases of dermatitis, the determination of IgE is of value.

Adolescent↗