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PubMed1989

Symptoms of asthma, methacholine airway responsiveness and atopy in migrant Tokelauan children.

503 migrant Tokelauan children between five and 15 years resident predominantly in Porirua and the Hutt Valley were surveyed as part of a study of asthma prevalence in a recently migrant population. The survey consisted of domiciliary interview with parents, physical examination, assessment of bronchial hyperresponsiveness and atopy, by allergen skin prick testing. Forty-three children (8%) had a history of wheezy breathing or asthma. 160 children (32%) had evidence of increased airway responsiveness defined as a PD20 (provocative dose of methacholine causing a less than or equal to 20% fall in FEV1, of less than or equal to 12.2 mumoL methacholine). Of the 43 children with a history of asthma, 40 (93%) had evidence of bronchial hyperresponsiveness, 36 (84%) were atopic and 35 (81%) had both bronchial hyperresponsiveness and atopy. Forty-five children (9%) were found to be wheezing on the day of examination only 16 of these had a history of wheezing. Twenty seven of the wheezing children demonstrated bronchial hyperresponsiveness and 22 of these were atopic. Of the 18 children wheezing but with no evidence of bronchial hyperresponsiveness only six were atopic. These contrasting findings suggest differences in the cause of symptoms among the children. Regional differences were observed for the prevalence of symptoms and signs of asthma, bronchial hyperresponsiveness and atopy. Hutt Valley Tokelauan children exhibited a higher prevalence than the Porirua children. Migrants to the Hutt Valley and Porirua are from different atolls, and these differences raise the possibility of a genetic influence on the development of asthma.

Adolescent↗

PubMed1989

Serum IgE and atopy in drug-sensitive patients.

One of the most interesting aspects of the pathogenesis of the allergic and pseudo-allergic reactions to drugs is the one concerning the possible roles of genetic factors, in general, and the relationship with atopy, in particular. We decided to study the correlation between the serum level of total IgE, the personal and familial history of atopy, and the allergologic tests (skin test, PRIST, RAST, etc) for one or more drugs taken by 465 patients with personal history of allergic reactions. From the data, we observed that the average amount of total IgE lies within the norm, 125.4 KU/L (+/- 209.2), without any significant difference between the allergic (132 KU/L) and the pseudo-allergic (121.8 KU/L) patients. The IgE levels tend to be higher in that part of the tested population which presented a circumstantial atopic status (11.8%) and they are not influenced by an allergic or pseudo-allergic reaction to drugs. According to these results, the relationship between drug hypersensitivity and atopy needs further investigation.

Age Factors↗

PubMedDate not supplied

[Hypertrophic stenosis of the pylorus. Correlations with allergy to milk proteins and atopy].

We performed a study concerning the relationship between hypertrophic pyloric stenosis (HPS), atopy and cow's milk protein allergy (CMPA). Familial history of atopy was documented in 17 (44.7%) of 38 infants having undergone Ramstedt pyloromyotomy for HPS, in 12 (23%) of 52 infants having undergone surgery for inguinal hernia and in 53 (26.9%) of 290 normal controls (significant differences between HPS and other groups). Moreover 9 (23.6%) of 38 infants with HPS presented personal history of eczema at follow-up compared with 3 (5.7%) infants having undergone surgery for inguinal hernia (p less than 0.01). A significant difference between HPS and other groups was also found when looking for familial history of CMPA: 26.3% vs % and 2.5% respectively (p less than 0.001). Eventually we discovered a higher than expected incidence of CMPA both in a retrospectively evaluated group of HPS and in 24 infants undergone Ramstedt pyloromyotomy and followed according to a standardized protocol for a mean period of 4 months (16.6%). The etiology of HPS remains obscure. Our data however suggest some relationship between HPS, atopy and particularly CMPA.

Female↗

PubMed1987

High IgE levels in diabetic children without atopy or insulin allergy.

The combined occurrence of atopy and diabetes of type I in childhood is extremely rare; this is explained in the literature by the different genetic backgrounds. In the present work, a study was made whether juvenile diabetes can be accompanied by symptom-free atopy. In 67 insulin-dependent diabetic children, the total and the specific IgE, and the IgG, IgA and IgM levels were determined, and cutaneous prick test was performed. In 23 of the examined children, the total IgE level proved to be higher than the age-related normal mean + 2 SD; the prick test revealed various degrees of positivity in 30% of these same children, with a complete lack of atopic symptoms. The total IgE levels were found to be elevated not only in the first year of the disease, but also in the following 5-10 years. The results indicate the existence of symptom-free atopy in insulin-dependent diabetes; additionally, the possibility of a genetically determined disturbance of IgE synthesis is suggested. Data are provided on the autoimmune pathogenesis of insulin-dependent diabetes.

Adolescent↗

PubMed1985

[Atopy screening: prick multitest, total IgE or RAST? On the value of allergologic testing of the staff of an industrial bakery].

The predictive value of diagnostic tests for the recognition and differentiation of allergic diseases of the immediate type has been evaluated on the basis of the results of a non-selective allergologic-pneumologic examination of the staff of an industrial bakery. Out of the 314 subjects tested, 22 (7%) had a respiratory allergy against flour (flour rhinitis and/or flour asthma), and 21 (6.7%) a preexistent atopic disease without actual symptoms of flour allergy. Thus the predominance of atopy in the group examined was 13.7%. A prick-multitest was carried out in all 314 subjects on each forearm and allowed simultaneous and easy application of twice eight test substances ("atopy-screening" and "bakery-line"). 50% of the bakers with flour allergy also showed positive skin tests with non-occupational inhalative allergens (housedust, housedust mite, pollen) while only 9.2% of the subjects without respiratory allergy to flour did so. 17.1% of the heavily exposed, asymptomatic bakers showed a positive immediate reaction to the highly sensitive intracutaneous test with wheat flour. Here the problem of latent sensitization arises. With histamine the prick-multitest resulted - compared to the intracutaneous test - in 1.6% "false negative" and 3.2% only questionably positive results. Furthermore, 6.1% of the subjects showed a strong, and 3.2% a very strong, nonspecific reaction to the control solution glycerin. Despite these restrictions the prick-multitest proved far superior to measurement of total serum IgE for screening of atopy. Technical improvements have been made in the meantime by the manufacturer. Specific IgE was detected in RAST screening in 59 of the 306 subjects who underwent blood tests. The geometric mean of total IgE values was only 75 U/ml, and for the RAST-negative subjects 23.3 U/ml, while their 95% confidence level was 225 U/ml. This logarithmic-normal distribution of the measured values, together with the excessive normal-atopic overlap, makes it impossible to lay the test cutoff point in a way which results in an acceptable relation between sensitivity and specificity. For the population examined the sensitivity of the total IgE measurement was already below 50% at a cutoff point of 80 U/ml, while the positive predictive value did not yet reach 50% at 160 U/ml. This diagnostic test is at present certainly used too often and without sufficient awareness of its very limited predictive value. As a screening method the RAST is too expensive. Furthermore, the problem of a latent sensitization also exists for the RAST.

Adolescent↗

PubMed1983

The incidence of atopy in steroid-responsive nephrotic syndrome: clinical and immunological parameters.

Fifty-nine children with steroid-responsive nephrotic syndrome (SRNS), ages ranging from two to 18 years, were studied to determine the incidence of atopy, using both clinical and immunological parameters. Children with SRNS were found to have a significantly higher incidence of atopy both in themselves (z = 2.51, p less than 0.05) and their first-degree relatives (z = 2.34, p less than 0.05). The proportion of children with raised serum IgE levels (60%) and the geometric mean (631 U/ml) in SRNS children were significantly higher than control values, 14.5% and 136 U/ml, respectively (p less than 0.0001). Intra-group comparison showed that children with multiple relapses (more than two relapses) had higher incidence of skin test positivity to house dust mite (p less than 0.01) and to two or more antigens (p less than 0.05). Our data would suggest that atopy may be a predisposing factor in local children with SRNS.

Adolescent↗

PubMed1982

[Heredity and prevention of atopy].

Although clinical studies have been supplying strong arguments in favour of a hereditary transmission of atopy for a long time, the latest works have not made it possible yet to specify the biologic support of this heredity. An obvious correlation, especially, has not been demonstrated between, on the one hand, atopic ground and HLA group and, on the other hand, between a high production of total IgE and HLA group. At present, the production of specific IgE only seems to be really subordinated to the HLA system; it is likely to be the expression of complex immunological disorders of a genetic determinism. Various environmental factors will contribute, on this predisposed ground, to the disclosure or to the worsening of the atopy. Some prevention of atopy may be undertaken. Extended breast feeding, eviction of some environmental nuisance and family affective balance thus represent useful preventive measures. The influence of the date of conception and of the pregnancy and delivery conditions does not appear to be insignificant; but, there, the prevention is more difficult to set up. Finally, the counting of the IgE in the cord blood could lead to the detection of high-risk newborns.

Breast Feeding↗

PubMed1980

Frequency of atopy, allergy, and previous general anaesthesia in surgical specialties.

This paper reports part of a large survey of atopy, allergy, and previous anaesthesia in 10 000 preanaesthetic patients. The occurrence of these risk factors in the various surgical specialties has been assessed. Obstetric patients have a significantly higher frequency of atopy and allergy than the total female population studied. Among males cardiothoracic patients are the only group to have a significantly higher frequency of atopy and allergy than the overall figure for their sex.

Anesthesia, General↗

PubMedDate not supplied

[Atopy, asthma and the judgement of preemployment fitness].

The preemployment medical examination is a practice viewed as important by recently introduced Italian laws (D.L. 277/91 and 626/94), even if its efficacy with regard to atopy is frequently a matter of controversy. It has been assumed that atopy (with a prevalence in the general population around 30%) is a predictive discriminant in the prevention of occupational allergic asthma, but a review of the literature shows that the hypothetical exclusion of 23 per cent of total job applicants (because they are atypical) would seem to prevent only 55 per cent of asthma cases. At the present time, the concept of discrimination in employment founded on presence of atopy is scientifically unsubstantiated and ethically unacceptable.

Asthma↗

PubMed1995

[Psoriasis vulgaris and its relation to atopy].

Psoriasis vulgaris and atopic dermatitis are considered as frequent dermatoses. There are descriptions of possible combination of both diseases when patients with psoriasis vulgaris display signs of atopy or clinical manifestations of atopic dermatitis. We have analysed 9 patients with psoriasis vulgaris and increased levels of IgE. In each case we have found signs of atopy and in one patient also clinical manifestation of atopic dermatitis. Other most frequent immunological markers were represented by increased levels of FW, IgA and C3 component of complement. The combination of psoriasis vulgaris and atopy is possible in one patient but there are many unsolved questions as to the conclusion whether such a case represents a random coincidence or association of both disease. (tab. 1, Ref. 14.)

Adolescent↗

PubMedDate not supplied

[Phadiatop-Paediatric, a new screening test for atopy: a comparison with RAST results].

The results obtained using a new in vitro screening test for atopy Phadiatop-paediatric (Phad-P) and RAST for multiple food and inhalant allergens in 132 children (82 with atopic dermatitis and 50 with a negative history of atopic symptoms are compared. 64% of the subjects were RAST-positive for food allergens (55/82) in those with dermatitis and only 5/50 in those without atopic symptoms. The only difference between the new test and the RAST is that a mixture of food and inhalant allergens, rather than a single allergen, is conjugated to the paper disk and the results are expressed as positive or negative so as to identify atopic subjects for further allergologic evaluation. The sensibility and specificity of Phad-P as compared to RAST were respectively 87% and 85% with an efficiency of 86%. On the basis of these data, assuming a 20% prevalence of atopy, in the general population the predictive value of negative results of the new test would be 97% and of positive results 59% with an expected efficiency of 86% values similar to those observed in other studies and at the moment considered satisfactory for a screening test fo atopy.

Allergens↗

PubMed1993

Prevalence of atopy in an inner-city asthmatic population.

Seventy-three patients at The Mount Sinai Hospital Emergency Room were investigated to determine the prevalence of atopy in asthma in a predominantly black and Hispanic inner-city population. Serum IgE levels and radioallergosorbent tests (RASTs) to eight common inhalant allergens were measured in both the asthmatic group and a nonasthmatic emergency-room control group. The mean total IgE level for the asthma group was 263.8 IU/mL compared to 63.8 IU/mL in the control group (p = 0.032), and 60% of the asthmatics had IgE levels in the atopic range (> 100 IU/mL). Increases in IgE were associated with age under 50 years but did not reach statistical significance. Cockroach, dust mite, cat, and dog were the most common RASTs in the asthmatic group; there were no positive RASTs in the control group. There was a correlation (p = 0.04) between age (less than 50 years) and increased numbers of positive RASTs. These results are similar to those of other studies that have associated atopy with asthma in rural and suburban populations. These data demonstrate that atopy is common in the asthmatic patients seen in The Mount Sinai Hospital Emergency Room and strongly suggest that management of atopic factors should become routine in the care of adult asthmatic patients.

Adolescent↗

PubMed1997

Genetic studies of atopy and atopic dermatitis.

Atopy and the atopic disorders are likely to result from multifactorial inheritance, with interaction between genetic and environmental factors. It has been proposed that at least two major mechanisms, non-antigen specific (total IgE levels) and antigen specific (specific IgE antibodies and skin tests), regulate the immune response to allergens in humans: firstly, a gene/genes independent of the human leucocyte antigen system which is involved in the regulation of total IgE levels, and secondly, a specific immune response gene/genes associated with major histocompatibility complex class II genes which are involved in antigen-specific mechanisms. Candidate genes have been proposed for both mechanisms and linkage has been found between atopy and at least three different gene loci. This paper reviews the evidence supporting a genetic basis for atopy and atopic dermatitis and outlines recent advances in the molecular genetic mapping of genes associated with these disorders.

Dermatitis, Atopic↗

PubMed1997

The association of family size with atopy and atopic disease.

BACKGROUND: Studies in children have shown that family size is negatively associated with atopy and atopic disease. OBJECTIVE: To describe the association of family size with atopy and atopic disease in young adults. METHODS: A randomly selected sample of 1159 men and women aged 20-44 years provided information on respiratory symptoms, hay fever and eczema. Blood samples were taken for assessment of total IgE and specific IgE to house dust mite, grass, cat, Cladosporium and birch. The association of family size and birth order with respiratory symptoms, atopy and total IgE was assessed by multiple logistic and linear regression. RESULTS: There was a negative association between family size and the reporting of 'wheeze with breathlessness' (adjusted odds ratio for an increase of one sibling 0.85; 95% confidence interval 0.75-0.98), 'wheeze without a cold' (adjusted odds ratio for an increase of one sibling 0.85; 95% confidence interval 0.75-0.98) and 'asthma attacks' in the last 12 months (adjusted odds ratio for an increase of one sibling 0.77; 95% confidence interval 0.61-0.97), current 'hayfever and nasal allergies' (adjusted odds ratio for an increase of one sibling 0.84; 95% confidence interval 0.75-0.94) and sensitization to grass (adjusted odds ratio for an increase of one sibling 0.87; 95% confidence interval 0.76-0.99). Birth order was negatively associated with 'hayfever and nasal allergies' only. A decreased risk of sensitization to grass in those from large families did not fully explain the negative association between family size and hayfever. No statistically significant (P > 0.05) association of family size or birth order with the reporting of other respiratory symptoms, eczema, sensitization to the other allergens or total IgE was observed. CONCLUSION: There is a negative association between family size and some symptoms suggestive of asthma, 'hayfever and nasal allergies' and sensitization to grass in young adults. There is no consistent, significant association between family size and eczema, total IgE or sensitization to other allergens.

Adult↗

PubMedDate not supplied

In vitro IgE synthesis in neonates with different family history of atopy.

In this study we want to correlate family history of atopy and in vitro synthesis of IgE, IL4 and IFN gamma in 5 neonates with biparental (group A), 5 with uniparental (group B) and 5 with absent family history of atopy (group C). An aliquot of neonatal blood mononuclear cells (NBMC) was incubated in presence of PHA in combination with the phorbol ester acetate (TPA). The supernatants of cultures were harvested after 48-72 hours of incubation and stored at -20 degrees C until testing for lymphokine production by ELISA kits. Only one neonate of group B showed detectable in vitro synthesis of IL4 (45 pg/ml) after PHA + TPA stimulation. All the others failed to produce detectable levels either of IL4 or IFN gamma. Another aliquot of NBMC was cultured in the presence of saturating concentrations of rhIL4 for 48 h. After this pre-incubation step, the non-adherent cells were cultured in the presence of: 1) rhIL4; 2) rhIL4 + anti-IL4 antibody (Ab); 3) rhIL4 + anti-IFN gamma Ab; 4) rhIFN gamma, 5) rhIFN gamma + anti-IFN gamma Ab + rhIL4; 6) PWM + rhIL4; 7) unstimulated culture. The supernatants of these cultures were tested for their IgE content. In general, spontaneous IgE production by NBMC was very low, rhIL4 did not induce a significant increase of IgE synthesis. The other modalities of stimulations did not produce significative changes. We did not observe significative differences among the three groups of neonates. On the basis of our results, we conclude that NBMC aren't able to produce significative amounts of IgE in vitro either spontaneously or after IL4 stimulation. This test and the evaluation of IL4 and IFN gamma in vitro production aren't useful markers of atopy predisposition.

Adult↗

PubMed1998

The genetics of atopy.

Since the original introduction by Coca and Coombs in 1923, the concept of atopy has always been linked to the relevance of an inherited predisposition in causing immediate-type hypersensitivity reactions to common allergens. However, the mechanisms underlying this predisposition have long been vague and controversial. Only recently, the better knowledge of the basic pathophysiological abnormalities of atopy as well as the availability of molecular biology techniques for gene mapping, have renewed the interest of several research groups for the genetics of atopy and have produced substantial progress in its understanding.

Asthma↗

PubMed1998

Genetic association between atopy and behavioral symptoms in middle childhood.

The relationship of atopic and behavioral symptoms in a community sample of 66 monozygotic and 141 dizygotic twin pairs, ages 4-11 years, was investigated via mother report questionnaires. Within-person correlation between atopic symptoms and Child Behavior Checklist internalizing symptoms (CBCL-INT) was .21 (p < .001) for the total sample. Cross-correlations between atopy and CBCL-INT were .26 for monozygotic and .04 for dizygotic twins. A common and specific factor model applied to the data revealed that the cross-correlation between atopy and CBCL-INT was mainly due to genetic influences (77% of the covariance). This study supports the hypothesis that there is a shared genetic risk for atopy and internalizing symptoms.

Analysis of Variance↗

PubMed2002

The impact of atopy on neutrophil activity in middle ear effusion from children and adults with chronic otitis media.

OBJECTIVE: To identify the relationship of neutrophil activity to allergy as reflected by the level of myeloperoxidase (MPO) in ears of atopic patients with chronic otitis media with effusion (OME) by objective testing. DESIGN: Evidence of neutrophils was measured in the effusion of atopic patients with chronic OME. Atopy was determined by intradermal and/or in vitro testing of allergic reaction to 10 inhalants, 2 molds, and 5 foods. SUBJECTS: Effusion MPO was measured prospectively in 138 ears from 106 consecutive patients with chronic OME. RESULTS: A total of 86 (81%) of 106 patients with OME tested atopic by in vitro or in vivo testing. Excluding 36 ears with purulence, the mean MPO level was 3132 microg/L in 84 atopic vs 142 microg/L in 18 nonatopic ears (P<.001). A total of 78 (90%) of 87 patients with OME were atopic. CONCLUSIONS: The surprising finding of marked elevation of effusion MPO in atopic patients but very low levels in nonatopic patients (P < .001) suggests that atopy may contribute to elevated levels of neutrophil activity in OME. An atopic patient may respond differently from a nonatopic one to the microbial or viral products of acute inflammation owing to the presence of primed inflammatory cells. This study provides confirmation on a cellular level that neutrophils are an integral part of the inflammatory process in OME to a disproportionate degree among atopic patients.

Adult↗