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Results for “Bronchial Provocation Tests”

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PubMed1989

Immunochemical characterization of cocos nucifera pollen.

The Cocos nucifera pollen, as one of the sources of allergen responsible for immediate hypersensitivity reaction, was confirmed by skin prick test, bronchial provocation test, and RAST. The whole pollen extract (WPE) of C. nucifera was fractionated by combination of gel filtration and ion-exchange columns with fast protein liquid chromatography (Pharmacia, Uppsala, Sweden). Three protein peaks designated Cocos II, Cocos VI, and Cocos VII exhibited allergenic properties, as tested by skin prick test, direct IgE ELISA, bronchial provocation test, and immunoblot analysis. In RAST inhibition, Cocos IIa (a high-molecular-weight protein) obtained by fractionation of Cocos II on Mono Q column (fast protein liquid chromatography) (Pharmacia) was found to be the most potent allergen in Cocos WPE, followed by Cocos VI and Cocos VII, which are low-molecular-weight proteins. The reference patterns of Cocos WPE on crossed immunoelectrophoresis and thin-layer isoelectric focusing were established for future standardization of Cocos WPE to be used in the diagnosis and immunotherapy of allergic patients.

Allergens↗
PubMed1991

Late asthma caused by inhalation of Lepidoglyphus destructor.

We report the case of a grain worker who had immediate nasal and conjunctival symptoms and late-phase asthmatic reactions after handling stored grain. Allergy to one storage mite, Lepidoglyphus destructor, was demonstrated by skin testing, specific IgE, and bronchial provocation tests. Bronchial challenge with L. destructor provoked only a late phase asthmatic reaction without an immediate reaction despite the fact that immediate skin tests and specific IgE had been positive. Pretreatment with cromolyn sodium prevented any asthmatic reaction after bronchial challenge. An IgE immunologic mechanism could explain the clinical findings.

Administration, Inhalation↗
PubMed2005

Pharaoh ant (Monomorium pharaonis): newly identified important inhalant allergens in bronchial asthma.

The nonstinging house ant, Monomorium pharaonis (pharaoh ant), was recently identified as a cause of respiratory allergy. This study was performed to evaluate the extent of sensitization to pharaoh ant, and its clinical significance in asthmatic patients. We carried out skin prick tests in 318 patients with asthma. Specific IgE (sIgE) to pharaoh ant was measured by ELISA, and cross-reactivity was evaluated by ELISA inhibition tests. Bronchial provocation testing was performed using pharaoh ant extracts. Fifty-eight (18.2%) of 318 patients showed positive skin responses to pharaoh ant, and 25 (7.9%) had an isolated response to pharaoh ant. Positive skin responses to pharaoh ant were significantly higher among patients with non-atopic asthma than among those with atopic asthma (26.0% vs. 14.9%, p<0.05). There was significant correlation between sIgE level and skin responses to pharaoh ant (rho=0.552, p<0.001). The ELISA inhibition tests indicated that pharaoh ant allergens had various pattern of cross-reactivity to house dust mites and cockroaches. Bronchial provocation tests to pharaoh ant were conducted for 9 patients, and eight showed typical asthmatic reactions. In conclusion, pharaoh ant is an important source of aeroallergens, and it should be included in the skin test battery for screening the causative allergens in patients with asthma.

Administration, Inhalation↗
PubMed1996

Wheat threshing dust--a "new allergen" in April-May nasobronchial allergy.

OBJECTIVE: To identify the allergen(s) responsible for mid April-mid May nasobronchial allergy seen in North India. DESIGN: Case control study. SETTING: Children living in and around Chandigarh (urban, rural). SUBJECTS: 39 children suffering from wheat harvest period (mid April-mid May) respiratory allergy along with randomly selected controls. METHODS: Aerobiological surveys were done from March to June for identification of prevailing allergens for performing allergy tests. Patients were subjected to skin tests (ST), nasal provocation tests (NPT) and bronchial provocation tests (BPT) with extracts prepared from identified pollens and fungal spores. Specific IgE (SIgE) was assayed by ELISA and comparison between pre-season, season and post-season values made. RESULTS: 81% patients had ST positive to antigen of wheat threshing dust (WTD), 30% to fungal antigens, 14% to wheat dust antigens and none to the wheat plant (WP) antigens. Nasal provocation test and bronchial provocation tests were also positive to WTD in 80% and 66% patients, respectively. WTD SIgE was demonstrated in 77% of ST positive patients. CONCLUSIONS: These in vivo and in vitro tests confirm wheat threshing dust as a major causative inhalant allergen for the April-May nasobronchial allergy; in addition, fungal allergens also play a role in 1/3rd of these patients.

Adolescent↗
PubMed2000

Occupational asthma caused by bacillary amylase used in the detergent industry.

Four cases are reported of occupational asthma due to amylase derived from Bacillus licheniformis, used in detergent washing powders. It is thought that these are the first reported cases of asthma due to this enzyme in the detergent industry. All four employees (men) were from the same factory and none had a history of asthma or atopy. All developed symptoms of wheeze at work after an initial symptom free period. Symptoms improved during periods away from work. All undertook serial peak flow recordings (not diagnostic) and underwent skin prick tests, radio allergosorbent test (RAST) measurement, and specific bronchial provocation testing. The bronchial provocation testing was performed by a dust tipping method in a single blind manner, with lactose as an inert control and powdered amylase, provided by the employer, as an active agent. Serial measurements of forced expiratory volume in 1 second (FEV(1)) were recorded and histamine provocative concentration causing a 20% fall in FEV(1) (PC(20)) tests were determined before and 24 hours after each challenge. Patient 1 developed an isolated early reaction, patient 2 an isolated late reaction, and patients 3 and 4 developed dual reactions. All showed an increased non-specific bronchial responsiveness after active challenge. The introduction of encapsulated enzymes in the detergent industry was followed by a reduction in the incidence of respiratory sensitisation. These patients developed occupational asthma despite working only with encapsulated enzymes. This highlights the importance of careful surveillance after the introduction of new agents in the workplace.

Adult↗
PubMed1997

Asthma, bronchial hyperreactivity and mediator release in children with birch pollinosis. ECP and EPX levels are not related to bronchial hyperreactivity.

BACKGROUND: Symptoms of allergic asthma are triggered by allergen exposure inducing allergic inflammation and hyperreactivity of the bronchi. OBJECTIVES: To investigate the possible relationship between clinical symptoms and signs of asthma, i.e. bronchial variability as measured by peak expiatory flow rate (PEFR), bronchial hyperreactivity (BHR) and mediators of allergic inflammation. METHODS: Twenty-eight children with pollinosis, but no obvious history of asthma, were studied at three occasions, i.e. before, during and after (autumn) the birch pollen season. Twelve children sensitive to birch pollen were considered as the case group. Sixteen children, who were only clinically sensitive to grass pollen, served as controls. Subjective symptoms of asthma were recorded by visual analogue scale, BHR was estimated by methacholine bronchial provocation tests, bronchial variability PEFR and circulating mediators of inflammation, i.e. eosinophil cationic protein, eosinophil protein X, myeloperoxidase and tryptase in serum. RESULTS: Bronchial hyperreactivity and by PEFR was more pronounced after than during the season (P < 0.01), whereas eosinophil mediators and the peak expiratory flow rate increased during the season (P < 0.05). Except for between PEFR variability and BHR in the autumn (r = 0.45; P = 0.014), no correlations were found. However, in the autumn, the majority of children were still hyperreactive in the bronchi and showed PEFR variability but the levels of eosinophil mediators in serum had returned to normal levels. CONCLUSION: Signs and symptoms of asthma did not correlate with serum levels of mediators of allergic inflammation. Bronchial hyperreactivity and PEFR variability persisted after the pollen season when signs of bronchial inflammation had disappeared. We hypothesize that eosinophil mediators and other markers of allergic inflammation disappear after the late-phase reaction, whereas BHR persists. This would explain the lack of correlation between the levels of eosinophil mediators in serum and symptoms of asthma and BHR.

Adolescent↗
PubMed1998

Asthma caused by Ficus benjamina latex: evidence of cross-reactivity with fig fruit and papain.

BACKGROUND: Ficus benjamina or weeping fig is a plant used increasingly for indoor decoration that can cause allergic rhinitis and asthma. OBJECTIVE: We report a clinical and immunologic study in a patient with perennial asthma caused by F. benjamina latex in whom several episodes of angioedema of the oropharyngeal tract and tongue followed ingestion of figs and kiwi. METHODS: Hypersensitivity to latex from F. benjamina and from Hevea brasiliensis, fig fruit, kiwi, papain, and bromelain was investigated by means of skin prick test, specific IgE determination by CAP, histamine release test, and bronchial provocation test to F. benjamina latex. CAP-inhibition assays were carried out to study possible cross-reactivity among these antigens. RESULTS: Hypersensitivity to F. benjamina latex, fig, kiwi, and proteases was demonstrated by means of skin prick test, determination of specific IgE and histamine release test. Bronchial provocation test with F. benjamina latex resulted in a dual asthmatic reaction, confirming the etiologic role of this plant. A rise of eosinophil cationic protein in patient's serum was observed 21 hours after bronchial challenge, suggesting activation of eosinophils. Inhibition assays showed that F. benjamina latex as liquid-phase inhibited up to 95% the CAP to fig and up to 57% the CAP to papain. Neither sensitization nor cross-allergenicity with H. brasiliensis latex was found. CONCLUSIONS: Hypersensitivity to F. benjamina latex may cause IgE-mediated respiratory allergy. The association with allergy to fig and papain is likely due to the existence of cross-reactive allergen structures.

Adult↗
PubMed1993

Diagnostic tests in enzyme allergy.

BACKGROUND: Allergies to enzymes occur frequently in enzyme manufacturing plants. In epidemiologic studies the number of exposed subjects with symptoms is considerably higher than the number of sensitizations as assessed by skin tests or RAST. It was the aim of this study to evaluate the sensitivity and specificity of skin prick tests, enzyme allergosorbent test, and immunoprint with enzymes by using the results of bronchial provocation tests as the "gold standard." METHODS: We performed 82 bronchial provocation tests with nine different enzymes in 42 chemical plant workers, all of whom had reported work-related symptoms. All tests with the exception of bronchial provocation tests were also performed in 10 atopic and 10 healthy control subjects. RESULTS: Thirteen workers showed positive results to bronchial provocation tests (50% or greater fall in specific airway conductance) with an enzyme at a maximal concentration of 10 mg/ml. Equivocal test results, that is, tests with a 30% or greater and less than 50% fall in specific airway conductance were seldom. Skin prick tests with nondialyzed aqueous enzyme extracts at a concentration of 10 mg/ml yielded a sensitivity of 100% and a specificity of 93%. Control subjects had no cutaneous reactions to enzymes. Discrepancies between skin tests and bronchial provocation tests occurred in 5 of 82 tests, all with a positive skin test and a negative bronchial provocation test. False-positive skin tests were considered more likely in four subjects and a false-negative bronchial challenge more likely in one case. Enzyme allergosorbent test was 62% sensitive and 96% specific, and atopic control subjects showed positive results in two cases. Results of immunoprint with amylase showed one main band at pH 3.4; this band was also found in exposed subjects without further signs of sensitization, but was not found in control subjects. All but one person with positive results to bronchial provocation tests with enzymes showed bronchial hyperresponsiveness. We identified 13 subjects with bronchial hyperresponsiveness, but without occupational allergy: five of these had sensitizations to nonoccupational allergens and the remainder showed bronchial hyperresponsiveness without any detectable cause. CONCLUSIONS: Occupation-related symptoms were not indicative of occupational allergy. Bronchial provocation tests and skin prick tests with nondialyzed aqueous enzyme extracts were appropriate techniques for the diagnosis of enzyme allergy.

Bronchial Provocation Tests↗