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PubMed1994

Diagnostic value of recombinant Aspergillus fumigatus allergen I/a for skin testing and serology.

BACKGROUND: We report a clinical study comparing the recombinant Aspergillus fumigatus allergen I/a (rAsp f I/a) to two commercial A. fumigatus extracts in skin prick tests, intradermal tests, and serologic assays. METHODS: Patients with allergic bronchopulmonary aspergillosis and A. fumigatus-allergic patients with asthma, and control subjects, including allergic patients with asthma without allergy to A. fumigatus and healthy subjects, were investigated. RESULTS: All patients with allergic bronchopulmonary aspergillosis (n = 15) reacted to skin prick tests with the commercial extracts, and eight were sensitized to rAsp f I/a. Of 10 patients with well-characterized A. fumigatus-allergic asthma nine showed positive skin prick test results to at least one of the commercial extracts, and five reacted to rAsp f I/a. There was a strong correlation between skin test reactivity to rAsp f I/a and rAsp f I/a-specific serum IgE as determined by an antigen-specific ELISA. The healthy control subjects (n = 7) and allergic patients with asthma without A. fumigatus allergy (n = 6) did not react in skin prick and intradermal tests to rAsp f I/a, nor did they have detectable amounts of rAsp f I/a-specific IgE. In addition, patients with allergic bronchopulmonary aspergillosis showed significant elevated levels of rAsp f I/a-specific IgG4 and IgG1 but no significant differences in rAsp f I/a-specific serum IgA levels when compared with the healthy control subjects. CONCLUSIONS: The data show that rAsp f I/a is a major allergen with biologic relevance in some A. fumigatus-allergic individuals as evaluated by skin prick tests, intradermal tests, or serologic methods. Furthermore, no discrepancies were observed between skin test results and rAsp f I/a-specific IgE. Hence the correlation between rAsp f I/a skin test results and serologic data indicates the potential of recombinant allergens for clinical applications and diagnosis of allergies.

Adult↗
PubMed1975

V. Effect of enzymes and temperature on the serological activity of the antigen of Fasciola gigantica.

The partially purified extract of Fasciola gigantica was incubated with enzyme pepsin and samples were taken at different time intervals from 0-24 hours, and tested intradermally for diagnosing bilharziasis. The enzymatic degradation of the protein molecule results in the progressive decrease and eventually the complete disappearance of serological activity. This showed that the protein portion of the antigen was deemed necessary for its activity in intradermal tests for diagnosing schistosomiasis. Amylase, even at a concentration of 5 per cent, did not influence the activity of the partially purified extract of Fasciola gigantica. This showed that the carbohydrate portion of the antigen has no effect on serological activity. The partially purified extract of Fasciola gigantica was subjected to heating at 37 degrees C, 50 degrees C, and 60 degrees C for periods of two, six and 24 hours, and tested intradermally for diagnosing schistosomiasis. Heating decreased the reactivity of the supernatant liquid of the protein solution but did not completely inactivate the serologically active component which is fairly stable at 50 degrees C. Temperatures higher than 50 degrees C started to affect the serological activity of the protein solution. The higher the temperature, the shorter is the time required for the inactivation of the protein. This shows that the serologically active component is protein and not polysaccharide which resists much higher temperatures.

Amylases↗
PubMed1997

Bevel-down superior to bevel-up in intradermal skin testing.

BACKGROUND: Intradermal skin testing is one of the most widely used procedures in the diagnosis of hypersensitivity diseases in vivo. It is critical to perform the test accurately and expediently. Yet, there are few articles describing its detailed technique or proficiency available. OBJECTIVES: To identify the better method for intradermal testing between the bevel-up and bevel-down techniques. METHODS: Three inexperienced testers performed intradermal injections using both methods. Four sets of paired trails each consisting of ten injections were applied randomly, alternating between the same volunteer subject's contralateral arms. Duration to complete ten injections was measured. Numbers of injection sites that bled, that squirted into the air, and failed to form a bleb were counted. The overall comfort level was determined. RESULTS: The time to complete the injections by bevel-up and by bevel-down methods were 165.5 +/- 31.3 and 152.5 +/- 27.4 seconds, respectively (P < .015). The number of injection sites that bled was higher in the bevel-up method, particularily on trial one (P < .001). Completion rate of successful bleb formation in bevel-down was 27.3 as compared with 23.3 in bevel-up method (P = .013). The comfort level was higher with the bevel-down than the bevel-up method (P = .0001). CONCLUSION: The bevel-down method of intradermal testing is superior to the bevel-up method.

Equipment and Supplies↗
PubMed1995

Cutaneous adverse reactions after intra-articular injection of triamcinolone acetonide.

A patient is described with a disseminated morbilliform and partially persistent urticarial dermatitis following intra-articular injections of triamcinolone acetonide. A delayed-type hypersensitivity to triamcinolone acetonide was observed after patch and intradermal testing. However, an immediate-type hypersensitivity to this drug was not observed. A delayed-type sensitization to betamethasone, dexamethasone and prednisolone, but not to hydrocortisone was also observed after patch testing. Intradermal tests with these representatives of corticosteroids were all negative. Although little is known yet about the relationship between immediate and delayed-type hypersensitivity and the side-effects of oral use of corticosteroids, the absence of positive skin tests to corticosteroids other than triamcinolone acetonide may indicate a safe use of these drugs orally or via injection.

Betamethasone↗
PubMed1985

Viral contamination of intradermal skin test syringes.

Intradermal skin tests are often performed using a common syringe with multiple needles. Bacterial contamination of intradermal skin test syringes can occur as a result of apparent siphoning caused by needle changing. The bacterial contamination of the syringe can be prevented by flushing the contaminated needle prior to changing. In this study, two different needle changing techniques were examined using a polio virus contaminant. Viral contamination of the syringe was not prevented by flushing the infected needle prior to removal. All syringes were contaminated with virus regardless of needle changing technique. We, therefore, cannot recommend the continued use of a common syringe for intradermal skin tests between patients regardless of needle changing technique.

Equipment Contamination↗
PubMed1990

Simultaneous anaphylaxis to thiopentone and a neuromuscular blocker: a study of two cases.

Two women experienced anaphylactoid reactions after induction of general anaesthesia. Prick tests, intradermal tests (IDT), human basophil degranulation tests (HBDT) and a quaternary ammonium sepharose radioimmunoassay were undertaken several weeks later and repeated together with a leucocyte histamine release (LHR) test after 4 months. Anaphylaxis to suxamethonium was documented by four tests in patient 1 and to pancuronium by four tests in patient 2. Anaphylaxis to thiopentone was shown with IDT, HBDT and LHR in both women. It was concluded that simultaneous anaphylaxis to thiopentone and a neuromuscular blocker had occurred in these patients.

Adult↗
PubMed2000

Cetirizine inhibits bradykinin-induced cutaneous wheal and flare in atopic and healthy subjects.

BACKGROUND: Kinins are vasoactive mediators involved in allergic reactions. When applied on the skin or in the nose, bradykinin (BK) elicits inflammation that is poorly affected by previous H1-blockade. The aim of this study was to compare the possible effect of cetirizine (an H1-antagonist) on wheal and flare responses to BK, histamine, and compound 48/80 in atopic and healthy subjects. METHODS: In a randomized, double-blind, crossover study, eight atopic and eight healthy subjects received cetirizine (10 mg/day) or placebo for 3 days before cutaneous tests. Intradermal tests (IDT) and prick tests (PT) were performed with BK (20 nmol/ml for IDT and 20 micromol/ml for PT), histamine (100 microg/ml IDT and 100 mg/ml PT), and compound 48/80 (100 microg/ml IDT and 100 mg/ml PT) as positive controls and saline as negative control. The skin responses were monitored by measurement of wheal and flare areas. RESULTS: BK, histamine, and 48/80 induced wheal and flare reactions in all placebo-treated subjects. Histamine elicited larger wheal and flare reactions than BK and 48/80. IDT with BK induced four- to six-fold larger wheal and flare reaction than PT. No differences in BK-induced wheal and flare were observed between atopic and healthy subjects. In atopic subjects, cetirizine induced a significant reduction of flare reactions after the BK test (80% for IDT, and 94% for PT [P<0.01]). Moreover, cetirizine reduced significantly BK-induced wheals by 70% for IDT (P<0.01) and 65% for PT (P<0.01). A similar inhibiting effect of cetirizine was also observed in healthy subjects. CONCLUSIONS: These findings showed that the wheal and flare reactions induced by BK challenge were markedly inhibited by previous intake of cetirizine. The mechanism by which this effect is mediated cannot be established at present.

Adolescent↗
PubMed2000

Cetirizine inhibits bradykinin-induced cutaneous wheal and flare in atopic and healthy subjects.

BACKGROUND: Kinins are vasoactive mediators involved in allergic reactions. When applied on the skin or in the nose, bradykinin (BK) elicits inflammation that is poorly affected by previous H1-blockade. The aim of this study was to compare the possible effect of cetirizine (an H1-antagonist) on wheal and flare responses to BK, histamine, and compound 48/80 in atopic and healthy subjects. METHODS: In a randomized, double-blind, crossover study, eight atopic and eight healthy subjects received cetirizine (10 mg/day) or placebo for 3 days before cutaneous tests. Intradermal tests (IDT) and prick tests (PT) were performed with BK (20 nmol/ml for IDT and 20 micromol/ml for PT), histamine (100 microg/ml IDT and 100 mg/ml PT), and compound 48/80 (100 microg/ml IDT and 100 mg/ml PT) as positive controls and saline as negative control. The skin responses were monitored by measurement of wheal and flare areas. RESULTS: BK, histamine, and 48/80 induced wheal and flare reactions in all placebo-treated subjects. Histamine elicited larger wheal and flare reactions than BK and 48/80. IDT with BK induced four- to sixfold larger wheal and flare reaction than PT. No differences in BK-induced wheal and flare were observed between atopic and healthy subjects. In atopic subjects, cetirizine induced a significant reduction of flare reactions after the BK test (80% for IDT, and 94% for PT [P < 0.01]). Moreover, cetirizine reduced significantly BK-induced wheals by 70% for IDT (P < 0.01) and 65% for PT (P < 0.01). A similar inhibiting effect of cetirizine was also observed in healthy subjects. CONCLUSIONS: These findings showed that the wheal and flare reactions induced by BK challenge were markedly inhibited by previous intake of cetirizine. The mechanism by which this effect is mediated cannot be established at present.

Adolescent↗
PubMed1985

Determination of immunity to varicella-zoster virus by means of an intradermal skin test.

An intradermal varicella skin test, utilizing heat-inactivated noninfectious viral antigen, was evaluated in 16 adults known to be immune or susceptible to varicella and in 109 adults with no history of varicella. The skin test was well tolerated, compared favorably with established methods of determining immunity to varicella, and accurately predicted which subjects would develop clinical varicella after close exposure.

Adult↗
PubMed1975

A study of serum immunoglobulins including IgE and reaginic antibodies in patients with bronchial asthma in relation to the spectrum of the disease.

Immunoglobulins G, A, M, D, and E were studied in the sera obtained from sxity-nine bronchial asthma patients, who were graded objectively according to atopic score. Among other associated atopic diseases, they often had allergic rhinitis. Ninety-one per cent of these patients had elevated serum IgE levels and the mean level of serum IgE was more than 3-5 times higher than that observed in the normal subjects. Moreover, as their atopic score increased, the serum IgE levels were also elevated, and every patient with high atopic score, had elevated serum IgE levels. This indicates the association of atopic state with serum IgE level. Furthermore, reaginic antibodies were studied in some of these patients by intradermal tests, Prausnitz-Küstner (PK) reaction, conjunctival and bronchial provocation tests. Intradermal and PK tests were comparable and proved to be the most sensitive method of detecting reagins. The intensity of these reactions correlated significantly with serum IgE LEvel, although this relationship is not invariably present. The reaginic activities in the sera of the patients with atopic bronchial asthma also compared well with the positive bronchial test (induced asthma) by inhalation of specific aerosol although this association is also not always present. Eleven patients with high atopic score had isolated serum IgA deficiency. There was a significant rise of mean serum IgM in comparison to the controls.

Adolescent↗