Search PubMed⌕ Search

Biomedical subjects

M J Reid

Publications and source records attributed to M J Reid.

At least 37 records · Page 2Linked to original sources
PubMed1990

Allergic Bipolaris sinusitis: clinical and immunopathologic characteristics.

Allergic Aspergillus sinusitis was first reported in 1983. We present the first three cases of allergic fungal sinusitis caused by the black fungus Bipolaris spicifera. The patients were young, atopic, and immunocompetent. All three patients demonstrated pansinusitis with nasal polyps and underwent multiple surgical procedures. Pathologic features included a characteristic mucoid exudate containing eosinophils, Charcot-Leyden crystals, and fungal hyphae. In two cases there was bony erosion revealed by computed tomography scan but no histologic evidence of direct fungal invasion into the mucosa or bony trabeculae. Immunologic features, including total eosinophil count, total serum IgE, immediate and late-phase skin response to B. spicifera, serum precipitins, and specific IgE and IgG to B. spicifera, are described. B. spicifera is a previously unrecognized cause of allergic fungal sinusitis that may be an underdiagnosed disorder. This diagnosis should be considered in atopic patients with nasal polyps and pansinusitis unresponsive to conventional medical therapy. Diagnostic criteria include characteristic histologic allergic mucin, culture identification of fungus, positive immediate cutaneous reactivity to fungal extract, positive serum precipitins, and elevated specific IgE and IgG antibodies.

Adolescent↗
PubMed1989

Early lymphocyte transformation abnormalities in human immunodeficiency virus infection.

Two hundred twelve patients with enzyme immunoassay and Western blot confirmation of human immunodeficiency virus (HIV) infection were evaluated with anergy panel, lymphocyte cell surface phenotyping, lymphocyte transformation, and serum immunoglobulins. Mitogen responses were used to develop a lymphocyte transformation index (LTI) comparing the summation of each individual's response to its normal control. By multiple regression, anergy panel, absolute CD4 level, and LTI show a progressive decline and IgA shows a progressive increase when correlated with a worsening Walter Reed (WR) classification (R = 0.84). Lymphocyte transformation is first abnormal in WR class 1, absolute CD4 in WR class 3, and anergy and serum IgA in WR class 4. The above markers are useful to assess immunologic function in HIV infection. Lymphocyte transformation abnormalities precede other immunologic deficits in HIV positive patients. Serial evaluation of these markers may help define the immunologic response and natural history of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The relationships between late cutaneous responses and specific antibody responses with outcome of immunotherapy for seasonal allergic rhinitis.

Mountain cedar (MC) (Juniperus ashei) causes a significant and isolated seasonal allergic rhinitis in south-central Texas during the winter months. Retrospective studies have indicated that patients segregate into two categories based on skin test reactions: single positive skin test to MC only and multiple positive skin tests. These two populations differed in age, personal and family history of atopy, levels of both IgE and total MC-specific IgE (sIgE), and symptomatology. It has been speculated that the subjects with only a single positive skin test may actually be nonatopic and develop an IgE response to MC because of some peculiarity of the antigen. In a prospective, randomized, controlled trial, we tested the efficacy of immunotherapy (IT) with MC extract in 51 subjects, 12 single positive skin tests and 39 multiple positive skin tests, to determine if these differences indeed exist and if IT is equally effective in both groups. We failed to demonstrate significant differences in age, sex, MC sIgE, total IgE, initial immediate cutaneous response, initial late cutaneous response, or personal or family history of atopy. IT was equally effective in both groups of subjects with no significant differences noted in response to MC sIgE, MC sIgG1, MC sIgG4, or with suppression of the late cutaneous response. In addition, we found that suppression of the late cutaneous response correlated significantly with cumulative dose of MC extract, postseasonal level of MC sIgG1 and MC sIgG4, and improvement of symptomatology. Suppression of the late cutaneous response may be a clinically useful parameter to follow in monitoring patients during IT. Caution is advised because this procedure may result in systemic reactions.

Adolescent↗
PubMed1989

Prolongation of simple and choice reaction times in a double-blind comparison of twice-daily hydroxyzine versus terfenadine.

Newer, nonsedating antihistamines provide a therapeutic alternative for the patient with allergy whose work is impaired by the side effects of traditional H1 antihistamines. To assess the differential effect of these antihistamines on reaction times and subjective symptoms, we compared terfenadine, 60 mg twice daily, to hydroxyzine, 25 mg twice daily, in a double-blind, placebo-controlled, crossover study of 16 healthy, asymptomatic adults. Simple reaction time and choice reaction time were measured with a computer-based, eye-hand, reaction-time testing apparatus. Reaction times and symptom scores were assessed 90 minutes after the fourth and tenth doses of each drug. Hydroxyzine, but not terfenadine, significantly prolonged both simple and choice reaction time (p less than or equal to 0.0001). However, decision time, the time to process one bit of spatial information, was not prolonged by either antihistamine. Therefore, hydroxyzine prolonged the interpretation and response to stimuli of the central nervous system without increasing single-bit processing time. Although terfenadine was not different from placebo for any symptom assessed, hydroxyzine produced significant drowsiness (p = 0.001), dry mouth (p = 0.022), and irritability (p = 0.021). During the 5 days of hydroxyzine administration, neither objective nor subjective symptoms demonstrated the development of tolerance. No correlation was found between subjective symptoms and prolongation of reaction times by hydroxyzine, suggesting that side effect symptoms of traditional antihistamines are unreliable predictors of objective performance. Terfenadine provides a promising therapeutic alternative to traditional antihistamines for individuals performing critical tasks.

Adult↗
PubMed1989

Suppression of the late cutaneous response by immunotherapy.

In a prospective, double-blind, placebo-controlled study, we examined the effect of mountain cedar (MC) immunotherapy on the MC-induced late cutaneous response (LCR). Fourteen MC-sensitive patients were intradermally skin tested before and after immunotherapy with MC extract. We measured the size of the wheal at 15 minutes and the area of tissue swelling at 6 hours. Patients were matched by the size of the LCR and started receiving either MC immunotherapy or placebo immunotherapy. MC-specific immunoglobulins (MC sIgG, MC sIgG1, MC sIgG4, and MC sIgE) were measured by ELISA. Symptom-medication scores (SMSs) were recorded on a daily basis during the MC season and tabulated at the end of the study. Comparison of the 14 paired patients revealed no significant differences between MC-treated and placebo-treated groups in preimmunotherapy MC sIgG1 and SIgG4. However, when MC immunotherapy was compared to placebo immunotherapy, patients receiving MC immunotherapy developed significantly higher MC sIgG1 (p less than 0.04) and MC sIgG4 (p less than 0.01) after immunotherapy. Patients receiving MC immunotherapy also demonstrated significantly greater suppression of the LCR after immunotherapy (p less than 0.005) with the postimmunotherapy LCR correlating significantly with both MC sIgG4 (rs = 0.715; p = 0.008) and cumulative dose of MC received (rs = 0.808; p = 0.004). MC sIgE was similar in both groups after immunotherapy. The reduction in SMSs in the MC-treated group did not reach significance, nor was there a correlation of SMSs with MC sIgE, sIgG, sIgG1, or sIgG4.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

The relationship of serum IgA concentration to human immunodeficiency virus (HIV) infection: a cross-sectional study of HIV-seropositive individuals detected by screening in the United States Air Force.

Serum immunoglobulins were measured in 107 patients with human immunodeficiency virus seropositivity. Each patient was categorized by the Walter Reed staging classification and serum concentrations of immunoglobulins were compared with patient staging. Serum IgM concentrations were normal in all but nine patients. Serum IgG concentrations were elevated in 74 of 107 patients, with no significant differences noted between different stages of disease severity. Serum IgA concentrations were elevated in 38 of 107 patients, with a significant relationship noted between increasing staging category and increasing serum IgA concentration (p = 0.0001). Serum IgA concentrations in patients with human immunodeficiency virus seropositivity may be a useful marker of immunologic progression of disease.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Epidemiology of emergency room asthma in northern California: association with IgE antibody to ryegrass pollen.

To examine the relationship between allergy and acute attacks of asthma, we have examined adult patients with acute asthma presenting during a defined pollen season. Sera from 59 patients presenting with acute asthma to the David Grant Medical Center emergency room at Travis Air Force Base during the spring "epidemic" of asthma were assayed for IgE antibody (Ab) to five allergens (mite, cat, cockroach, ryegrass pollen, and ragweed) with RAST. Control sera were obtained from 34 patients without asthma and 25 employees. The results demonstrate that 92% of the patients with asthma had greater than 200 units of IgE Ab to ryegrass pollen (approximately 20 ng of IgE Ab per milliliter) compared to 14% of the control subjects (chi 2 = 69; p less than 0.0001; odds ratio = 69). Some of the grass pollen--allergic patients also had increased levels of IgE Ab to ragweed, but only 25% had greater than 200 units. In contrast, there was no significant difference between subjects with asthma and control subjects in the prevalence of IgE Ab to the three indoor allergens (mite, cockroach, and cat). Twelve percent of the patients with asthma compared to 5% of the control subjects had greater than 200 units of IgE Ab to one of these three (chi 2 = 0.98; p greater than 0.1; odds ratio = 2.5).(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Anti-Idiotypic↗
PubMed1988

Pediatric acquired immunodeficiency syndrome with negative human immunodeficiency virus antibody response by enzyme-linked immunosorbent assay and Western blot.

A 5-month-old white girl having persistent oral candidiasis was brought to medical attention because of acute respiratory distress, pneumonia, and hypoxia that worsened despite supportive care and antibiotics. Bronchial lavage fluid yielded Pneumocystis carinii. The diagnosis of acquired immunodeficiency syndrome (AIDS) was suspected, although enzyme-linked immunosorbent assay (ELISA) and Western blot tests were both negative for human immunodeficiency virus (HIV) antibody. Immunologic evaluation included the following results: a low normal CD4/CD8 ratio 0.88, CD4 lymphocytes 493/microL, and elevated IgA 539 mg/dL and IgM 175 mg/dL with normal IgG 492 mg/dL. Lymphocyte stimulation study results were depressed. Lymphocytes sent for culture were subsequently positive for HIV. The mother was HIV antibody positive by enzyme-linked immunosorbent assay and Western blot but belonged to no high-risk group and was asymptomatic except for chronic diarrhea. The father was HIV antibody negative. The patient was treated with pentamidine and IV gamma-globulin with good clinical response and a rapid decrease of IgM and IgA toward normal values. Subsequent candidal pneumonia and candidal esophagitis were treated successfully with amphotericin B. The patient has received prophylactic IV gamma-globulin infusions for 6 months and remains HIV negative by enzyme-linked immunosorbent assay and Western blot. This case of pediatric AIDS highlights the need to consider HIV infection in the differential diagnosis of any child with physical findings or illnesses suggestive of AIDS-related complex or AIDS, even when HIV serologic findings are negative and parents belong to no high-risk group. Parental testing for HIV antibody is suggested in such cases.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The natural history of human immunodeficiency virus infection in screened HIV positive U.S. Air Force personnel: a preliminary report.

We prospectively studied 157 HIV antibody-positive U.S. Air Force personnel identified by universal ELISA screening and confirmed by Western blot. They were initially evaluated and then re-evaluated at least once at approximately 1 year intervals. In order to determine which if any demographic and serologic cofactors were significantly related to progression of immunodeficiency early in the course of disease, we compared these variables with the mean change in CD4 cells per month and with progression in Walter Reed stage. Upon entry into the study, the subjects were classified as follows: sex: 153 (97.5%) male, 4 (2.5%) female; race: 84 (53.5%) white, 63 (40.1%) black, 8 (5.1%) Hispanic, and 2 (1.3%) Oriental; age: mean of 28.6 years (63.0% between 20 and 32 years); and Walter Reed stage: 108 (68.8%) Walter Reed 1, 26 (16.6%) Walter Reed 2, 9 (5.7%) Walter Reed 3, 6 (3.8%) Walter Reed 4, 5 (3.2%) Walter Reed 5, and 3 (1.9%) Walter Reed 6. The mean follow-up period was 12.2 months (range of 2 to 35 months). The mean change in CD4 cells per month was -0.072 (range of -94.75 to +67.58). Factors at entry that are significantly related to loss of CD4 cells included serum IgA over 300 mg/dl (p = 0.0450) and anergy (p = 0.0093). Factors at entry significantly related to progression in Walter Reed stage included serum IgA over 300 mg/dl (p = 0.0001), low absolute CD4 count (p = 0.0001), and low CD4/CD8 ratio (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1987

Isotypic and antigenic restriction of the blocking antibody response to ryegrass pollen: correlation of rye group I antigen-specific IgG1 with clinical response.

To investigate the role of blocking antibodies in allergen immunotherapy (IT), we analyzed IgE, IgG, and IgG subclass 1 to 4 antibody responses to ryegrass group I antigen (RGGI) in a prospective double-blind, heterologous allergen, allergen-controlled trial of grass-pollen IT in 18 adults with seasonal rhinitis and asthma. Serum was assayed preseasonally before starting IT and again in midseason at time of documented highest natural exposure. Antibodies were measured by ELISA, and immunogenic specificities of ryegrass extract were examined by Western immunoblots. Nine subjects receiving grass-pollen IT and nine control subjects had similar clinical and immunologic status before IT. RGGI-specific IgE antibodies (sIgE) did not change from pretreatment levels in actively treated subjects but increased in control subjects (p less than 0.002). RGGI sIgG increased approximately thirteen-fold with active IT versus threefold during natural seasonal exposure (p less than 0.0005). The IgG-blocking response to RGGI was restricted to IgG1 and IgG4. Ten nonatopic subjects had similar RGGI sIgG1 but lower or undetectable sIgE and sIgG4 than the 18 atopic study subjects. Active IT dramatically increased RGGI sIgG4 (p less than 0.001) and to a lesser extent RGGI sIgG1 (p less than 0.01). Immunoblots demonstrated eight IgE-binding ryegrass-polypeptide allergens, with RGGI ubiquitous, and 11 IgG-binding polypeptides, including all eight allergens. A negative correlation between seasonal rhinitis symptom-medication scores and RGGI sIgG1 levels was found (r = -0.62, p less than 0.01), but no other immunologic parameters assayed were related to clinical improvement. Although RGGI sIgG4 predominates in the blocking response and is a useful marker of effective IT, early beneficial biologic effects may involve IgG1 antibodies.

Allergens↗
PubMed1986

Seasonal asthma in northern California: allergic causes and efficacy of immunotherapy.

Inland areas of northern California have an intense grass pollination in the spring of each year. This is accompanied by a stirking rise in the incidence of asthma. We documented this relationship and designed a trial to test the efficacy of immunotherapy for grass-pollen asthma. Aeroallergen counts were performed on the roof of the allergy clinic of David Grant Medical Center from January 1981 to December 1984 by a gravity collector. These counts were compared to counts done on a Rotorod at a nearby hospital from July 1982 to September 1984. Climatologic factors were also tabulated. Visits for asthma and rhinitis to our emergency room and asthma admissions to our hospital were counted for the 4-year period. A randomized, double-blinded, placebo-controlled trial of immunotherapy with grass-pollen extract was performed from November 1984 to June 1985. Two groups of clinically and immunologically well-matched subjects were started on an accelerated preseasonal trial of immunotherapy. One group received a standardized grass extract, and the other group did not. Both groups received other extracts of aeroallergens to which they were skin test positive that occur locally in the spring and summer. This was done because of our dissatisfaction with a histamine placebo used in a previous pilot study. Symptom medication scores (SMS) and immunologic parameters were followed. For the 4-year period, grass-pollen count (GPC) correlated strongly with asthma emergency room visits (r = 0.90; p less than 0.001) and for rhinitis (r = 0.92; p less than 0.001). Asthma admissions also correlated strongly with GPC (r = 0.72; p less than 0.001). Other aeroallergens either did not correlate significantly or occurred in such small numbers that they could not be seriously considered. Rotorod counts supported these conclusions with the exceptions of some Basidiomycetes. Climatologic factors demonstrated no relationship to the incidence of asthma. Asthma SMS were lower in the grass-treated group, p less than 0.05. Rhinitis SMS were also lower but did not reach significance, p = 0.11. RGGI sIgE did not rise significantly in the grass-treated group but did in the placebo-treated group. RGGI sIgE rose in both groups, although to significantly higher levels in the grass-treated group, p less than 0.001. The asthma SMS were inversely related to increasing RGGI cumulative dose, p less than 0.10. Linear regression analysis of the dose-response scattergram suggests that a cumulative dose of approximately 90 micrograms of RGGI may be desirable.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

Prospective survey of local and systemic reactions to immunotherapy with pollen extracts.

To assess the relative risk of local and systemic reactions to injections of pollen extracts and to examine the predictive value of these local reactions for systemic reactions, a prospective survey of local and systemic reactions was performed from October 1981 to June 1983 at a large military allergy clinic. Four hundred and sixteen patients received 26,645 injections of pollen extracts. Of the total, 25,508 injections (95.7%) were not associated with reactions, 1,055 injections (4.0%) were associated with local reactions (669, less than 2 cm in diameter; 279, 2 to 5 cm; and 107 greater than 5 cm), and 82 injections (0.3%) were associated with systemic reactions. Seventy patients experienced 82 systemic reactions. Of these, 25 (36%) had no prior local reactions. Eighteen males and 52 females had systemic reactions. The sensitivity of local reactions as a predictor of systemic reactions was 64%, the specificity was 1.2%, the positive predictive value was 12%, and the negative predictive value was 14%. Proportionally, more women than men experienced systemic reactions, P less than 0.05. We made the following conclusions. Most injections of pollen extracts were not associated with local or systemic reactions. The majority of reactions were local. The presence of local reactions was not helpful in predicting which patients would develop systemic reactions. Women appeared to be at greater risk for systemic reactions than men.

Erythema↗
PubMed1985

Underestimation of specific immunoglobulin E by microtiter plate enzyme-linked immunosorbent assays.

We developed an ELISA by use of monoclonal anti-IgE to measure allergen-specific IgE. We measured perennial ryegrass (PRG) specific immunoglobulin E (sIgE) with conventional single incubations and with the recently reported transfer method to decrease interference in the assay. Paired sera in 10 patients before and during immunotherapy with PRG extract were analyzed for PRG sIgE with single serum incubations and with the sum of five serial serum incubations. A standardized reference serum and patient sera were incubated 12 hours and then transferred to a second well, incubated 12 hours more, and transferred again. The process was repeated until five pairs of wells had been incubated with each serum dilution. Color was developed, and optical density was measured. PRG sIgE was calculated by interpolation from the reference curve. Evidence of interference was inferred when less PRG sIgE was detected by single incubation than by transfer. Inhibition of 71.3% occurred in the sera drawn during immunotherapy. Inhibition of 32.9% was found before immunotherapy. Also, a late peaking of the well-to-well curve of optical density was observed in nine of 10 sera drawn during immunotherapy (the exception had not reached full strength), whereas all of the sera drawn before immunotherapy had normal curves. This suggests that sIgE determinations performed in microtiter plate format with single incubations will usually underestimate the sIgE level. This drawback needs to be kept in mind by the clinician interpreting the results of these assays.

Enzyme-Linked Immunosorbent Assay↗
PubMed1983

Reduction of interference by specific IgG with a modified microtiter solid-phase radioimmunoassay to measure honeybee venom IgE.

By means of monoclonal mouse anti-human IgE antibody, the microtiter solid-phase radioimmunoassay (MSPRIA) was modified to measure honeybee venom (HBV) IgE. HBV IgG was measured by MSPRIA(G) using affinity column purified goat anti-human IgG antibody and correlated with results obtained with staphylococcal protein A-SPRIA. Nonlinear specific IgE dilution curves were associated with high HBV IgG content. By serial transfer and assay of the supernatant, the interference of IgE by specific IgG could be reduced. The degree of interference was correlated with the specific IgG content. The principle of serial supernatant transfer and assay was applied to the standardization of reference HBV IgE serum, and the quantitation of HBV IgE contents in patients and controls. HBV IgE levels in patients allergic to honeybee stings correlated with the skin-test endpoint titrations. While 75% of the allergic patients were skin-test positive, 83% of them were IgE positive by the MSPRIA and 67% were IgE positive by the RAST.

Antibodies, Anti-Idiotypic↗
PubMed1983

Honey bee venom specific immunoglobulin G4 in honey bee sting allergic patients and bee keepers.

Honey bee venom (HBV) IgG4 antibody was studied in bee keepers and honey bee sting allergic patients on immunotherapy using mouse monoclonal anti-human IgG4 antibody in a modified microtiter solid phase radioimmunoassay (MSPIRA). The mean HBV IgG4 in bee keepers was 31 units/ml. In patients the mean HBV IgG4 pre- and post-immunotherapy were 2.9 and 11.6 units/ml, respectively, representing a mean rise of 7.3-fold as compared to a rise of 1.6-fold for total HBV IgG. The mean HBV IgG level in bee keepers was 14 micrograms/ml which was not significantly different from the mean level of 17 micrograms/ml in allergic patients at diagnosis. The percentage interference of HBV IgE detection in vitro correlated with HBV IgG but not with HBV IgG4. On the other hand, there was an inverse relationship between serum HBV IgE and HBV IgG4 levels while none was found for HBV IgE and IgG.

Antibodies, Anti-Idiotypic↗
PubMed1982

A quantitative enzyme-linked immunosorbent assay for honeybee venom-specific immunoglobulin G.

A quantitative enzyme-linked immunosorbent assay (ELISA) for honeybee venom-specific IgG is reported. This ELISA surmounts the problem of poor reproducibility due to nonparallelism of dilution curves in previously reported ELISAs. The assay is performed in polyvinyl "U" microtiter plates in which HBV is physically adsorbed to the wells. The antigen is sequentially overlaid with human serum albumin, unknown serum diluted in 10% normal goat serum (NGS), and peroxidase-labeled anti-human IgG in NGS. o-Phenylenediamine is used a substrate. The addition of stabilizing protein (NGS) is shown to be crucial in producing parallel dilution curves in this heterogeneous antigen-antibody system. Sensitivity is at or below 1 ng/ml. Coefficient of variation (using a midrange serum) is 12.1% for triplicate wells, 15.5% for sequential dilution, and 15.0% for six entirely separate assays. The assay correlates well with other methods, notably with the Staphylococcus aureus protein A solid-phase radioimmunoassay (r = 0.976).

Antibody Specificity↗