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PubMedDate not supplied

[Results of a screening for atopy and aspecific bronchial hyperreactivity in 6-year-old children].

In the course of a clinic-anamnestic study performed from November 1984 to April 1985 by the collaborators of USL 40 Maternal-Infantile Service, among the children (1569) of the first primary school, 622 children has been selected for possible, probable and verified asthma. For making deeper the diagnosis, 358 children had gone to the respiratory allergologic section of division of pneumology and respiratory allergology of Cardarelli Hospital. The control group was formed from 12 children without atopic familiarity and without asthmatic tendency. Among the 358 children, 127 were asymptomatic but with familiar anamnesis positive for atopy; 219 had or had suffered allergic symptomatology. The authors had studied all children by Prick-test with a standard battery of allergens and with by methacholine aspecific bronchial reactivity test. The familiar tendency to atopy was present in 81.1% of studied children, with prevalence of maternal tendency (41,83%) in comparison with this of ascendents and collaterals. Among the asymptomatic subjects with atopic familiarity only 27.56% was skin positive for one or more allergens, while 59.82% of symptomatic subjects was skin positive. The bronchial aspecific reactivity with methacholine was increased in the 62% of asymptomatic and in the 84.69% of symptomatic subjects. The aspecific bronchial reactivity level in mean was higher in the children with bronchial asthma but also the subjects with rhinitis and chronic cough has showed a higher level in comparison with adults affected of similar symptomatology. In 8 children the authors have studied the reproduction of PD20 methacholine which was very high.

Age Factors↗
PubMed1979

Is there a negative correlation between malignancy and respiratory atopy?

A history of respiratory atopy (seasonal hay fever or asthma) was sought among 218 patients with malignancy of endodermal origin (lung, gut, bladder, prostate), 104 patients with mesodermal malignancy (hematological, sarcomas, genitourinary system), 70 patients with ectodermal malignancy (skin and breast) and 303 age and sex matched controls. There was a significantly lower frequency of respiratory allergy in patients with endodermal malignancy when compared with their matched controls (6.4% compared to 13.2%, p less than 0.005). There were no significant differences among any of the other groups. Patients with respiratory atopy appeared to have some degree of protection against developing malignancies of endodermal origin. This may relate to immunologic factors, an inherent difference in the endodermal cell layer in atopic individuals or as yet undertermined factors.

Adult↗
PubMed1983

[Atopy and generalized allergic reactions to insect stings].

458 patients with systemic allergic reactions following hymenoptera stings were investigated with regard to the incidence of atopic disease. Personal atopy (13.7%) and a family history of atopy (26.4%) were not found more frequently than in a normal population. The age of the first manifestation of hymenoptera sting allergy was however significantly lower in atopic than in non-atopic patients, sensitization occurred following a smaller number of stings and there was a preponderance of respiratory symptoms.

Age Factors↗
PubMed1982

[Atopy and associated diseases].

In this study of the literature, the authors review the possible association between atopy and other conditions. The mostly reported observations are related to atopic dermatitis, but there is also some real relationship with respiratory allergy: this is true for mucoviscidosis. Some association are significant and interesting from the pathogenetic point of view: they may be classified under three headings (digestive and renal diseases, immunologic disturbances). Therefore, this study refers to intestinal absorption disturbance, gluten sensitive enteropathy, dermatitis herpetiformis, colic diseases, and also to glomerulopathies, immediate and delayed hypersensitivity deficiency and polymorphonuclear functional deficiency. Other associations do exist, but the low number of cases and the absence of a common pathogenesis allow no conclusion to be drawn (ectodermal anidrotic ectodermal dysplasia, Dubowitz syndrome). Some of them are certainly only fortuitous: this should be more definitely established by later studies. Some diseases may be accompanied by an eczematiform dermatitis (phenylketonuria, anomalies of histidin metabolism). Frequency of associations with alopecia areata and dominant ichthyosis vulgaris is also discussed. This review gives the possibility of emphasizing the absence of statistically significant hematopathic evolution of atopic dermatitis and calls attention on the Wiskott-Aldrich-syndrome as a model for the studies on atopy.

Agammaglobulinemia↗
PubMed1981

[Correlation between exfoliatio linguae areata and atopy].

One hundred thirty-two atopic patients have been investigated for coincidental tongue lesions. There was a significantly increased frequency of exfoliatio linguae areata (35.7%) amongst the patients when compared to a control group. These results let suggest that exfoliatio linguae areata is a possible manifestation of atopy. Psychosomatic factors which probably contribute to both exfoliatio linguae areata and atopy are suggested to explain the high incidence of this anomaly of the tongue in atopics.

Adolescent↗
PubMedDate not supplied

Screening for atopy in a coffee processing factory.

Screening for blood IgE mediated allergy (atopy) by the RAST technique among 76 people working in a coffee processing factory showed rather unexpected findings: although we found a prevalence of positivity (17.1%) to the common airborne antigens (pollens, mites, cat, Alternaria tenuis) which was close to the prevalence of atopy among normal adults in our area (19.3%), only one case of allergy to green coffee and two cases to castor bean came to the fore. Specific IgG4 antibodies were measured only for castor bean and green coffee, and rather elevated figures were found: green coffee 17.1%, castor bean 13.1%. The occurence of positive RASTs to castor bean is more likely to be due to contamination of the bags containing green coffee. The low prevalence of RAST positivities to green coffee, and the elevated specific IgG4 antibodies to both castor bean and green coffee antigens, raise several possibilities which are discussed; however, all the subjects but one having elevated specific IgG4 levels to green coffee worked in more exposed areas. Probably IgG4 antibodies in this particular case are acting as blocking antibodies.

Adolescent↗
PubMedDate not supplied

Cord blood mononuclear leukocytes of neonates at risk of atopy have a deficiency of arachidonic acid.

Essential fatty acids and their delta-6-desaturated derivatives are major components of cellular membrane phospholipids, contributing to their stability and functions. They are also precursors of inflammation mediators such as prostaglandins and leukotrienes, and are involved in cellular immunoregulation. Recent studies have stressed the importance of essential fatty acids in various diseases. Patients with atopic dermatitis have altered essential fatty acids levels in plasma and a clinical improvement has been shown after oral administration of essential fatty acids. The aim of our study was to investigate the distribution of essential fatty acids in the membranes of cord blood mononuclear leukocytes of newborns at risk of atopy, and to correlate the levels of essential fatty acids at birth with total IgE values and with the onset of atopic disease. Newborns at risk of atopic disease have a significant reduction in arachidonic acid in the membranes of cord blood mononuclear leukocytes. Our data show a significant decrease in arachidonic acid in neonates at risk of atopy, suggesting that the abnormality of essential fatty acids is a primary phenomenon associated with atopic status.

Arachidonic Acid↗
PubMed1994

Factors influencing the occurrence of airway hyperreactivity in the general population: the importance of atopy and airway calibre.

The factors that determine the occurrence of airway hyperreactivity in the general population are not clearly understood. This study was designed to assess the independent effects of age, atopy, smoking and airway calibre. In a random sample of 2,415 adults aged 18-70 yrs we measured reactivity to methacholine as the dose provoking a 20% fall (PD20) in one-second forced expiratory volume (FEV1), atopy as the mean skin wheal response to three common environmental allergens, and airway calibre as the baseline FEV1 in absolute terms, as percent predicted (FEV1 % predicted) and as percent forced vital capacity (FEV1 % FVC). Hyperreactivity, defined as a PD20 < or = 12.25 mumol, was present in 314 (13%) of the sample, and before adjustment for FEV1 was more common in females (independent odds ratio (OR) = 2.05 (95% confidence interval 1.6-2.7)), current smokers (OR = 1.89 (1.3-2.6)), atopics (OR = 1.39 (1.3-1.5) per mm skin wheal), and in older age groups (OR for age 60-70 yrs relative to 18-29 yrs = 2.70 (1.7-4.3)). However, the odds of hyperreactivity were also strongly and independently related to absolute FEV1 (OR = 0.46 (0.27-0.77) per litre), FEV1 % predicted (OR = 0.96 (0.94-0.98) per percent), and FEV1 % FVC (OR = 0.92 (0.90-0.94) per percent; combined chi-square on 3 df = 312, p << 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Asthma and atopy as diseases of unknown cause. A viral hypothesis possibly explaining the epidemiologic association of the atopic diseases and various forms of asthma.

The basic etiology of asthma and atopy is unknown. Family grouping of cases is evident and has led to the assumption that genetic predisposition to making excessive IgE responses and in some cases a genetically determined tendency to have irritable bronchi are the fundamental causes of these conditions. Interplay between these hereditary predispositions and environmental factors such as allergen exposure are thought to explain all of the characteristic findings. Many cases, however, develop without a positive family history, and there are a variety of findings not easily explained by current theory. The increasing incidence of these conditions makes it necessary to question long held assumptions and explore other hypotheses. A review of difficult to explain characteristics and epidemiology of asthma and atopy makes a hypothesis involving a transmissible agent or agents plausible enough to warrant serious consideration.

Asthma↗
PubMed1994

Differences in IL-4 release by PBMC are related with heterogeneity of atopy.

Atopy is heterogeneous and the IgE immune response of patients allergic to a single allergen (monosensitized) differs from that of those allergic to multiple allergens (polysensitized). Since interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) regulate human IgE synthesis in vitro, we determined whether cytokines may be involved in the heterogeneity of atopy by comparing the serum IgE and sCD23 titres to the cytokine profile of T lymphocytes from 44 atopic patients (13 mono- and 31 polysensitized) and seven non-atopic subjects. Monosensitized patients were allergic to grass or cypress pollens or house dust mites, and polysensitized ones to many pollen species (n = 5) or many allergens (n = 26). Total serum IgE was lower in the control group than in both atopic groups and in the monosensitized group than in the polysensitized one. IgE immunoblots to orchard grass pollen and house dust mites were less heterogeneous in the monosensitized group than in the polysensitized one. IL-4 production by in vitro-activated peripheral blood mononuclear cells (PBMC) was significantly higher in the polysensitized group than in the monosensitized, and marginal in the control group. In contrast, IFN-gamma production was strongly reduced in both atopic groups, and IL-2 production comparable in the three groups. IgE and soluble CD23 (sCD23) release was higher in the atopic groups than in the control, and higher in the polysensitized group than in the monosensitized one. This study shows that PBMC of mono- and polysensitized subjects have a different IL-4 and sCD23 profile and suggests that human beings may be classified into high and low IgE responders on the basis of IL-4 production.

Adolescent↗
PubMed1994

[Mechanisms of bronchial hyperreactivity: role of airway inflammation and atopy].

The mechanisms of airway hyperresponsiveness are numerous and complex. The inflammatory process is one of the most important. It is characterized by epithelial damage and sloughing, by cellular infiltration of the bronchial mucosa and submucosa and by anatomical modifications of the bronchial wall. The cellular infiltrate is characterized by the presence of eosinophils, lymphocytes, monocytes-macrophages and mast cells. These cells are activated and release bronchoconstrictor and proinflammatory mediators. Eosinophils have toxic effects on the bronchial epithelium through the release of basic proteins, while lymphocytes play a central role through the release of cytokines, which can activate and recruit other cells. Mast cells have an important role of starter of the reaction but may also maintain it. Allergen inhalation in the laboratory, when a late response occurs, is responsible for an inflammatory reaction comprising eosinophil influx and activation and T lymphocyte activation. The intensity of the reaction is related to the transient increase in airway hyperresponsiveness confirming the important role of atopy and allergic reactions in airway hyperresponsiveness. However the same kind of inflammatory reaction can be present without atopy and antiinflammatory treatments, even if they reduce airway hyperresponsiveness, may not completely abolish it. This emphasises the complex mechanisms involved in persistent airway hyperresponsiveness.

Asthma↗
PubMed1996

Allergen avoidance in the primary prevention of atopy.

Atopy development cannot yet be predicted with certainty, and primary prophylaxis has to be directed at every 'at-risk' infant. However, substantial progress has been made in identifying environmental factors associated with allergic disorders. The process of sensitisation to common allergens may begin in utero. The influence of adjuvants, especially passive smoking, is considerable in individuals with established atopic disease. This article examines the role of intervention during pregnancy and the first year of life in the primary prevention of atopy and suggests a number of measures based on the current evidence.

Air Pollutants↗
PubMed1996

Serum IgE levels, atopy, and asthma in young adults: results from a longitudinal cohort study.

To explore the natural history of asthma and its relation to allergic responses, we examined the relation between total serum IgE in early adulthood and a history of respiratory symptoms, airway hyperresponsiveness (AHR), and atopy during childhood. We studied 180 subjects aged 18-20 years who had been studied since the age of 8-10 years. We measured wheeze in the previous year by questionnaire, AHR by histamine inhalation test, atopy by skin prick tests, and serum IgE levels by immunoassay. Subjects with AHR in early adulthood had higher IgE levels (mean 257.0 IU/ml) than subjects with past AHR (mean 93.3 IU/ml) or with lifelong normal responsiveness (mean 67.6 IU/ml) (P < 0.001). Subjects who had symptoms had higher IgE levels (mean 125.9 IU/ml) than those who were lifelong asymptomatic (mean 63.1 IU/ml) (P < 0.001). Recent wheeze, AHR, and allergic sensitization all had a positive relation to serum IgE, but IgE was not more predictive of AHR than skin prick tests. The finding that young adults who are sensitized to common allergens are highly likely to have AHR even in the absence of symptoms is further evidence of the fundamental role of IgE-mediated responses in the natural history of AHR throughout childhood and into adulthood.

Adolescent↗
PubMedDate not supplied

Basophil count in neonates is not suitable for atopy predictivity.

Basophil granulocytes and their mediators are involved in the pathogenesis of allergic inflammation. We evaluated basophil count, blood histamine content, eosinophil count and serum total IgE levels in one hundred-thirteen healthy newborns at birth. 102 children were prospectively studied with a follow up to 18 months of age for development of atopic disorders. No difference was found in newborns with biparental family history of atopy (FHA) in comparison with newborns with monoparental FHA and with newborns without FHA. Children who developed atopic disorders had neonatal basophil counts higher than those who did not develop atopic symptoms (p = 0.03). No significant correlation was found between basophil and eosinophil counts (rs = 0.013), between basophil count and serum total IgE levels (rs = 0.012) and between basophil count and blood histamine content. Positive predictive value and sensitivity of basophil count for allergy up to 18 months of age was only 33% and 27%, respectively. Our data indicate that an increased basophil count at birth is not associated with FHA and is not a good predictive marker of atopy.

Basophils↗
PubMed1996

Survey of gastrointestinal reactions to foods in adults in relation to atopy, presence of mucus in the stools, swelling of joints and arthralgia in patients with gastrointestinal reactions to foods.

BACKGROUND: Food intolerance in adults is mostly associated with vague symptoms and not clearly related to atopy and food allergy. A combination of different pathogenetic mechanisms may be responsible for the symptoms. OBJECTIVE: The aim of this study was to describe patients with a history of food-related gastrointestinal symptoms in relation to the presence of mucus in the stools, joint swelling and arthralgia and to determine whether or not there is an association between the presence of these parameters, atopic disease and the presence of immune complexes in serum. METHODS: Fifty-eight patients consecutively referred to our clinic with food-related gastrointestinal symptoms were investigated. RESULTS: Thirty-five patients (60%) had mucus in their stools, 24 patients (41%) complained about joint swelling and 41 patients (71%) had arthralgia. There were no correlations between these parameters and atopy according to Phadiatope test or skin prick test (SPT). No correlations were found between the occurrence of mucus in the stools, arthralgia and joint swelling. There were significantly higher levels of circulating immune complexes in patients with a history of arthralgia compared with patients with no such history (P < 0.03) and the number of individuals with the presence of such immune complexes was higher among the patients with arthralgia than among the patients without. In general the patients did not relate the exposure to certain foods to symptoms like joint swelling, arthralgia and presence of mucus in the stools. However, there were significant positive correlations between food-related gastrointestinal symptoms in the following instances: chocolate-induced gastrointestinal symptoms and mucus in the stools (P = 0.006), vegetable-induced gastrointestinal symptoms and mucus in the stools (P = 0.002) and meat-induced gastrointestinal symptoms and mucus in the stools (P = 0.003). In a group of individuals without food-related symptoms investigated separately, a very low frequency of mucus in the stools, joint swelling and arthralgia was seen (none, two and three individuals of the 20 subjects, respectively). Of 41 patients with immediate onset of gastrointestinal symptoms, 20 were atopic according to Phadiatope and SPT. Of 11 patients with late onset of symptoms 10 were negative in Phadiatope and SPT (P < 0.05). The most frequently involved foods were fruits, vegetables, milk, fish and meat. CONCLUSION: The results suggest the involvement of different inflammatogenic mechanisms in food-related gastrointestinal symptoms.

Adolescent↗
PubMed1997

Predictability of early atopy by cord blood-IgE and parental history.

BACKGROUND: Atopic family history and cord blood IgE have been used as predictors of atopic disease in newborns for about 20 years, but at least for cord blood IgE the sensitivity has been shown to be very low. The objective of this paper was to evaluate whether parental history and cord blood-IgE were more accurate predictors for the appropriate atopic phenotypes in the infants rather than for any atopy. METHODS: A total of 1314 newborn infants was recruited in six German obstetric departments in 1990 and followed-up for 2 years. Four hundred and ninety-nine (38%) were at high risk for atopy with at least two first degree atopic family members and/or elevated cord-blood IgE concentrations. RESULTS: The cumulative incidence of atopic dermatitis over the first 2 years of life (AD24) amounted to 20.1%, and there was a significant association with AD history of the mother (OR 2.5, 95%CI 1.46-4.26) and of the father (OR 3.53, 95%CI 1.90-6.54). The cumulative incidence of recurrent wheezing in the first 2 years of life (RW24) amounted to 16.1%, and was positively associated with asthma history (OR 2.11, 95%CI 1.33-3.60) and sensitization history (OR 1.64, 95%CI 1.34-2.36) of the mother, but with neither for the father. RW24 was less prevalent in girls than in boys (OR 0.64, 95%CI 0.47-0.89). Thirty-one per cent of infants were sensitized (CAP test value > 0.35 kU/L) against at least one of nine food or inhalative allergens (S24) and this was significantly associated with cord blood-IgE value (OR 2.43, 95%CI 1.69-3.49), and sensitization history of the mother (OR 1.64, 95%CI 1.18-2.41). Using multiple logistic regression analysis, the prediction of AD24 by AD of parents, of RW24 by asthma of parents, and of sensitization by cord blood IgE was of low accuracy. CONCLUSION: The predictive capacity of parental history and cord blood IgE is not high enough to recommend them as screening instruments for primary prevention. The majority of atopic manifestations and of sensitization occur in infants with no demonstrable risk at birth.

Adult↗
PubMedDate not supplied

Atopy and bronchial hyperresponsiveness in pure extrinsic childhood asthma.

Nonspecific bronchial hyperresponsiveness and atopy are considered risk factors in the development of asthma. Bronchial responsiveness to allergens could be the most important factor in extrinsic asthma. The trial was designed to investigate the role of specific and nonspecific bronchial responsiveness and atopy in a pure model of extrinsic asthma in children. One hundred and thirty-seven patients with pollen allergy were evaluated. Twenty children with allergy to grass pollen (Lolium perenne) alone, with symptoms only in the grass pollen season, were selected. Their score of symptoms, airway responsiveness to methacholine in and out of season, airway responsiveness to Lolium perenne out of season, and total and specific IgE were assessed. Twelve were male and eight female. Mild asthma was observed in 14, and moderate asthma in six. Age of onset of symptoms ranged from three to 13 years of age. Significant seasonal increase in airway responsiveness to methacholine was found (p = 0.002). Specific bronchial challenge test was positive in all patients. Lolium pernne PD20 ranged from 2.3 to 155.5 inhalation units. An inverse association between age of onset of symptoms and severity of asthma was shown (p = 0.001). Increase in nonspecific bronchial responsiveness was related to the appearance of symptoms during the spring, but it showed no relationship to the severity of symptoms. Severity of asthma during the spring correlated with the intensity of allergen airway responsiveness (p = 0.02). Levels of total and specific IgE were not related to the degree of specific or nonspecific airway responsiveness. Severity of extrinsic childhood asthma is determined by bronchial response to allergens. Bronchial hyperresponsiveness to methacholine during the spring can be the consequence of environmental exposure to allergens. The intensity of airway responsiveness to methacholine has no predictive value in the severity of pure extrinsic childhood asthma.

Adolescent↗
PubMed1997

ALATOP-RIA in the screening of atopy in a non Caucasian population.

UNLABELLED: ALATOP is an "in vitro" radioimmunoassay screening test for atopy, previously validated in a caucasian population. The aim of the study was to assess the usefulness of a screening test of atopy in a non caucasian population. We select a non caucasian population (n = 208), from hospital immunoallergy consultations, Cape Verde Republic (Africa). It was determined the sensitivity, specificity and predictive values comparing with skin prick tests (SPT) results for the 208 patients, and with clinical data (Clin) in 115 patients. It was also determined the levels of total IgE, done by IRMA. RESULTS: Using different corrections factors, 0.85 gives the best results: ALATOP/SPT-Sensitivity-88.5% +/- 4.34; Specificity-73.8% +/- 8.41; Positive predictive value-66.9%; Negative predictive value-91.4%; Efficiency of the test-79.3%. ALATOP/CLIN-Sensitivity-95.2% +/- 3.89; Specificity-71.2% +/- 12.07; Positive predictive value-65.6%; Negative predictive value-96.2%; Efficiency of the test-80.0%. The mean values of total IgE were-406 IU/ml. CONCLUSIONS: The mean value of total IgE was significantly increased even in the ALATOP-/SPT-not saw in caucasian populations. The use of a different correction factor (0.85) for ALATOP, optimize the test, showing a good negative predictive value, but raises the question of adapted compositions of screening tests for different populations.

Adolescent↗