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Biomedical subjects

X Baur

Publications and source records attributed to X Baur.

At least 235 records · Page 13Linked to original sources
PubMed1990

[Baking ingredients, especially alpha-amylase, as occupational inhalation allergens in the baking industry].

Baker's asthma is the most frequent occupational lung disease in Switzerland and West Germany. Cereal flours, and more rarely flour parasites, are implicated as the responsible allergens. Based on an observation of a case of baker's asthma due to monovalent sensitization to alpha-amylase used as additive to flour, 31 bakers with occupational asthma and/or rhinitis were routinely tested by skin tests and serological RAST examinations for allergic sensitivity to flour, alpha-amylase and other bakery additives. 17/31 subjects (55%) reacted positively in scratch tests to a commercial powdered alpha-amylase and 13/20 (65%) to a lecithin preparation. 23/31 (74%) and 19/31 (61%) were RAST positive to wheat and to rye flour respectively. 32% had RAST specific IgE to alpha-amylase (from Aspergillus oryzae), 19.3% to soya bean flour and 16% to malt. 7/12 and 5/12 respectively reacted to trypsin inhibitor and lipoxidase, the main allergens in soya bean. In two patients monosensitization to alpha-amylase was present. In accordance with other reports we recommend that baking additives, especially alpha-amylase, should be tested in allergological diagnosis of occupational diseases in flour processing workers. Full declaration of all additives used in the bakery industry is needed.

Adolescent↗
PubMed1990

Allergen-directed expression of Fc receptors for IgE (CD23) on human T lymphocytes is modulated by interleukin 4 and interferon-gamma.

T lymphocytes bearing Fc receptors (FcR) for immunoglobulins are known to have immunoglobulin class-specific regulatory functions. Here we report that expression on T cells of the low-affinity FcR for IgE (Fc epsilon RII/CD23) is preferentially induced by stimulation with antigens that cause an IgE response. T cells from eight patients allergic to the hemoglobin of Chironomus thummi thummi mosquito larvae (CHIT I) were analyzed for reactivity with the anti-FcERII/CD23 monoclonal antibody (mAb) M-L25 under various conditions. No Fc epsilon RII/CD23+ T cells were observed among freshly isolated, resting peripheral blood mononuclear cells (PBMC). Stimulation of PBMC with CHIT I, however, induced a marked although transient Fc epsilon RII/CD23 expression on a large portion of the allergen-activated T lymphocytes. It reached a maximum of 37.2 +/- 4.6% Fc epsilon RII/CD23+ T cell blasts on day 5 of culture. The selectivity of this expression became evident when compared to non-allergenic control antigens: after stimulation of PBMC with tetanus toxoid or purified protein derivative from tuberculin a maximum of 4.6% +/- 1.4% and 4.2% +/- 1.1% T cell blasts was found to express Fc epsilon RII/CD23, respectively. Activation by an anti-CD3 mAb was insufficient to induce Fc epsilon RII/CD23 on T cells. The allergen-stimulated Fc epsilon RII/CD23+ T cells exclusively belonged to the CD4+CD29+ helper inducer T cell subset. Using a cDNA probe coding for the B cell Fc epsilon RII/CD23, Northern blot analysis revealed a 1.7-kb Fc epsilon RII/CD23 mRNA in extracts of highly purified allergen-stimulated T cells. It was of the same size as Fc epsilon RII/CD23 mRNA of the lymphoblastoid B cell line WI-L2. Of several cytokines tested [interleukin (IL) 1 to IL 6, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha] only IL 4 and IFN-gamma significantly modified allergen-induced Fc epsilon RII/CD23 expression on T cells. The latter was enhanced nearly twofold in the presence of IL 4, and was almost completely abrogated by IFN-gamma. IL 4, however, could not increase the number of Fc epsilon RII/CD23+ T lymphocytes either alone or in combination with an anti-CD3 mAb. Taken together, the selective induction of Fc epsilon RII/CD23 on T cells by allergen and its inclusion in the regulatory network of cytokines point to an important role of Fc epsilon RII/CD23+ T lymphocytes in the human IgE response.

Allergens↗
PubMed1990

New aspects of isocyanate asthma.

Air concentration of isocyanates are associated with the frequency of induced diseases. Asthma, bronchitis and rhinitis, chronic obstructive lung disease, and allergic alveolitis, respectively, were observed in exposed workers. Inhalation challenge tests with isocyanates found some 14% of symptomatic persons immunologically sensitized. At and above current threshold limit values (10 ppb) there is a risk of lung function deterioration also in asymptomatic workers.

Air Pollutants, Occupational↗
PubMed1990

Histamine release from human basophils by the insect allergen Chi t I.

Hemoglobins of the Diptera species Chironomus thummi thummi (Chi t I) are potent inhalant allergens. Chi t I-specific histamine release was measured by a new radioimmunoassay in whole human blood taken from 20 sensitized patients, 11 exposed nonsensitized probands, and 11 nonexposed controls. The sensitized patients, who all had positive skin tests and radioallergosorbent test results with Chi t I, showed a significantly higher histamine release than the two other groups. However, within the patient group, the percentage of released histamine did not correlate with the intensity of the skin test response or the concentration of Chi t I-specific IgE antibodies. Our results demonstrate that this method is a sensitive and specific in vitro test for evaluation of IgE-mediated sensitization.

Adult↗
PubMed1990

[New occupational inhaled pollutants].

New information about occupation-relative inhalative injuries, are reflected in the "Bill on the Modifications of the Regulations Governing Occupational Disease" of 22. 03. 1988; thus, for example, (benign) diseases of the pleura due to asbestos dust (No. 4103 and 4104), malignant neoplasias of the airways and lungs induced by nickel (No. 4109), and cooking plant gas (No. 4110), adenocarcinomas of the nasal sinuses, induced by oak and beech wood dust (No. 4203), exogenous allergic alveolitis, also those induced by other than agricultural dusts (No. 4201) (3) have all undergone modification. Current occupationalmedical problems represented in more detail include the hairdressers' asthma induced by hair bleaching agents, bronchopulmonary diseases induced by cooling and lubricating agents, "metal fume fever", asthma induced by enzyme dusts, flour and baking additives, bronchopulmonary and systemic diseases induced by acid anhydrides and isocynates.

Air Pollutants, Occupational↗
PubMed1990

[Diagnosis of irritative-toxic isocyanate asthma with the isocyanate exposure test].

We investigated 10 healthy control subjects, 15 asthmatics without occupational exposure to isocyanate, and 45 "isocyanate workers" with workplace-related respiratory symptoms. In none of the cases did the skin test or the IgE-RAST reveal a type I sensitisation to isocyanate. The investigation programme included a lung function test, provocation with metacholine or acetylcholine, and an isocyanate challenge test under controlled clinical conditions. A total of 17 "isocyanate workers", and 1 asthma patient with no occupational exposure to isocyanate revealed a positive bronchial obstructive reaction to the isocyanate challenge test. In 10 of the patients, the MCH (ACH) test was positive; 2 were chronically obstructive, but 6 patients showed no signs of bronchial hyperreactivity. No significant differences in the severity of the bronchial obstructive reaction induced by isocyanate exposure were observed between patients with and those without bronchial hyperreactivity. In the group of "isocyanate workers", the isocyanate challenge test was observed to be superior to the MCH (ACH) provocation test in terms of sensitivity (0.68 versus 0.62) and specificity (1.0 versus 0.61), this difference being more obvious in the overall group (sensitivity 0.71 versus 0.62; specificity 0.98 versus 0.49).

Airway Resistance↗
PubMed1989

[Treatment of the severe asthma attack and status asthmaticus].

For the treatment of severe attacks of asthma, too, inhalable beta 2-sympathomimetic agents form the basis of drug therapy. It is, further, necessary to apply these agents systemically together with theophylline, the best approach to pre-status and status asthmaticus being continuous i.v. application following a bolus administration (dose of beta 2-sympathomimetic 0.04 mg/kg x min, for theophylline 10-15 micrograms/kg x min). Furthermore, 50-200 mg prednisolone equivalent are administered i.v. Secretolysis and increased expectoration are ensured by a copious supply of liquids, inhalation of saline mists, administration of acetyl cysteine or ambroxol, together with physical-therapeutic measures. Also important is the administration of oxygen and the calming of the anxious, agitated patient by adopting a relaxed, calm approach and devoting the patient sufficient attention. The uncritical use of sedatives (cave: depressive effect on respiration) is to be rejected. If, despite increasing the dose of the beta 2-sympathomimetic agent (approx. 0.06 micrograms/kg x min), no improvement is seen after 1-2 hours, or if global respiratory failure develops or exhaustion of the respiratory musculature is threatening, intensive monitoring and care should be initiated. If necessary, the patient is intubated and ventilated; in therapy-refractory situations, bronchoalveolar lavage should be employed as an adjunctive measure.

Airway Resistance↗
PubMed1989

[Hyposensitization in bronchial asthma--still a current therapeutic procedure?].

39 patients with proven extrinsic asthma underwent a placebo-controlled crossover, single-blind hyposensitization study for two years. 29 persons completed the study. Neither one year of hyposensitization treatment nor one year of placebo led to an appreciable change in the allergen dosages eliciting significant asthmatic reactions in bronchial challenge tests. Allergen-specific bronchial hyperreactivity was lost twice after allergen treatment and four times under placebo. Only when one assumes a more favorable outcome in patients with immediate asthmatic reactions as compared with those with dual or late asthmatic reactions could hyposensitization be shown to be superior to placebo: during hyposensitization 50% of patients with dual reactions changed to immediate reactions (in the case of placebo 7%); placebo was associated rather with a change from immediate to dual reactions in 31% (in the case of hyposensitization 0%). No parameter could be found by which individual outcomes of hyposensitization could be predicted. It is concluded that hyposensitization should be performed only if avoidance of causative allergens is not possible and drug treatment, including inhalant corticosteroids and cromoglycate, has not proved to be efficient.

Adolescent↗
PubMed1989

Immunoprint pattern in patients with allergic bronchopulmonary aspergillosis in different stages.

Individual immunoprint patterns of sodium dodecylsulfate-polyacrylamide gel electrophoresis-separated Aspergillus fumigatus (Af) allergens/antigens were evaluated in 28 patients with allergic bronchopulmonary aspergillosis in stages II to V. It could be demonstrated that active disease (stage III) is characterized by a very strong IgE response against a variety of Af components, whereas the IgE antibody pattern in corticosteroid-treated patients who have demonstrated improvement is much weaker. In patients in remission (stage II), it is minimal. In contrast, many patients in stage V without corticosteroid treatment demonstrated a strong reactivity of IgE antibodies, indicating persisting active disease. The pattern of IgG antibodies with individual Af components resembles, in general, that of IgE antibodies; however, discrimination between different stages and between treated patients is much weaker. Our results indicate that a certain relationship between the different stages of allergic bronchopulmonary aspergillosis and Af immunoprint patterns exists.

Allergens↗
PubMed1989

Allergy to dialysis materials.

One hundred and six unselected patients were screened for allergic symptoms, specific IgE against ethylene oxide (ETO), isocyanates (ISO), formaldehyde (FA), phthalates (PHT), total IgE and eosinophil count. Complement activation was measured during cellulosic dialysis in atopic patients and in a control group. Sixteen patients demonstrated mild allergic symptoms during dialysis treatment. Ten of them had IgE elevation and eosinophilia. Eight of these patients had positive RASTs (ETO: n = 5, ETO-ISO(?)-FA: n = 2, ISO-PHT: n = 1) against dialysis material. All eight had an eosinophilia and seven showed an IgE elevation. An amelioration of symptoms could be obtained in three patients with elevated (greater than 15%) ETO-binding values after switching to ETO-free dialysers; avoiding PHT- and ISO-containing dialysis materials allergic symptoms remained constant. Cuprammonium rayon-induced complement activation had a more rapid onset and was more pronounced in atopic patients. The study confirms the role of ETO, but not of the other dialysis materials in the allergic sensitisation of haemodialysis patients.

Complement Activation↗
PubMed1988

[Baking ingredients as a contributory cause of baker's asthma].

140 bakers with occupation-related asthma symptoms and/or rhinoconjunctivitis were tested for specific IgE antibodies against various enzyme-containing baking components. 5-24% of subjects were sensitive to several carbohydrate-splitting enzymes obtained from mould fungi (amyloglucosidase, hemicellulase and alpha-amylase), as well as/or against soya flour. But allergies against the proteolytic enzymes papain and B. subtilis protease were rare (about 1%). These results indicate that various baking components, especially mould enzymes, play a not insignificant role in the causation of baker's asthma.

Allergens↗
PubMed1988

[Allergic bronchopulmonary aspergillosis with hay dust-induced alveolitis and bronchial asthma].

A 55-year-old female farmer had all the clinical, biochemical and radiological signs diagnostic of allergic bronchopulmonary aspergillosis. Remarkably she also had symptoms of farmer's lung and exogenous allergic bronchial asthma with specific types I and III sensitisation due to Aspergillus antigens inhaled with straw-dust. In addition to the usual asthma treatment she also received antimycotic agents and corticosteroids. Antigen exposure was strictly avoided. These measures brought about lasting regression of the disease manifestations and of the high concentrations of IgE and IgG antibodies against many Aspergillus antigens.

Antibodies, Fungal↗
PubMed1988

[Treatment of severe bronchial asthma and status asthmaticus with intravenous fenoterol].

In eight patients with moderately severe bronchial obstruction intravenous bolus injection and continuous (four-hour) infusion of fenoterol (a beta 2-sympathomimetic) achieved a significant reduction in airway resistance after previous inhalation of the drug. Plasma levels of about 1.1 ng/ml were sufficiently effective. Intravenous administration of fenoterol gave a more rapid bronchospasmolytic response than theophylline-ethylenediamine (10 patients). In contrast to the latter drug, fenoterol caused a significant rise in heart rate. Intravenous fenoterol is thus an alternative to systemic theophylline administration for severe obstructive disorders of ventilation. Because of their additive effect, simultaneous and continuous intravenous administration of both drugs is recommended in the treatment of pre-status and status asthmaticus.

Acute Disease↗
PubMed1988

Autosomal dominant Emery-Dreifuss syndrome: evidence of a neurogenic variant of the disease.

The first German family with autosomal dominant Emery-Dreifuss syndrome (EDS) is described, with electrophysiologic and myopathologic results providing evidence of a primary neurogenic disease. According to classification of the scapulo peroneal syndrome without cardiomyopathy, we conclude that there are two variants of EDS: one myopathic, the other neurogenic in origin. Therefore, the term Emery-Dreifuss muscular dystrophy should be avoided. Instead, each case of EDS should be classified as myopathic or neurogenic with X chromosome recessive or autosomal dominant inheritance.

Adolescent↗