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Biomedical subjects

X Baur

Publications and source records attributed to X Baur.

At least 91 records · Page 5Linked to original sources
PubMed1998

Exposure-response relationships of occupational inhalative allergens.

Only a few threshold limit values exist at present for allergens in the workplace known to cause bronchial asthma. This contrasts with the great number of occupational asthma cases observed in industrialized countries. Recently published studies provide clear evidence for exposure intensity response relationships of occupational allergens of plant, microbiological, animal or man-made origin. If allergen exposure levels fall short of determined limit values, they are not associated with an increased risk of occupational asthma. Corresponding data are available for wheat flour (1-2.4 mg/m3), fungal alpha-amylase (0.25 ng/m3), natural rubber latex (0.6 ng/m3), western red cedar (0.4 mg/m3) and rat allergens (0.7 microg/m3). It is suggested to stipulate legally binding threshold limit values (TLV/TWA) on this basis in order to induce more effective primary preventive measures. If no reliable data on the health risk of an occupational airborne noxa exist, the lowest reasonably practicable exposure level has to be achieved. Appropriate secondary preventive measures have to be initiated in all workplaces contaminated with airborne allergens. Verified exposure-response relationships provide the basis for risk assessment and for targeted interventions to reduce the incidence of occupational asthma also in consideration of cost benefit aspects. 'Occupational asthma is a disease characterized by variable airflow limitation and/or airway hyperresponsiveness due to causes in a working environment. These causes can give rise to asthma through immunological or non-immunological mechanisms. Up to 15% of all asthma cases are of occupational origin or have at least a significant causal occupational factor. According to the New Zealand part of the European Respiratory Health Survey, an increased risk of asthma prevalence was found for several occupations such as laboratory technicians, food producers, chemical workers, plastic and rubber workers. The Spain part of this study comprising 2646 Spanish subjects showed an asthma risk to be attributed to occupational exposures between 5 and 6.7%. Main asthma-inducing agents in the workplace are flour, grain and feed dust, animal dander/urinary proteins and isocyanates. Further, several inhalative irritants such as chlorine, acid or alkaline aerosols play a pivotal role. Many low molecular weight chemicals have irritative as well as allergenic effects on the airways, e. g. isocyanates and acid anhydrides. In addition to chronic or repetitive exposures, also singular accidental exposure to high concentrations of irritative or toxic airborne substances can cause occupational asthma. This condition is frequently called reactive airways dysfunction.

Allergens↗
PubMed1998

Cloning, expression and characterization of the major latex allergen prohevein.

BACKGROUND: About 70-80% of latex allergic health care workers are sensitized to prohevein (Hev b 6.01), a 20 kDa cysteine-rich chitin-binding protein of Hevea latex. OBJECTIVE: This study reports on the bacterial cloning, expression and immunochemical characterization of rHev b 6.01. METHODS: Prohevein was expressed in the periplasmatic space of Escherichia coli as maltose binding protein (MBP) fusion protein and purified to homogeneity after factor Xa cleavage. The IgE binding capacity of both rHev b 6.01 and prohevein isolated from fresh Hevea latex was compared by immunoblotting experiments using sera of latex-allergic patients. The diagnostic value of rHev b 6.01 was analysed by enzyme allergosorbent test (EAST). RESULTS: Two different cDNA clones of rHev b 6.01 were established. The deduced amino acid sequence of both clones revealed two and three amino acid differences in the C-terminal domain of prohevein compared with the original database entry. Purified rHev b 6.01 bound with high affinity to chitin as its natural counterpart isolated from natural latex. In IgE-immunblotting using sera of affected subjects binding intensity to both proteins was comparable indicating a very high antigenic similarity. The diagnostic value of MBP-prohevein was tested in EAST using sera of 33 latex-allergic subjects. The in vitro test showed high sensitivity and specificity and proved the diagnostic value of uncleaved MBP-prohevein. CONCLUSIONS: The production of recombinant latex key allergens with defined quality like prohevein is a straightforward strategy for the development of standardized in vitro test systems.

ATP-Binding Cassette Transporters↗
PubMed1998

Baker's asthma due to the enzyme xylanase -- a new occupational allergen.

The asthmatic baker showed IgE-mediated sensitization to xylanase of Aspergillus niger used as a baking additive. Inhalative challenge with approximately 0.5 microg of the enzyme resulted in an immediate-type asthmatic reaction. This case, as well as a preliminary screening of symptomatic bakers, shows that xylanase is a further relevant type I-sensitizer in the baking industry.

Administration, Intranasal↗
PubMed1998

[Occupational medicine aspects of nasal diseases].

BACKGROUND: With respect to occupational and environmental exposure risks and corresponding diseases, upper and lower airways show similarities and common aspects, e.g., in allergic reactions to inhalant allergens as well as in disorders caused by chemical irritants, toxic or cancerogenic substances. In addition to special occupational medical preventive examinations, an otolaryngologist is involved in the diagnosis, assessment, and therapy of occupational ENT diseases. RESULTS AND CONCLUSIONS: A significant proportion of ENT illnesses is work-related or represents an occupational disease. Factual figures are presented. A detailed occupational history of ENT patients should be prepared. If required, the factory physician or the expert in occupational medicine should be contacted to assist in appropriate preventive measures. In case of a confirmed diagnosis, the disease has to be reported.

Humans↗
PubMed1998

Results of wearing test with two different latex gloves with and without the use of skin-protection cream.

A total of 109 subjects reporting symptoms indicating type I hypersensitivity reactions to natural rubber latex (NRL) gloves was included in this study, and 66 of them had latex-specific IgE antibodies. They underwent provocation tests by wearing two types of NRL gloves with high (n=103) and low (n=75) allergen contents. The first glove type caused positive skin reactions in 30% of IgE-positive and in 3% of IgE-negative subjects. After application of a commercially available skin protection (barrier) cream, the frequencies of positive skin responses in wearing tests increased to 41% and 7%, respectively. The gloves with low allergen content did not cause hypersensitivity without skin-protection cream but induced responses in 5% of IgE-positive subjects when this cream was applied. Corresponding findings were obtained in intraindividual comparisons of test results, which were possible in 69 cases. Of all wearing-test responders, 92% had latex-specific IgE antibodies. Our results demonstrate that high allergen contents in latex gloves frequently elicit skin responses in NRL-sensitized subjects, and that skin-protection creams may favor the uptake of allergens from gloves, thus increasing allergic reactions. The stipulation of a legally binding threshold limit value (TLV) for allergens in NRL products is urgently needed. This TLV should not be set above 2 microg allergen/g rubber.

Adult↗
PubMed1998

Characterized allergens causing bakers' asthma.

Although airborne allergens in bakeries and confectioneries cause one of the most common forms of occupational asthma, namely, bakers' asthma, only a few of them are known in detail so far. Here we summarize current knowledge of bakery allergens and describe our own two-dimensional (2-D) immunoelectrophoresis studies of wheat-flour allergens as well as the allergenic baking enzyme Asp o 2. Out of approximately 700 soluble wheat polypeptides, 70 show IgE binding; the following wheat-flour allergens could be identified and characterized: members of the alpha-amylase inhibitor family (14-18 kDa), acyl-CoA oxidase (26 kDa), peroxidase (36 kDa), and fructose-bisphosphate aldolase (37 kDa). However, the great majority of the soluble wheat-flour allergens, mainly located in the 27-, 55-, and 70-kDa areas of the 2-D immunoblots with pI values of 5.8-6.8, 5.9-6.5, and 5.5-6.1, respectively, are not known at present. Asp o 2, to which approximately 25% of all bakers with respiratory symptoms are sensitized, is a well-characterized starch-cleaving enzyme. We conclude that great effort is still needed to describe all major wheat-flour allergens. As shown by Asp o 2, knowledge of the causative allergens and their characteristics enables us to initiate very effective preventive measures such as the introduction of granulated allergenic products.

Allergens↗
PubMed1998

Water-soluble cooling lubricants induce airway hyperresponsiveness in rabbits.

Airway hyperresponsiveness (AHR) to water-soluble cooling lubricants (CL) induced by aerosol administered by tracheal tube was studied in a rabbit model of occupational lung disease. Two commercial CL were examined: the first was of the boric acid amine ester type without biozide (CL-BAE), the second was of the sulfonate type with biozide (CL-SB). 50, 5.0 or 0.5 mg/m3 CL was administered over a period of twice 2 h to six different groups of rabbits. Airway responsiveness (AR) to aerosols of 0.2% and 2.0% acetylcholine solution (ACH) was measured before and after each exposure to CL. A control group A of nine animals not exposed to CL showed no significant respiratory responses following inhalation of 0.2% ACH for 1 min. Conversely, inhalation of 2.0% ACH almost doubled the dynamic elastance (Edyn) in the ACH challenge test in this animal group. Airway resistance (RI), Edyn, slope of inspiratory pressure generation (delta Pes/tI), arterial pressure (Pa) and arterial blood gas tensions (PaO2, PaCO2) were not significantly altered during and after exposures to CL. However, after CL-BAE inhalation of 50 and 5 mg/m3 over 4 h, the amplitude of the ACH-induced airway obstruction indicated by the changes in Edyn rose significantly to almost five times the control response before exposure (group C, D, p < 0.005). Similar changes in RI and delta Pes/tI were obtained. After inhalation of 0.5 mg/m3 CL-BAE (group D), no significant changes in AR were observed. Similar to CL-BAE inhalation of 50 mg/m3, CL-SB caused enlarged AR in the ACH challenge test (group E), whereas no significant changes were found after exposure to 5.0 and 0.5 mg/m3 in groups F and G. In summary, CL aerosols with and without biozide in the range of 50 and 5 mg/m3 applied via tracheal tubes increased AR to ACH within 4 h of exposure in a time- and concentration-dependent manner. It has to be assumed that this augmented AR indicates an increased risk of developing lubricant-induced obstructive lung diseases.

Acetylcholine↗
PubMed1998

Acute exposure to hair bleach causes airway hyperresponsiveness in a rabbit model.

Ammonium persulphate (APS) and hydrogen peroxide (H2O2) are used as oxidants in many industrial processes and are the main constituents of standard hair bleaching products. In a previous study, it was demonstrated that aerosols of APS induce alterations in airway responsiveness. The present study examined whether exposure for 4 h to a hair bleach composition (containing APS, potassium persulphate and H2O2) or H2O2 could induce airway hyperresponsiveness and/or an obstructive ventilation pattern in a rabbit model. Exposure to the aerosols altered neither baseline airway resistance, dynamic elastance, slope of inspiratory pressure generation nor arterial blood pressure and blood gas measurements. Similarly to APS, hair bleach aerosols containing > or =10.9 mg x m(-3) persulphate (ammonium and potassium salt) in air and > or =1.36 mg x m(-3) H2O2 in air caused airway hyperresponsiveness to acetylcholine after 4 h of exposure. Aerosolized H2O2 (> or =37 mg x m(-3) in air) did not influence airway responsiveness to acetylcholine. The results demonstrate that hair bleaching products containing persulphates dissolved in H2O2 cause airway hyperresponsiveness to acetylcholine in rabbits.

Aerosols↗
PubMed1998

[Latex allergy: local hypersensitivity reaction cause by an esophageal catheter in compliance determination].

We report on two latex-allergic subjects who developed local hypersensitivity reactions after their lung compliance was measured by an oesophagus balloon catheter. Protein and allergen analyses of this catheter showed values of 85 and 9.8 micrograms per gram rubber. It is concluded that latex-allergic subjects should not undergo examinations with latex allergen-containing catheters. To our knowledge, this is the first report on allergic reactions caused by latex balloons of an oesophagus catheter.

Adult↗
PubMed1998

[Quantification of inhaled exposure to alpha-amylase in 2 bakeries].

BACKGROUND: Baker's asthma and baker's rhinitis are among the most frequent occupational diseases. A major cause is the high exposure to flour dust in the workplace and to allergenic enzymes like alpha-amylase from Aspergillus oryzae (allergen name: Asp o 2). METHODS: To quantify allergen exposure in the workplace, 31 personal dust samples in a conventional small bakery (six workers) and in a biobakery (seven workers) were collected. Using a recently developed two-site enzyme-linked immunosorbent assay based on monoclonal antibodies to alpha-amylase from Aspergillus oryzae, the allergen content of these dust samples was determined. RESULTS: Dust exposure in the biobakery was in the range between 3.5 and 12 mg/m3 (median: 5.2 mg/m3) and in the conventional bakery between 0.9 and 118 mg/m3 (median 8.5 mg/m3). 23 out of 31 exposure measurements showed values higher than 4 mg/m3 (threshold limit value for inhalable dust). In the biobakery, no fungal alpha-amylase could be detected. 15 out of 17 samples taken in the conventional bakery contained fungal alpha-amylase in the range between 0.2 and 88 ng per mg dust. The geometric mean of alpha-amylase exposure in this bakery was 13 ng Asp o 2/m3, and the maximum exposure was 4.8 micrograms/m3. In four cases, fungal alpha-amylase was detected although exposure to dust was below the threshold limit of 4 mg/m3. CONCLUSIONS: This study in two German bakeries shows that preventive measures to reduce contact to allergens have not been sufficiently realised. Relevant alpha-amylase exposure occurred at low dust levels illustrating that dust measurements are not adequate to control alpha-amylase exposure. For fungal alpha-amylase an additional threshold limit should be established.

Aspergillus oryzae↗
PubMed1998

[Asthma and rhinoconjunctivitis caused by castor bean dust].

A 57 years old trader of agricultural goods with chronic asthma had attended our medical department for diagnosis and therapy. Since more than 35 years the patient had always experienced work-related asthma episode and rhinoconjunctivities when he worked in workplace where castor-bean oil cake as fertilizer was sold. With the intensive contact with castor-bean containing goods beginning about eight years ago, his asthma attack had become chronic. The allergological diagnosis confirmed that he had high-degree type I-allergy to castor-bean allergens.

Agricultural Workers' Diseases↗
PubMed1997

Comparison of the binding potential of various diisocyanates on DNA in vitro.

Inhalation of diisocyanate vapors is associated with immediate-type hypersensitivity reactions and direct toxic responses. The genotoxic effects of diisocyanates have not been clarified. The aim of this study was to examine the changes in DNA following in vitro exposure to three most commonly used diisocyanates (toluene diisocyanate, TDI; methylenediphenyl-4,4'-diisocyanate, MDI; and hexamethylene diisocyanate, HDI) and to compare their binding potential using melting behavior of DNA and electrophoresis studies in DNA. Following incubation of DNA with MDI (pure and mix) and HDI we found no differences in the melting behavior compared to the control calf thymus DNA. However, DNA treated with TDI showed differences in the shape of the native DNA curves due to changes in hyperchromicity and exhibited 14% more DNA reconstitution after renaturation. The small changes in the melting behavior of native DNA do not suggest the formation of DNA intrastrand cross-links but rather conformational changes of single- and double-stranded DNA. These conformational changes were further explored by agarose electrophoresis of native and denatured calf thymus DNA. Control and all diisocyanate-exposed DNA showed no differences in the size of native DNA fragments. Conversely, electrophoresis of TDI mix-incubated DNA, following denaturation, showed a distinct reduction in the double-stranded DNA fragment size compared to the control, MDI-denatured (pure and mix), and HDI-denatured DNA. These findings may help to better understand the mechanisms of the genotoxic effect of TDI.

Animals↗
PubMed1997

Development of a two-site enzyme-linked immunosorbent assay for alpha-amylase from Aspergillus oryzae based on monoclonal antibodies.

A two-site monoclonal antibody ELISA was developed to quantify the allergen Asp o 2 (alpha-amylase from Aspergillus oryzae). Two mAbs recognizing distinct epitopes were selected, enriched by in vitro production in a modular minifermenter and affinity-purified. The first antibody was bound to microtiter plates which were then incubated with samples containing the allergen. Bound allergen was detected using a biotinylated second antibody and peroxidase-polymer-labelled streptavidin. The assay had a sensitivity of 0.6 ng/ml and did not react to high concentrations of wheat and rye flour or yeast proteins. The mAb ELISA will be useful in individual or epidemiological studies of baker's asthma to assess workplace allergen concentrations and the efficacy of allergen exposure prevention. It can be used as a standard assay for the quantification of alpha-amylase and the establishment and control of threshold limits in European bakeries.

Allergens↗
PubMed1997

[Exposure testing with powdered gloves in 60 health care workers with latex allergy].

BACKGROUND AND OBJECTIVE: Type 1 sensitization to natural rubber latex occurs in up to 22% of health care workers. Most sensitizations are due to the use of powdered latex gloves. Work place-associated exposure tests were performed to ascertain how frequently persons who developed breathing difficulties, rhinitis/conjunctivitis or obstructive respiratory tract illness when using powdered latex gloves are allergic to latex. PATIENTS AND METHODS: 60 persons (48 women and 12 men; mean age 29 +/- 7 years) with type 1 sensitization to natural rubber latex were studied. The past history was obtained through a questionnaire specially designed for those with latex allergy. Diagnostic measures included prick tests with different latex allergens, measuring the concentrations of total and latex-specific IgE and exposure trials, related to the work place, with powdered vinyl and latex gloves. RESULTS: The prick tests with various latex allergens produced significant skin reactions in 59 subjects, 58 had latex-specific IgE antibodies (0.47 kU/l- > 100 kU/l). Exposure tests with powdered latex gloves produced rhinitis in 55 and conjunctivitis in 38 persons, urticaria in 3 and cough in 19. Whole-body plethysmography demonstrated a significant rise in respiratory tract resistance in 13, a reduction in 1-second expiratory volume of at least 20% in 15. Abnormal values in both tests were noted in 8 subjects. CONCLUSION: The breathing difficulty reported by all subjects was in most cases due not to bronchial obstruction but to obstructed nasal breathing. In cases with breathing difficulty on exposure to latex gloves a latex allergy should be considered as the cause. Powdered latex gloves present a danger to health care personnel and should no longer be used.

Adult↗
PubMed1997

A longitudinal study of circulating lymphocyte subsets in the peripheral blood during the acute stage of Guillain-Barré syndrome.

Activated T cells are implicated in the pathogenesis of Guillain-Barré syndrome (GBS). Blood samples from 16 patients with GBS were studied with flow cytometry during the acute stage of their disease to define circulating lymphocyte populations. During the progressive phase of GBS the T-suppressor/inducer (CD4/CD45RA) subset was decreased (10.3 +/- 4.4%, P < 0.05) and the T-helper/ inducer (CD4/CD29) subset was increased (34.9 +/- 9.2%, P < 0.05) compared to sex and age matched patients with other neurological diseases (OND, 15.5 +/- 5.7% and 27.8 +/- 8.6%, respectively) and healthy controls (16.5 +/- 6% and 28.1 +/- 8.5%, resp.). Within the CD8 population, the activated T-cytotoxic/suppressor (CD8/CD38) subset was increased during the progressive (13 +/- 10.1%, P < 0.05) and plateau phase (16.4 +/- 16.9%, P < 0.01) of GBS compared to OND patients (6.2 +/- 2.3%) and healthy controls (5.8 +/- 2.5%). The proportion of activated T cells (CD3/CD25) was increased during the progressive (9.3 +/- 3.8%, P < 0.05) and plateau phase (11.5 +/- 5.5%, P < 0.01) compared to OND patients (6.6 +/- 2.7%) and healthy controls (5.5 +/- 2.5%). The changes of T cell subsets normalized during the early recovery phase of GBS. 2 patients with serological evidence of antecedent cytomegalovirus (CMV) infection had abnormal high proportions (mean +/- 2 (SD) of healthy controls) of CD8 lymphocytes and correspondingly abnormal low proportions of CD4 lymphocytes during all phases of GBS. In contrast, the CD8 proportions were abnormal low in 3 patients with serological evidence of recent Campylobacter jejuni infection. There was no correlation between the proportions of lymphocyte subsets and the disability score during the maximum of the disease and after half a year. In conclusion, we found further evidence of T cell activation during the acute stage of GBS by the demonstration of an increased proportion of activated CD8+ T cells, which may be directly cytotoxic to Schwann cells. The abnormalities of the CD8 subset in some GBS patients seem to depend on the nature of the preceding infection.

Acute Disease↗