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PubMed1997

Atopy phenotype in subjects with variants of the beta subunit of the high affinity IgE receptor.

BACKGROUND: Fc epsilon RI plays a central role in atopy, thus genetic variants of Fc epsilon RI-beta may alter receptor function to enhance atopic responses and may manifest as a more severe atopic phenotype and more symptomatic atopic disease. The immunological and clinical features of atopy in children with and without the Leu 181 variant of Fc epsilon RI-beta were compared. METHODS: Sixty British nuclear families, including 10 families with the Fc epsilon RI-beta variant Leu 181, recruited via a young proband with atopic asthma were analysed for atopic parameters including total IgE, specific IgE, and clinical atopic disorder. RESULTS: Compared with other children (combined atopic and non-atopic subjects), maternally inherited Leu 181 was associated with increased levels of total IgE (odds ratio (OR) 4.82, 95% confidence interval (CI) 1.02 to 27.66, p < 0.01) and a positive IgE response to grass pollen allergen (OR 7.45, 95% CI 1.56 to 35.52, p < 0.005) but not wheeze (OR 1.97, 95% CI 0.56 to 7.69), asthma (OR 2.25, 95% CI 0.65 to 7.85), or required medications (OR 0.95, 95% CI 0.29 to 3.14). There were trends for each atopic parameter to be more marked in atopic children with maternally inherited Leu 181 than in atopic children without Leu 181. Children with maternal Leu 181 had significantly raised eosinophils but there was no difference in basophil levels compared with other atopic children. CONCLUSIONS: The Leu 181 variant of Fc epsilon RI-beta, or another identified variant in linkage disequilibrium, may promote the development of atopy.

Adolescent↗
PubMedDate not supplied

[Prevalence of atopy in chronic fatigue syndrome].

BACKGROUND: Several hypotheses have been postulated to explain the etiopathogenesis of chronic fatigue syndrome (CFS). Among these, immunologic dysfunction has been proposed. Up to 30 % of these patients have a history of allergic disease. The aim of this study was to investigate whether allergic sensitization is higher in patients with CFS than in the general population. METHODS: Twenty-five patients with CFS and 20 controls were evaluated. A clinical history for allergy was taken and immediate hypersensitivity tests were performed. RESULTS: Twelve patients (48 %) and eight controls (40 %) had a family history of atopy. Personal histories of atopy were as follows: rhinoconjunctivitis: 12 patients (48 %), seven controls (35 %); asthma: five patients (20 %), two controls (10 %); food allergy: three patients (12 %); atopic dermatitis: two patients; contact dermatitis: two patients. No statistically significant differences were found between the groups in any of the variables (p > 0.05). In the CSF group, 3.4 % (15/441) of the inhalant prick tests were positive, and in the control group 3.8 % (16/420) were positive. None of the tests for hypersensitivity to food or latex were positive. CONCLUSIONS: In our study atopy was not more prevalent in patients with CFS than in healthy controls, although the CSF group tended to report more respiratory symptoms and drug allergies.

Adolescent↗
PubMedDate not supplied

The natural course of atopy determined by skin prick tests in patients with bronchial asthma and/or rhinitis.

BACKGROUND: The skin prick test (SPT) is the cheapest, most widely used and practical method for the diagnosis of allergic diseases. The results of repeat test might show variations due to aging. OBJECTIVE: To perform repeat SPTs to determine possible changes in the atopy rate in general as well as changes in the allergen spectrum of atopic patients occurring over time and to identify the factors that could affect this change. METHODS: A total of 222 patients who received a diagnosis of bronchial asthma and/or persistent rhinitis in our Adult Allergy Unit and who attended follow-up visits in the outpatient unit over a 2-year period were enrolled. SPT with 10 visit common aeroallergens were performed at the first and the second test was performed after an interval of at least 2 years. RESULTS: The mean age was 36.4 +/- 11.4 years and 77.5 % of the patients were women. The mean interval between the two tests was 43.4 +/- 20.0 (minimum = 24-maximum = 105) months. Repeat tests showed that the atopy rate decreased from 58.6 % to 47.7 %; sensitivity rates to 10 allergens also decreased. These differences were statistically significant (p <0.05). CONCLUSION: The atopy rate determined by SPTs tends to decrease over time. The most important factor affecting this decrease is time itself.

Adolescent↗
PubMedDate not supplied

Promoter polymorphism in the candidate genes, IL-4, IL-9, TGF-beta1, for atopy and asthma.

This paper will review genetic variations in the structure of three important candidate genes with varying effects in atopy and asthma that may have significant overall susceptibility associations in relation to the development of atopy and asthma. The three cytokine genes involved are interleukin (IL)-4, IL-9 and transforming growth factor beta1, and the nature of the polymorphisms may be related to significantly higher outputs of these cytokines in atopy and asthma.

Asthma↗
PubMed1996

Airways reactivity, atopy and bronchoalveolar lavage in male smokers with airflow obstruction.

Although cigarette smoking plays a major role in the development of chronic obstructive pulmonary disease, risk factors that might predispose susceptible smokers to develop manifest airflow obstruction are poorly defined. The aim of this study was to investigate whether BAL cell profiles, bronchial hyperresponsiveness, and atopy were different in smokers with and without airway obstruction. Fifty-seven current smokers with (n = 22) and without airflow obstruction (n = 35), defined spirometrically, and 8 nonsmoking subjects (controls) were studied (fiberoptic bronchoscopy and bronchoalveolar lavage (BAL), measurement of IgE concentrations and skin prick testing with common allergen extracts, methacholine bronchoprovocation testing). Mean values of forced expiratory volume in 1 s (FEV1) percent predicted were significantly lower in smokers with obstruction than in those without obstruction (53.1 +/- 16.9 vs. 72.5 +/- 16.6, p < 0.001). Smokers with airflow obstruction showed an improvement in FEV1 < 20% after inhalation of two puffs of 0.250 mg terbutaline. Current smokers as opposed to controls had significantly (p < 0.01) higher values of cells/ml in BAL (78 +/- 72.4 x 10(4) vs. 28.7 +/- 14.5 x 10(4)) and macrophages (90.5 +/- 19.4 vs. 84.3 +/- 9.3%) and lower values of lymphocytes (5.4 +/- 15.4 vs. 13.1 +/- 10.7%). Smokers with obstruction to airflow showed significantly (p < 0.05) higher values of cells/ml in BAL (102 +/- 88 x 10(4)) than smokers without airflow obstruction (63.4 +/- 57.5 x 10(4)) with no differences in differential cell counts. The provocation concentration of methacholine producing a 20% reduction in FEV1 (PC20) was also lower in smokers with obstruction than in smokers without obstruction (2.9 +/- 3.5 vs. 6.4 +/- 7.2 mg/ml, p < 0.05). Differences in atopy were not found. In summary, current smokers with airflow obstruction tended to have more cells recovered by BAL and greater airway responsiveness than smokers without obstruction, although atopy-related parameters were not different for both groups.

Aged↗
PubMed1982

Evidence for the Carter effect in atopy.

In atopy, the sex ratio deviates markedly from unity when the specific organ manifestations are considered separately. In atopic asthma, the male to female ratio is about 2:1. In the children of patients affected with atopic asthma, we determined the incidence of atopic dermatitis, atopic asthma and atopic rhinitis. Among children of women affected with atopic asthma, we found more often atopic manifestations than among children of men affected with atopic asthma (44 vs. 25.5%). This phenomenon, called the Carter effect, can be explained by the multifactorial mode of inheritance. A certain number of genes is necessary for clinical signs of atopy to become manifest. Women with atopic asthma have a higher threshold and therefore transmit more predisposing genes to their children. This demonstration of the Carter effect is a further argument in favor of polygenic inheritance of atopy.

Adolescent↗
PubMed1995

Prevalence of atopy and pollinosis in the adult population of Switzerland (SAPALDIA study). Swiss Study on Air Pollution and Lung Diseases in Adults.

The Swiss SAPALDIA study is a large multicenter cross-sectional study initiated in 1991 to evaluate the relationship between environment and respiratory symptoms and diseases in adults, and included subjects from eight areas in Switzerland with distinctive environmental characteristics. We present here prevalence data for atopy, pollinosis and atopic asthma obtained from a random sample of 8,357 adults (18-60 years) assessed by standardized computer-based interview as well as by allergy skin prick tests (SPTs) (performed with Phazet) to grass, birch and Parietaria pollen, house dust mite, cat and dog epithelia and the moulds Alternaria and Cladosporium and by an in vitro allergy screen test (Phadiatop CAP FEIA system). On the basis of a positive Phadiatop (total 28.9%; males 32.9%, females 25.0%; p < 0.001) and/or a positive SPT (total 23%; males 25.0%, females 20.8%; p < 0.001), 32.3% of the study population were considered atopic (males 35.7%, females 28.8%; p < 0.001). Concerning the prevalence of skin sensitization (SPT wheal > or = 3 mm), the highest rate was observed for grass (12.7%), followed by house dust mite (8.9%), silver birch (7.9%), cat (3.8%) and dog (2.8%), whereas moulds and Parietaria elicited less than 1% positive SPTs. The prevalence of atopic rhinitis (rhinitis symptoms associated with atopy) was 13.5% (males 14.3%, females 12.6%; p < 0.05) and the prevalence of current hay fever varied between 9.1% (questionnaire answer and a positive SPT to at least one pollen), 11.2% (questionnaire answer and presence of atopy) to 14.2% (questionnaire answer only) with no significant difference by sex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

A genetic map of chromosome 11q, including the atopy locus.

Atopy is a common and genetically heterogeneous syndrome predisposing to allergic asthma and rhinitis. A locus linked to the atopy phenotype has been shown to be present on chromosome 11q12-13. Linkage has only been seen in maternally derived alleles. We have constructed a genetic linkage map of the region, using 15 markers to span approximately 27 cM, and integrate previously published maps. Under a model of maternal inheritance, the atopy locus is placed within a 7-cM interval between D11S480 and D11S451. The interval contains the important candidate gene FCERIB.

Alleles↗
PubMed1996

Allelic association of gene markers on chromosomes 5q and 11q with atopy and bronchial hyperresponsiveness.

To investigate genetic factors in asthma and atopy, we sought allelic associations for 12 markers near candidate loci for serum total, immunoglobulin E (IgE), and bronchial hyperresponsiveness (BHR) to inhaled histamine in 131 families comprising 685 individuals, selected randomly without regard to atopy or asthma. Nonparametric linkage and association analyses were performed with the Nonparametric Analysis of Lineage and Association (NOPAR) program, and parametric analyses were performed with the Complex Inheritance with Diathesis and Severity (COMDS) program on an ordered polychotomy of ranked scores. On chromosome 11q, allele 168 at the D11S527 locus was significantly associated with BHR (p<0.0003) but not with log IgE. At the D11S534 locus, allele 235 was significantly associated with log IgE (p = 0.007) but not with BHR. Both D11S527 and D11S534 were too distant from the gene encoding the high-affinity IgE receptor FcepsilonRIbeta to account for the association. At the interleukin-9 (IL-9) locus, the 118 allele showed significant association with serum total IgE (p<0.003) but not with histamine BHR. Parametric tests are more conservative, perhaps because they demand consistency with mendelian inheritance and tight linkage. These findings provide support for the view that both chromosomes 5 and 11 may contain genes relevant to asthma and atopy, a possible candidate being the interleukin-4 (IL-4) gene cluster. Because these associations are extremes in a large number of tests, they require confirmation in other samples.

Adolescent↗
PubMed1997

Specific IgE-dependent sensitization, atopy, and bronchial hyperresponsiveness in apprentices starting exposure to protein-derived agents.

Atopy, specific IgE sensitization, and bronchial hyperresponsiveness (BHR) were examined in a cohort of 769 apprentices starting career programs in animal health or veterinary medicine (Group 1), pastry making (Group 2), and dental hygiene (Group 3). The hypothesis were that: (1) a proportion of subjects can be "sensitized" although no significant specific occupational exposure has occurred; and (2) there is a relationship between baseline specific sensitization to work-related antigens and host characteristics. Skin tests were administered using 11 common inhalants and specific allergens, including six laboratory animal extracts, three cereal antigens, alpha-amylase, and latex. Methacholine challenge tests were performed. The prevalence of atopy was 54.4% in Group 1, 58.1% in Group 2, and 52.5% in Group 3. Skin reactivity to work-specific proteins was as follows: laboratory animal proteins, 13.8% in Group 1, 14.0% in Group 2, and 15.6% in Group 3. No subject was sensitized to alpha-amylase, whereas 1.2% in Group 1, 5% in Group 2, and 4.1% in Group 3 were sensitized to flour. Five subjects reacted to latex. BHR (PC20 < or = 8 mg/ml) was present in 17.6%, 21.2%, and 14.8% of subjects in Groups 1, 2, and 3, respectively. Specific sensitization was associated with positive skin reactions to common allergens, work-related symptoms, and BHR. These results suggest that students starting career programs with exposure to high-molecular-weight allergens have a low but substantial frequency of specific sensitization to work-related allergens that is related to atopy and BHR.

Adult↗
PubMed2001

Association of a promoter polymorphism of the CD14 gene and atopy.

Atopy is generally considered to be caused by interaction of genetic and environmental factors. Recently, an association of a C-to-T transition in the promoter region of the CD14 gene on chromosome 5q31.1 and atopic phenotypes was reported in a population study of school children in the United States. The aim of the present study was to investigate the association of the C allele of the CD14/-159 with phenotypes of atopy and asthma in an adult Dutch population in which linkage of total serum IgE and bronchial hyperresponsiveness to chromosome 5q31-33 is present. We studied 159 probands with asthma and 158 spouses as controls. Phenotypes for asthma (e.g., bronchial hyperresponsiveness, physician's diagnosis) and for atopy (e.g., total serum IgE level, intracutaneous skin test, allergic rhinitis) were studied. In this population, homozygotes for the C allele had a higher number of positive skin tests and higher total serum IgE levels (in skin test-positive individuals) and subsequently, more self-reported allergic symptoms including rhinitis and hay fever, compared with subjects with CT and TT alleles. We conclude that the -159 C-to-T promoter polymorphism in the CD14 gene may result in expression of a more severe allergic phenotype.

Adult↗
PubMed1990

The relationship of nonspecific airway responsiveness and atopy to the rate of decline of lung function. The Normative Aging Study.

Nonspecific airway hyperresponsiveness and atopy have been postulated to be risk factors that predispose individuals to the development of chronic obstructive pulmonary disease. The purpose of the present study was to examine the relationship of methacholine airway responsiveness and markers of atopy to rate of decline in lung function among 790 men, age 40 to 79 yr, followed in the Normative Aging Study. Airway responsiveness was assessed at the end of follow-up, which ranged from 14 to 24 yr. Multiple linear regression analysis indicated that greater methacholine airway responsiveness was associated with more rapid annual FEV1 decline. Stratified analysis suggested that this association was stronger among skin test-negative, current smokers. No significant relationship was found between serum IgE level and annual FEV1 decline. A weak but statistically significant correlation between eosinophil count and mean annual FEV1 decline was noted among skin test-negative individuals (r = -0.08; p = 0.03). Results from the present study do not show a clear association between atopy and decline in FEV1. These data, however, do indicate an independent association between heightened methacholine responsiveness on decline in FEV1 in adult males.

Adult↗
PubMed1991

Effect of atopy on the natural history of symptoms, peak expiratory flow, and bronchial responsiveness in 7- and 8-year-old children with cough and wheeze. A 12-month longitudinal study [published errarum appears in Am Rev Respir Dis 1992 Aug;146(2):540].

Recurrent lower respiratory tract symptoms are common and disabling in childhood, but little is known of their natural history and relationship to asthma. We report a 12-month longitudinal study designed to determine the influence of atopy on respiratory symptoms and bronchial responsiveness in 7- and 8-yr-old children. A postal questionnaire inquiring into the presence of respiratory symptoms was sent to 3,698 children aged 7 and 8 yr. Those reporting either current wheeze (14.8%) or current cough in the absence of wheeze (12.8%) were randomized, and a sample was invited to attend for skin testing. The following groups of symptomatic children entered the longitudinal study: 48 atopic children with cough, 48 atopic children with wheeze, 48 nonatopic children with cough, and 48 nonatopic children with wheeze. All children recorded twice daily the best of three peak expiratory flow (PEF) measurements and completed a 10-point symptom score card, each day for 1 yr. They also recorded all treatment taken and made a note of relevant life events. Each child was seen monthly for general assessment and for measurement of methacholine bronchial responsiveness. Despite the arduous nature of the study 183 of the 192 children (95.3%) successfully completed the 12 months of observation. Symptom groups were compared with regard to FEV1, bronchial responsiveness, symptom chronicity and severity, and diurnal and day-to-day variation in PEF. Atopy was associated with a lower FEV1, increased prevalence of bronchial hyperresponsiveness, greater within-day and between-day variation in PEF, and greater severity of respiratory symptoms compared with the absence of atopy. Wheeze was associated with lower FEV1, increased prevalence of bronchial hyperresponsiveness, greater within-day and between-day variation in PEF1 and greater severity of respiratory symptoms compared with cough [corrected].

Bronchial Provocation Tests↗
PubMed1993

Bronchial reactivity, atopy, and airway response to cotton dust.

Studies of cotton textile workers have found an association between atopy and drop in FEV1 over a workshift. We studied the response of previously nonexposed volunteers with and without a history of mild atopy to a 5-h exposure to 1 mg/m3 of respirable cotton dust in a model cardroom. All participants were nonsmokers, had no history of asthma, and had normal spirometry. Twenty atopic subjects gave a personal history of mild respiratory allergy to pollen, dusts, or animals that had been confirmed by a physician. Thirty-two nonatopic subjects had no history of allergy. Spirometry and a methacholine challenge test were performed 1 to 2 days prior to exposure. Spirometry was repeated immediately before exposure to cotton dust; spirometry and a methacholine challenge were performed immediately after exposure. Atopic subjects showed a significantly higher mean serum IgE level to Phadiatop, a screening test to common inhalant allergens, than did nonatopic subjects (mean percent binding, 32.1 versus 1.5; p < 0.001). Atopic subjects had a significantly greater mean fall in FEV1 during exposure (8.3% versus 4.9%, p < 0.05). The difference in FEV1 decline between atopic and nonatopic subjects was similar in magnitude to that reported for workshift FEV1 declines between textile workers with and without mild atopy. Atopic subjects had significantly higher baseline methacholine responsiveness than did nonatopic subjects (26% versus 0% reaching a PD20, p < 0.0005). After cotton dust exposure, there was a significant increase in airway reactivity in both groups (68% versus 20% reaching a PD20, p < 0.0005). For all subjects combined baseline responsiveness was significantly related to the change in FEV1 after exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

The influence of increased bronchial responsiveness, atopy, and serum IgE on decline in FEV1. A longitudinal study in the elderly.

We have performed a 4-yr prospective survey of the association of allergen skin test positivity, total serum immunoglobulin E (IgE), and bronchial responsiveness to methacholine, with longitudinal decline in FEV1, in subjects over 65 yr of age. In 1987, 324 subjects completed a respiratory questionnaire, and underwent measurement of FEV1 and FVC, methacholine challenge, skin prick testing (to Dermatophagoides pteronyssinus, cat fur, mixed grasses, and Aspergillus fumigatus) and estimation of total serum IgE. After an interval of 4 yr, 212 subjects were reexamined. The mean annual decline in FEV1 was significantly higher in males than in females, but was not significantly influenced by smoking habits defined at the start of the study. The relation of atopy (skin test reaction to allergen > or = 3 mm greater than saline control), increased bronchial responsiveness (PD20FEV1 < or = 6.4 mumoles methacholine) and serum IgE > 80 IU/ml, to annual decline in FEV1 was examined for each risk factor individually with adjustment for age, sex, height, and initial FEV1, by multiple linear regression. Both atopy and bronchial responsiveness were significantly associated with accelerated decline in FEV1. Elevated IgE was correlated with faster FEV1 decline in subjects who were current smokers at the start of the study. In a multiple regression model examining the mutually adjusted associations of all relevant variables with annual decline in FEV1, male sex was the most important predictor (B = 38.6 ml/yr, 95% Cl = 4.3, 72.9). Increased bronchial responsiveness also tended to be associated with accelerated decline in FEV1. In further analyses incorporating the same variables, but restricted to specific smoking categories, age was the only significant factor in the never-smokers, whereas both atopy (B = 44.5 ml/yr, 95% Cl = 3.8, 85.3) and increased bronchial responsiveness (B = 43.5 ml/yr, 95% Cl = 4.6, 82.3) were significant predictors of accelerated FEV1 decline in former and current smokers combined.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1980

Predisposing factors in anaphylactoid reactions to anaesthetic drugs in an Australian population: the role of allergy, atopy and previous anaesthesia.

One thousand patients undergoing anaesthesia in an Australian hospital were assessed by questionnaire to determine the incidence of previous anaesthesia, allergy and atopy. The patients were compared with a British group and with 85 patients who had life-threatening anaphylactoid reactions. The Australian and British groups were not significantly different. The Australian patients who had reactions showed a higher incidence of allergy, atopy, asthma and previous adverse reactions than the general population. The incidence was higher in females than males. Although the incidence is higher in the group of patients who reacted, the incidence is not sufficiently great to make pretreatment of patients with a history of allergy or atopy a reasonable prophylactic manoeuvre.

Anaphylaxis↗
PubMedDate not supplied

The relationship of atopy, smoking, and sensitization to methyltetrahydrophthalic anhydride.

We investigated the association of smoking, atopy and helper T (Th) cytokines with sensitization to methyltetrahydrophthalic anhydride (MTHPA) in occupationally exposed subjects. A population of 147 workers from two condenser plants using epoxy resin with MTHPA underwent a questionnaire survey and serologic investigation. Total and MTHPA-specific IgE levels were measured by the Pharmacia CAP system, and serum levels of interleukin (IL)-4, IL-13, and interferon-gamma (IFN-g) by enzyme immunoassay. The Pharmacia CAP-Phadiatop test, which detects serum IgE specific to most common aeroallergens, was also used. Ninety-six (65%) of the currently exposed workers had positive MTHPA-specific IgE. A significant difference was found in the frequency of positive specific IgE between atopic and non-atopic subjects (P<0.01), but not between smokers and non-smokers. As for smoking, the frequency of positive specific IgE was significantly (P<0.005) higher in smokers than that in non-smokers in non-atopic subjects. Multiple logistic regression analysis also confirmed significant contribution of atopy and smoking to the development of specific IgE (odds ration=3.2 and 10.5, respectively), suggesting that atopic subjects who became sensitized to P<0.01 may become sensitized to common aeroallergens. On the other hand, none of the Th cytokines contributed to the elevation of specific IgE levels. These results suggest that atopic subjects and non-atopic smokers are at increased rist of sensitization by P<0.01. However, to evaluate conclusively the effect of atopy on sensitization, further prospective studies are necessary.

Adult↗
PubMed2006

Pine dust, atopy and lung function: A cross-sectional study in sawmill workers.

An increased risk of asthma symptoms has previously been shown in 772 pine sawmill workers. The aim of the current study was to assess the association between dust exposure, lung function and atopy. Subjects with (n = 59) and without (n = 167) asthma symptoms were randomly selected from the previous survey. Lung function and atopy were determined using spirometry and skin-prick tests, respectively. Inhalable dust levels were measured on the same day. The geometric mean dust concentration was 0.52 mg x m(-3). Exposure to dry but not to green dust was associated with asthma symptoms. Green dust was associated with atopic sensitisation, particularly against outdoor allergens; no association was found for dry dust. Forced vital capacity, forced expiratory volume in one second and peak expiratory flow were significantly lower in workers exposed to high levels of green dust (-350 mL, -260 mL and -860 mL x s(-1), respectively) and dry dust (-230 mL, -190 mL and -850 mL x s(-1), respectively). These associations were observed both in subjects with and without asthma symptoms. No associations with cross-shift changes in lung function were found. Exposure to green pine sawdust may be a risk factor for atopy. Both green and dry dust were associated with obstructive as well as restrictive pulmonary effects.

Adult↗