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PubMed2002

Use of recombinant proteins in antibody tests for bovine tuberculosis.

Tuberculosis (TB) in cattle remains a major zoonotic and economic problem in many countries. Since the standard diagnostic assay, the intradermal test (IDT) with bovine PPD tuberculin, has less than optimal accuracy in all situations, other diagnostic methods such as serological assays have been investigated. Because of fundamental concerns for the low sensitivity and specificity of previous ELISA protocols, a profiling ELISA with nine purified, recombinant proteins of TB complex mycobacteria, was employed on samples from four groups of cattle: (a) naturally Mycobacterium avium-exposed and experimentally Mycobacterium bovis-infected, (b) officially-certified TB-free herds, (c) exposed to M. bovis in two field TB outbreaks and scored as bovine reactors in the gamma-IFN assay for bovine TB, (d) paratuberculosis (para TB)-infected. The described ELISA proved to be highly specific. In fact, the antibody (Ab) response could be consistently detected in 3 out of 3 endotracheally-infected calves and in 1 out of 3 contact-infected calves. There was also a very low prevalence of low-titered, non-specific Ab responses in paraTB-infected animals. As for the animals exposed to field TB outbreaks, 16 out of 28 gamma-IFN positive cattle were also Ab-positive; importantly, 7 out of 12 gamma-IFN positive, IDT-negative cattle showed Ab responses to TB proteins. In general, the profile of the Ab response varied among animals; the reaction to single recombinant antigens was sometimes transient and fluctuating, whereas the panel of antigens on the whole was indeed more effective in Ab detection.

Animals↗
PubMed2004

[Adverse reaction to the azo dye Pigment Red 170 in a tattoo].

A 30-year old white male presented with sharply demarcated pruritic lesions in a black and red tattoo on his wrist. The strongly infiltrated and slightly scaly eruptions started four months after tattoo application and were notably restricted to the red-colored areas. Symptoms got worse after UV exposure. Patch testing and photo patch testing with the used azo dye Pigment Red 170 (C.I. 12475) was negative. Histology revealed lichenoid dermatitis without signs of a granulomatous reaction. The verification of allergic sensitization in hypersensitivity reactions to tattoos by patch testing may be difficult due to the poor penetration into the skin of the applied azo pigments. Intradermal testing may be more sensitive but bears the risk of long lasting skin reactions.

Adult↗
PubMed1996

Fel d 1 peptides: effect on skin tests and cytokine synthesis in cat-allergic human subjects.

We tested peptide immunotherapy in cat-allergic humans, using a formation of two synthetic peptides, IPC-1 and IPC-2, each of which is 27 amino acids long and contains T cell-reactive regions of Fel d 1, the major cat allergen. In this exploratory, randomized, double-blind, parallel-group study, 42 subjects received s.c. injections of treatment peptides 250 micrograms or placebo weekly for four consecutive weeks. Changes in immediate- and late-phase skin test reactivity, and in antigen-driven cytokine synthesis were assessed. Epicutaneous (end-point titration) and intradermal tests were performed with cat extract (ALK SQ Cat Hair) containing Fel d 1, before the first injection, then 2, 6 and 24 weeks after the fourth and last injection of peptides or placebo. IL-4, IL-10 and IFN-gamma expression by circulating peripheral blood mononuclear cells (PBMC) in response to cat extract was measured using short-term bulk culture of PBMC and short-term limiting dilution analysis. Subjects who received peptide immunotherapy did not tolerate significantly more cat extract containing Fel d 1 in the skin tests 2, 6 or 24 weeks after the last injection than they did at baseline, and their late-phase responses did not decrease significantly compared to baseline. Substantial IL-4, IL-10 and IFN-gamma responses were observed following primary culture of cat antigen-stimulated PBMC; however, the intensity of cytokine synthesis and the IFN-gamma: IL-4 ratio were unchanged in peptide- and placebo-treated groups 6 and 24 weeks after the last injection. A few hours after the injections, subjects receiving peptides reported more allergic rhinitis and asthma symptoms and more pruritus than those receiving placebo. We conclude that under the conditions tested, peptide immunotherapy did not reduce immediate- or late-phase skin reactivity to cat extract containing Fel d 1 or modify cat antigen-specific cytokine production significantly.

Adult↗
PubMed1996

Flare-up at contact allergy sites in a gold-treated rheumatic patient.

Contact allergy to gold sodium thiosulfate and gold sodium thiomalate was established by skin testing in a rheumatic patient intended for gold therapy. An intramuscular test dose of gold sodium thiomalate (Myocrisin) induced a flare-up of previously positive epicutaneous and intradermal test reactions, with a histological and immunohistochemical picture compatible with an allergic contact dermatitis. Since gold allergy is frequent, the cutaneous side-effects of gold therapy ("gold dermatitis") may be explained by such an immunopathological reaction.

Antirheumatic Agents↗
PubMed1976

[Childhood sarcoidosis (author's transl)].

Between 1972--1974 26 children (15 boys and 11 girls) aged 11--14, with sarcoidosis were observed in county Szabolcs-Szatmár, Hungary. The number of cases varied between 1--6 per year, so the incidence of sarcoidosis is about 2--11/100000 for the age group 10--14 years of this county. Sarcoidosis was detected because of complaints in 4 cases, and by mass radiographic surveys in 22 cases. In each of the patients the thoracic form of sarcoidosis was in the foreground (in 6 cases mild bilateral hilar adenopathy, in 2 cases only unilateral hilar adenopathy, in 18 cases typical BHL-syndrome sometimes with "tumorous" adenopathy and in 7 cases out of the 18, hilar adenopathy and mottling in the lungs). The laboratory data were an unsatisfactory basis for the diagnosis. The tuberculin test was negative in 65 per cent. There was no proof for infection with atypical mycobacteria by intradermal tests. The most important basis of diagnosis was the biopsy (mediastinoscopy), especially in cases of simultaneous infection with tuberculosis. Prednisone treatment was carried out in the first place in cases of adenopathy and mottling, and in the cases of elevated serum calcium. Prednisone resistance was observed in two cases; in one of the patients it was secondary since it manifested itself only at the relapse of the BHL-syndrome; in the other patient the drug resistance was primary.

Adolescent↗
PubMed1988

Unusual lesion morphology and skin test reaction for Mycobacterium avium complex in macaques.

Three rhesus (Macaca mulatta) and one cynomolgus (M. fascicularis) monkey were euthanized because of positive reactions to intradermal tests with mammalian Old Tuberculin (mOT). All the animals had gross or microscopic lesions consisting of unitized macro- or microgranulomas with central necrosis, involving the lung or mesenteric lymph nodes. Small numbers of acid fast organisms were demonstrated in the lesions. Mycobacterium avium complex, serotype 2 was isolated from three of the cases. The cases were unusual because the lesion morphology and mOT hypersensitivity were more typical of mammalian tuberculosis than avian tuberculosis in monkeys.

Animals↗
PubMed1989

Skin test reactions to a phenol-soluble antigen of Brucella abortus among veterinary students, Lyon, France, 1984.

In December 1984, 424 students at the National Veterinary College, Lyon, France, were skin-tested with a phenol-soluble antigen of Brucella abortus B19. Of all students, 2.6% had a positive intradermal reaction indicating previous contact with Brucella. Prevalence of positive reactions was significantly lower among students from the three first school years (less than 2%) compared with students in their last school year (5.9%). These results are discussed and compared to the prevalence of brucellosis among cattle. Specificity (94%) of the intradermal testing resembles that of serological testing but its sensitivity (75%) seems to be better.

Brucella Vaccine↗
PubMed2006

Hypersensitivity reactions to iodinated contrast media.

Adverse reactions after iodinate contrast media (ICM) administration have been observed, which can be classified as immediate (i.e., occurring within one hour after administration) and delayed or non-immediate (i.e., occurring more than one hour after administration). Even though the incidence of ICM adverse reactions has been significantly reduced by the introduction of non-ionic compounds, immediate reactions still occur in about 3% of administrations. Different pathogenic mechanisms have been suggested for ICM reactions, including immunologic ones. Basophils and mast cells participate in immediate reactions through the release of mediators like histamine and tryptase, whereas a T-cell-mediated pathogenic mechanism is involved in most non-immediate reactions, particularly maculopapular rashes. Skin tests and specific IgE assays are carried out to diagnose immediate hypersensitivity reactions, while both delayed-reading intradermal tests and patch tests are usually performed to evaluate non-immediate reactions. However, in vitro specific IgE assays are not commercially available. As far as in vitro tests are concerned, a response involving ICM-related T-cell activity may be assessed by the lymphocyte transformation test. Allergologic evaluation appears to be indicated in hypersensitivity reactions to ICM, although the sensitivity, specificity, and predictive values of allergologic tests have not yet been established. This paper summarizes the current state of the art and addresses the research that is still needed on the pathogenic mechanisms, diagnosis, and prevention of ICM-induced hypersensitivity reactions.

Contrast Media↗
PubMed1989

Relationship between schistosomiasis and arthropathy.

This study was carried out to suggest criteria for diagnosing arthritis associated with schistosomiasis. 180 cases were classified into three clinical groups, 120 schistosomal arthritic group (I), 20 schistosomal non-arthritic (II), 20 arthritic non-schistosomal (III) and 20 controls (IV). Four tests were done to exclude other causes of arthritis namely, Erythrocyte sedimentation rate (ESR), Rose-Waaler test (RW) for rheumatoid factor (RF), antinuclear antibody test (ANA) and determination of serum uric acid (SUA) level. A history, clinical examination, urine and stool examination, intradermal test (IDT), indirect haemagglutination test (IHAT), circumoval precipitin test (COPT) and complete blood picture, were performed for all groups. 20 patients were selected randomly from group I and received praziquantel to be followed up 6 months later. Bilharzial ova were found in the excreta of group I and II. The percentage of positive IDT, IHAT and COPT in I & II was 90.8%, 90%, 88.3% and 85% respectively. Blood picture showed mild anaemia and from low to moderate eosinophilia. ESR was moderately raised. RF positivity was 6.6%, 10%, 65% and 5% in the four groups respectively. ANA positivity was 1.6%, 0%, 50% and 0% respectively. There was a marked improvement of arthritic manifestations after praziquantel in 90% of cases.

Arthritis, Infectious↗
PubMed1996

Clinical reactions to systemic provocation with gold sodium thiomalate in patients with contact allergy to gold.

In a double blind experimental study, 20 patients with a contact allergy to gold sodium thiosulphate were challenged intramuscularly with the chemically similar gold sodium thiomalate and with placebo. The most spectacular clinical reaction in the 10 patients given the active agent, was an epidermal and dermal flare up of healed patch-test reactions to the gold salts, as well as a high, but transient, rise in body temperature. Previous intradermal tests were similarly reactivated. In addition, toxicoderma-like rashes were observed in several cases, but a flare up of a previous contact dermatitis site was seen in one patient only. The specificity of the positive provocations was demonstrated.

Adult↗
PubMed1984

[Prevalence Of Intestinal Helminthic Infections And Skin Tests For Paragonimus And Clonorchis In Tuberculosis Patients]

This study was conducted to evaluate prevalence of intestinal helminthic infections and skin tests and Paragonimus and Clonorchis in tuberculosis(TB) patients in Korea. Stool examinations by formalin-ether technique and intradermal tests were carried out in 2 areas; Masan TB hospital and Kong-Ju TB hospital. 1. The positive rate of intestinal helminths of any kind was 51.7 % among 329 patients in Masan hospital, but 18.1 % among 215 patients in Kong-Ju hospital. 2. The infection rates of Trichocephalus trichiurus and Clonorchis sinensis were 20.7 % and 17.6 % respectively in Masan hospital patients, but the infection rates of T. trichiurus and C. sinensis were 6.5 % and 6.0 % respectively in Kong-Ju hospital patients. 3. In skin tests, positive reactions to Paragonimus and Clonorchis antigens were 22.0 % and 37.6 % respectively in Masan hospital patients. On the contrary, Kong-Ju hospital patients showed the positive rates of 15.2 % for Paragonimus and 27.2 % for Clonorchis respectively.

Journal Article↗
PubMed1991

Egg hypersensitivity and measles-mumps-rubella vaccine administration.

Because reports have described egg-sensitive individuals in whom anaphylaxis developed after measles vaccination, current recommendations include delaying administration of egg-derived vaccines until skin testing can be performed. Specifically, the 1988 Red Book recommends skin testing via scratch, prick, or puncture with 1:10 dilution of the vaccine and, if the result is negative, intradermal testing is suggested. The purpose of this study was to evaluate the likelihood of reaction to measles-mumps-rubella (MMR) vaccine in patients with documented egg sensitivity and to delineate the efficacy of skin-prick testing (SPT) to MMR as a predictor of hypersensitivity to the vaccine. Egg sensitivity was documented by initial SPT to egg and then, if possible, double-blind placebo-controlled food challenge (DBPCFC). Patients with a positive DBPCFC to egg or a history of anaphylactic egg sensitivity had a SPT with the MMR vaccine and then were given the MMR vaccine. Additionally, children with atopic dermatitis who had been previously proven egg sensitive via DBPCFCs were evaluated retrospectively for sensitivity to the MMR vaccine. Sixteen children with a history of egg sensitivity underwent SPT to egg, with a positive result 3 mm greater than the negative control found in 12 patients. Eight of these children had a positive DBPCFC to egg. The SPT to MMR vaccine was negative in all 16 children; vaccine administration followed with no resultant systemic problems. Three children had a local reaction at the site of injection. Twelve additional children with atopic dermatitis and egg sensitivity were reviewed. Each child had a positive SPT and DBPCFC to egg.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1979

Human pulmonary dirofilariasis presenting as a solitary pulmonary nodule.

A case of human pulmonary dirofilariasis had positive serologic testing postoperatively. Increased awareness of this entity as a cause of solitary pulmonary nodules may lead to preoperative serologic and intradermal testing, and to the possibility of arriving at a preoperative diagnosis.

Diagnosis, Differential↗
PubMed1987

Patients with bone marrow failure demonstrate decreased cutaneous reactivity to human C5a.

In vivo studies have shown that human C5a, a potent complement-derived anaphylatoxin and chemoattractant, produces immediate inflammatory reactions following intradermal injection in human skin. At concentrations within its potential physiologic range, intradermal injection of C5a elicits immediate wheal and flare reactions, increased vascular permeability, mast cell degranulation, and neutrophil-rich infiltrates. To assess the relative contribution of interacting cellular elements to C5a-induced inflammation in normal human skin, purified human C5a was tested intradermally in 8 patients with bone marrow failure (BMF). Reactions to C5a in patients with BMF were compared with responses at identical test sites in healthy volunteers and other patients with cutaneous disorders. Patients with BMF demonstrated significantly less wheal and flare reactivity following intradermal injection of C5a than controls (p less than 0.05 and less than 0.02, respectively). In these studies, patients with the greatest cytopenia generally showed the least cutaneous reactivity to human C5a. Biopsies of C5a test sites in patients with BMF revealed an absence of leukocytes in marked contrast to neutrophil-rich infiltrates observed at test sites in healthy volunteers. Avidin-fluorescent and/or Giemsa staining of skin biopsies revealed no difference between the number of dermal mast cells in patients with BMF and samples of normal human skin. In addition, skin test studies with histamine (2 micrograms) and morphine (5 micrograms) performed to assess cutaneous vascular and mast cell responsiveness in patients with BMF, normal volunteers and controls with rhinitis revealed no significant differences in cutaneous reactivity to these pharmacologic agents. These in vivo studies demonstrate that patients with BMF specifically exhibit decreased cutaneous reactivity to human C5a and suggest that neutrophils make an important and an immediate contribution to inflammatory responses elicited by this anaphylatoxin.

Adolescent↗
PubMed1987

Potentiation of inflammatory reactions in guinea-pig skin by an angiotensin converting enzyme inhibitor (MK 422).

There have recently been reports of persistent cough and increased broncho-obstruction likely to have been induced by ACE inhibitors. In order to study the effect of MK 422 (the active parent diacid of enalapril) on the inflammatory response, ovalbumin-sensitized guinea-pigs were tested intradermally with ovalbumin, capsaicin and bradykinin. All inflammatory responses were enhanced by treatment with MK 422 for 2 days prior to testing as compared to the responses of control animals. Infiltration of neutrophils, eosinophils, basophils and monocytes was increased following ovalbumin challenge in the MK 422-treated animals. We suggest that skin reactions and airway symptoms noticed during ACE inhibitor therapy might have been due to induced or potentiated inflammatory reactions in the skin or in the bronchial wall.

Allergens↗
PubMed2004

Immunophenotyping of the cutaneous cellular infiltrate after atopy patch testing in cats with atopic dermatitis.

Cats with spontaneously occurring atopic dermatitis have clinical and immunocytochemical characteristics compatible with these in humans with atopic dermatitis (AD). The atopy patch test (APT) has proven to be a valuable tool in elucidating the disease process in humans. Additionally, the APT is very specific and bypasses the problem of conflicting results due to differences in chronicity of lesions of AD patients. We adapted the APT for use in cats to explore the suitability of the APT as a tool to study the onset of allergic inflammation in cats with atopic dermatitis. APT were performed in AD cats (n = 6) and healthy cats (n = 10). All cats were patch tested with two allergens in three different dilutions and a diluent control. The allergens for the APT were selected from positive intradermal test and /or prick test results and consisted of: Dermatophagoides farinae, D. pteronyssinus, Tyrophagus putrescentiae, and a grass pollen mixture. APT were read after 10, 24 and 48 h, and punch biopsies for immunohistochemical evaluation were collected at these time points. Macroscopically positive APT reactions were observed in three out of six cats at 24 and/or 48 h with allergen concentrations of 25,000 and 100,000 NU/ml. Reactions were not observed at negative control sites and neither in control animals. A significantly increased number of IL-4+, CD4+, CD3+, MHC class II+ and CD1a+ cells was found in one AD cat with positive APT reactions. Five out of six AD cats had significantly increased IL-4+ T cell numbers at 24 and/or 48 h. Our data indicate that in cats, macroscopically positive patch test reactions can be induced, which have a cellular infiltrate similar to that in lesional skin. We found a high specificity and a macroscopically positive APT reaction in half of the cats, which is similar to what is seen in humans. Hence, the APT in cats might be a useful tool in studying the immunopathogenesis of feline atopic dermatitis.

Allergens↗
PubMed1991

Immunologic defects in patients with refractory sinusitis.

Sixty-one patients with chronic sinusitis who were referred for an allergy evaluation were evaluated for immunologic competence including assessment of quantitative serum immunoglobulin levels, IgG subclass levels, and response to pneumococcal and Haemophilus influenzae vaccines. In addition to chronic sinus disease, recurrent otitis media and asthma exacerbation were common problems in this group. Five patients had an elevated age-adjusted IgE level and 22 patients had positive prick tests to one or more environmental inhalants; these findings suggest an allergic component in this subgroup. Twelve additional patients had highly reactive intradermal tests to common environmental allergens, which also may be clinically significant for underlying atopy. Eleven patients had low immunoglobulin levels, 6 had low immunoglobulin levels and vaccine hyporesponsiveness, and 17 had poor vaccine response only. Thus, 34 of 61 patients with refractory sinusitis had abnormal results on immune studies, with depressed IgG3 levels and poor response to pneumococcal antigen 7 being most common. In addition to allergy, immunologic incompetence may be an important etiologic factor in patients with chronic, refractory sinusitis.

Adolescent↗
PubMed2001

Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions.

Skin testing with a suspected drug has been reported to be helpful in determining the cause of cutaneous adverse drug reactions (CADR). Many isolated reports of positive drug skin tests are published, but without detailed information concerning the clinical features of the CADR and the method used in performing drug skin tests, such data are not very informative. A working party of the European Society of Contact Dermatitis (ESCD) for the study of skin testing in investigating cutaneous adverse drug reactions, has proposed the herein-reported guidelines for performing skin testing in CADR in order to standardize these procedures. In each reported case, the imputability of each drug taken at the onset of the CADR and a highly detailed description and characterization of the dermatitis need to be given. Drug skin tests are performed 6 weeks to 6 months after complete healing of the CADR. Drug patch tests are performed according to the methods used in patch testing in studying contact dermatitis. The commercialized form of the drug used by the patient is tested diluted at 30% pet. (pet.) and/or water (aq.). The pure drug is tested diluted at 10% in pet. or aq. In severe CADR, drug patch tests are performed at lower concentrations. It is also of value to test on the most affected site of the initial CADR. Drug prick tests are performed on the volar forearm skin with the commercialized form of the drug, but with sequential dilutions in cases of urticaria. Intradermal tests (IDT) are performed with sterile sequential dilutions (10-4, 10-3, 10-2, 10-1) of a pure sterile or an injectable form of the suspected drug with a small volume of 0.04 ml. Drug skin tests need to be read at 20 min and also later at D2 and D4 for patch tests, at D1 for prick tests and IDT. All these tests also need to be read at 1 week. The success of skin tests varies with the drug tested, with a high % of positive results, for example, with betalactam antibiotics, pristinamycin, carbamazepine and tetrazepam on patch testing, or with betalactam antibiotics and heparins on delayed readings of IDT. The results of drug skin tests also depend on the clinical features of the CADR. The use of appropriate control patients is necessary to avoid false-positive results.

Drug Eruptions↗