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PubMed2006

[Severe anaphylaxis from rocuronium].

Muscle relaxant drugs are the most frequent cause of anaphylactic and anaphylactoid reactions during anaesthesia. We report a case of a life-threatening anaphylactic reaction during induction of anaesthesia with severe bronchospasm as the first clinical symptom. Mechanical ventilation was nearly impossible. The patient required a multimodal antiallergic therapy and a high-dose catecholamine therapy for stabilization. Rocuronium was identified as the allergic agent using intradermal testing.

Anaphylaxis↗
PubMed1990

Recurrent allergic vulvovaginitis: treatment with Candida albicans allergen immunotherapy.

Recurrent vaginal candidiasis is a difficult problem for many women who do not respond to the usual antifungal agents. Normally these women have recurrent disease for many years before they are referred for evaluation of local vaginal hypersensitivity. We evaluated 18 women with recurrent vulvovaginal candidiasis that was unresponsive to all other modalities of therapy and who were skin-test positive to Candida albicans with a positive prick test or intradermal skin test. Three patients had late-phase skin test reactions only. Of the 18 study participants, 16 responded with significant improvement in the mean incidence of episodes of vaginitis per year from 17.2 +/- 2.0 to 4.3 +/- 1.8 (p less than 0.0004). Overall, there was approximately 79% improvement in these patients. More than half the women were also atopic but were not first seen with these allergic symptoms. These data suggest that certain women who have chronic vaginal candidiasis may have a local hypersensitivity response to Candida that may improve with allergy immunotherapy with C. albicans extract. A double-blind, placebo-controlled trial in a homogeneous group of women with standardized extract is needed to establish this as a recommended form of therapy in this subgroup of patients.

Adult↗
PubMed1992

Variation in skin inflammatory responses between sheep bred for resistance or susceptibility to fleece rot and blowfly strike.

Sheep which have been bred for resistance (R) or susceptibility (S) to fleece rot and blowfly strike, were tested for intradermal inflammatory responses to excretory and secretory products of Lucilia cuprina larvae. R rams and lambs gave significantly larger skin weals than S animals. In addition, R and S rams were infected with L cuprina first instar larvae and wound exudates were collected. In the first 12 hours of infection R rams released significantly more exudate protein at the wound site than S rams. Correlations suggested that exudate production was stimulated by both larval burden and inflammatory responses, however, in the R group the inflammatory correlation was positive while in the S group it was negative. The results imply that inflammatory responses may play a role in innate resistance to L cuprina. The difference in inflammatory responses suggests genetic differences between the flocks and therefore could show some potential as a trait for indirect selection for resistance to fleece rot and body strike.

Animals↗
PubMed1978

Serological and clinical investigations of human hydatid case in Libya.

Fifty surgically confirmed cases of hydatid disease in Eastern Libya were investigated. Of these, 30 had cysts of the liver, five had extra-hepatic abdominal cysts and 15 had cysts in the chest, including the lungs. Ten cases of malignancy of the liver and five cases of malignancy of the lung were used as controls. Differential diagnosis of cancer was made by measuring the ESR and glycoprotein levels (elevated x 4 and x 3 respectively, in cancer cases). Serum bilirubin, SGOT, SGPT and serum alkaline phosphatase levels were also significantly raised in malignancy, while the total protein levels and eosinophilia were the same in both diseases. The intradermal test was positive in 88%, the haemagglutination test in 86% and the complement fixation test in 70% of cases. In the post-operative follow-up, complement-fixing antibodies disappeared somewhat faster than did the haemagglutinins. The positive skin test cases, however, remained positive throughout the 12-month follow-up period.

Blood Sedimentation↗
PubMed1989

Double-blind, placebo-controlled study of nicergoline in the treatment of pruritus in patients receiving maintenance hemodialysis.

Pruritus is a common symptom among patients undergoing long-term hemodialysis. The effect of nicergoline, an ergoline, on pruritus was studied in products released during dialysis. In a first experiment series, 20 age-matched normal individuals, 25 patients receiving hemodialysis without pruritus, and 15 patients receiving hemodialysis with pruritus had intradermal tests with 500 micrograms of papaverine. All patients with pruritus had a small papaverine skin test response, and mean values were significantly (p less than 0.0001, Mann-Whitney U test) smaller in patients with pruritus. All patients with pruritus entered in a crossover, double-blind trial with nicergoline. In a first period of six dialyses, they received either nicergoline (daily oral dose, 30 mg, and intravenous dose during dialyses, 5 mg) or placebo. In the second period of six dialyses, patients received the crossover treatment. Nicergoline was effective in 13/15 patients, eight of these patients having a complete remission of pruritus. When nicergoline was stopped, patients relapsed within 24 to 48 hours. All patients who improved during the trial were then treated with a daily dose of 30 mg of nicergoline for 6 months. Seven patients had a complete remission, five had moderate symptoms, and one patient relapsed. This study demonstrated that some hemodialyzed patients with pruritus of unknown etiology had improvement with nicergoline.

Adult↗
PubMed1991

Skin test reactivity in patients suffering from lung and breast cancer.

Mast cells and histamine-mediated reactions may be altered in patients with cancer. In an attempt to characterize the possible skin defects in patients with cancer, we tested 22 patients suffering from lung cancers, 30 from breast cancers, and 30 age-matched normal individuals, using several compounds, in investigating the pathophysiology of the skin response. Histamine hydrochloride (10 and 100 mg/ml) and codeine phosphate (9%) were tested by prick test. Substance P (50 and 500 ng per injection site), phentolamine (20 micrograms per injection site), and carbachol (1 microgram per injection site) were tested by intradermal skin tests. Skin mast cells were also microscopically examined in 10 patients with lung cancer, five with breast cancer, and 10 normal subjects. The mean wheal sizes induced by all the tested substances were similar in patients with cancer and chronic bronchitis and in normal individuals. The flare to histamine, codeine phosphate, and substance P was completely abolished in 7/22 patients with lung cancer, but the lack of flare was not related to the age of the patients, nor to the staging of cancer, nor to metastasis. The mean numbers of alcian blue-stained or toluidine blue-stained positive mast cells were similar in normal subjects and in subjects with cancer. This study does not confirm the skin hyporeactivity of patients with cancer.

Adult↗
PubMed1992

Immediate type of allergy in statis growers.

Three statis growers complaining of immediate allergic symptoms induced by harvesting statis in a plastic greenhouse were examined to clarify their allergic conditions. Distinct positive reactions in the intradermal test and nasal and eye provocation test to the statis extracts were shown in all three cases. High score of radioallergosorbent test (RAST) IgE and remarkable RAST inhibitory effects to the statis extracts were seen in these cases. The immunologic cross-reactivity between statis and chrysanthemum was absent in the RAST inhibition in the patient labeled case C who had complained of the same allergic symptoms when handling chrysanthemums in the off-season for harvesting statis. Those results indicated that the allergic conditions of the present cases were from an immediate type of allergy mediated by a specific IgE antibody to the statis extract.

Adult↗
PubMed1993

Comparisons of specific and nonspecific bronchoprovocation in subjects with asthma, rhinitis, and healthy subjects.

BACKGROUND: We studied subjects with atopic asthma, atopic rhinitis, and nonatopic healthy subjects to evaluate responsiveness to bronchoprovocation with both methacholine and allergen. METHODS: Subjects with a demonstrable FEV1 PD20 to methacholine or allergen (responders) were further analyzed for putative sensitivity (PD20 FEV1) and reactivity (dose-response slopes) to determine whether any characteristics could distinguish individuals with asthma from other responders. Subjects were recruited without sex restrictions and were between the ages of 18 and 45 years old. They were nonsmokers, had no other medical problems, and were free of upper respiratory infection for at least 6 weeks before challenge. All had a history taken, physical examination, limited laboratory screening, chest radiography, pulmonary function testing, and intradermal skin testing before admission to the study. RESULTS: Although the groups were significantly different in both sensitivity and reactivity to methacholine, responses to allergen bronchoprovocation were sufficiently similar between responders with asthma and those with rhinitis to prevent separation on the basis of either sensitivity or reactivity. The fall in FEV1 at the nadir of the late response, which was greater in the asthma group, was significantly correlated with sensitivity and reactivity of the immediate response to allergen but not to methacholine. Regression analysis demonstrated a stronger association between allergen and methacholine responsiveness in subjects with rhinitis than in subjects with asthma. CONCLUSION: We concluded that (1) nonspecific bronchial hyperresponsiveness fails to explain why patients with allergic asthma have clinical asthma as a result of allergen exposure and patients with allergic rhinitis do not; (2) hyperresponsiveness to allergen does not simply reflect quantitative or qualitative airway nonspecific hyperresponsiveness; and (3) clinical asthma may involve mechanisms difficult to elucidate by laboratory bronchoprovocation techniques.

Adolescent↗
PubMed1995

Immunological responses and protection against Mycobacterium bovis in calves vaccinated with a low dose of BCG.

Groups of calves (20 per group) were vaccinated subcutaneously with a single dose of BCG Pasteur (6 x 10(4) or 6 x 10(6) colony forming units) and two months later, 15 calves from each group were challenged intratracheally with virulent Mycobacterium bovis. Vaccination with either dose of BCG induced significant protection against the development of tuberculous lesions compared to non-vaccinated controls. Seven months after BCG vaccination, many of the vaccinated animals which had no lesions and were M. bovis culture-negative at necropsy showed positive reactions for M. bovis in three assays for measuring cellular immune responses (comparative intradermal test, interferon-gamma assay and lymphocyte proliferation assay). This effect was most noticeable in the BCG-vaccinated calves which had been challenged with M. bovis rather than in the non-challenged animals. Antibody responses to M. bovis were very low or absent in the calves during the study. The kinetics of the interferon-gamma response of peripheral blood lymphocytes cultured in vitro with bovine PPD showed that BCG vaccination induced a rapid rise in the response followed by a sharp decline, while infection with virulent M. bovis resulted in an increase in the interferon-gamma response by four weeks after challenge and this response remained high through the study.

Animals↗
PubMed2005

Immunodiagnosis and its role in schistosomiasis control in China: a review.

Parasitological techniques (stool examination and/or urine filtration) are still the diagnosis of choice in national schistosomiasis control programmes the world over. However, the success of current control efforts, mainly due to the large-scale administration of praziquantel, emphasises the need for a more sensitive approach. In addition, microscopy is labour-intensive and time-consuming, while declining compliance rates after repeated chemotherapy make good coverage for the long-term increasingly problematic. China's success in the control of schistosomiasis is contributing to an enhanced understanding of the need for better and more sensitive screening methods. Immunodiagnostic techniques have a high sensitivity, are easy to perform and are an excellent epidemiological tool for the screening of target populations in schistosome-endemic areas. These assays are also useful for the surveillance of cure after chemotherapy, and for periodic control of transmission of the infection after it has been eliminated in an area. A succinct historical background of using immunodiagnosis for schistosomiasis japonica in China is given, together with a review and evaluation of the relative efficacy of the main techniques applied, i.e. the intradermal test, the circumoval precipitation test, the indirect hemagglutination assay, the dye dipstick immunoassay and different kinds of enzyme-linked immunosorbent assay applications. The important role of immunodiagnosis in the screening for schistosomiasis in China is discussed.

China↗
PubMed2006

Biopotency and identification of allergenic proteins in Periplaneta americana extract for clinical applications.

Commercial cockroach extracts for diagnosis and therapy show batch-to-batch variation. This study aimed to standardize Periplaneta americana extract based on major IgE binding components using hypersensitive patients' sera. Extracts were prepared in phosphate buffered saline (PBS) or NH(4)HCO(3), from freeze-dried or 37 degrees C dried material and compared with commercial extracts by immunobiochemical methods. Cockroach positive patients' sera were collected after intradermal tests and specific IgE enzyme linked immunosorbent assay (ELISA). Allergenic proteins were identified by western-blotting and potency of extracts determined by ELISA-inhibition. Adult P. americana extract from freeze dried source material in PBS (PA extract) resolved into 45 protein bands and showed 22 IgE binding components with pooled patients' sera. It required 9-12 ng self-proteins for 50% ELISA-inhibition. Individual patients' sera identified 23, 28, 35, 38, 40, 49, 72, 78 and 97 kDa as major IgE binding components in PA extract. Nymph extract exhibited similar potency and protein profile to PA extract with 72 and 78 kDa proteins present in high intensities. Commercial extracts exhibited only 6-11 IgE reactive bands compared to PA extract and required 40 folds or more protein for 50% ELISA-inhibition. PA extract from freeze-dried source material seems a potent allergen preparation with 9-major IgE binding components. It can be referred to upgrade the quality of commercial extracts exhibiting low potencies due to poor quality source material, inadequate extraction procedures and improper storage.

Allergens↗
PubMed2006

Analysis of IgE binding proteins of mesquite (Prosopis juliflora) pollen and cross-reactivity with predominant tree pollens.

Pollen from the mesquite tree, Prosopis juliflora, is an important source of respiratory allergy in tropical countries. Our aim was to partially characterize the IgE binding proteins of P. juliflora pollen extract and study cross-reactivity with prevalent tree pollen allergens. Intradermal tests with P. juliflora and five other tree pollen extracts were performed on respiratory allergy patients from Bikaner (arid) and Delhi (semi arid). Prosopis extract elicited positive skin reactions in 71/220 of the patients. Sera were collected from 38 of these 71 patients and all demonstrated elevated specific IgE to P. juliflora. Immunoblotting with pooled patients' sera demonstrated 16 IgE binding components, with components of 24, 26, 29, 31, 35, 52, 58, 66 and 95 kDa recognized by more than 80% of individual patients' sera. P. juliflora extract is allergenically potent requiring 73 ng of self-protein for 50% inhibition of IgE binding in ELISA inhibition. Cross-inhibition assays showed close relationship among P. juliflora, Ailanthus excelsa, Cassia siamea and Salvadora persica. IgE binding components of 14, 41, 52 and 66 kDa were shared allergens whereas 26 and 29 kDa were specific to P. juliflora. The findings suggest that purification of cross-reactive allergens will be helpful for diagnosis and immunotherapy of tree pollen allergic patients.

Adolescent↗
PubMed2004

Simulation of alternatives for the Dutch Johne's disease certification-and-monitoring program.

To identify optimal method(s) for certification and subsequent monitoring of Mycobacterium avium subsp. paratuberculosis (Map)-unsuspected herds, certification-and-monitoring schemes were studied using a stochastic simulation model ("JohneSSim"). JohneSSim simulated the within-herd transmission and economic aspects of Map in closed Dutch dairy herds. The model was validated with field observations on Map-unsuspected herds. The current Dutch certification-and-monitoring schemes were compared with 11 alternative schemes in which individual and pooled fecal culture, ELISA, Johnin-intradermal test and gamma-IFN ELISA were used, varying the test frequency, tested age group and number of tested animals. On reaching the 'Map-free' status with the standard certification scheme, 11% of the simulated herds were not truly Map-free. Therefore, the designation 'Map-free' should be changed into, for instance, 'low-risk Map'. In the most-attractive alternative certification scheme, the 'Map-free' status was reached after four herd examinations (at 2-year intervals) consisting of serial testing of all cattle > or = 2 years of age with a pooled fecal culture and individual fecal culture of positive pools. This scheme resulted in lower total and annual discounted costs and a lower animal-level prevalence at reaching the 'Map-free' status compared to the standard scheme, assuming that there was no new introduction of the infection. Schemes to monitor the 'Map-free' status were compared, assuming that this status was reached with the standard certification scheme. In comparison to the standard monitoring scheme, none of the alternative monitoring schemes resulted in both a lower animal-level prevalence of undetected pre-existing Map infections in closed herds, and lower median annual discounted costs. Results of the model were very sensitive to the assumed sensitivity of the fecal culture test and to management measures that prevent within-herd transmission of Map. If these preventive measures were taken, the probability of undetected Map infections in closed 'Map-free' herds was decreased substantially.

Animal Husbandry↗
PubMed2004

The immunopathogenesis of flea allergy dermatitis in dogs, an experimental study.

In this study, we investigated the development of clinical disease and immune responses in the development of an experimental model of flea allergy dermatitis. Dogs were randomly divided into four treatment groups and were infested with fleas on two different feeding schedules (continuous and episodic). Group 1 consisted of four non-exposed dogs (negative controls) and Group 2 consisted of six dogs exposed to fleas continually. Groups 3 and 4 consisted of 14 dogs each that were exposed to fleas on an episodic schedule (two consecutive days every other week for 12 weeks). Group 4 also received intraperitoneal injections of a low dose of lectin (ricin) with immunomodulatory properties. The purpose of Group 4 was to investigate the effects of ricin on enhancing the development of clinical signs, flea antigen-specific IgE levels and altering the number of CD4+ and CD8+ T cell subsets in peripheral blood. Clinical signs developed in all flea exposed dogs, however, the dermatology lesion scores were less and shorter in duration for continuously exposed dogs compared to episodic exposed dogs, independent of ricin treatment. Lesion development was concentrated in the flea triangle and consisted principally of erythema, followed by alopecia, excoriation, papules, and crusts. CD4+ and CD8+ lymphocyte subsets or IgE levels were not altered by ricin treatment. Flea antigen-specific IgE values were highest in dogs exposed to fleas on a continuous basis compared to those episodically exposed. A greater percentage of clinical responder dogs with negative flea-specific IgE titers or negative intradermal test (IDT) were present in the episodic exposure groups than in the continuous exposure group. IgE titers corresponded slightly better with clinical responders than the IDT. The agreement between the IgE titers and IDT was good (weighted K = 0.67). Histopathology of skin samples were consistent with a Type I hypersensitivity. In conclusion, we were able to develop a model of flea allergy dermatitis by experimentally exposing dogs to fleas on an episodic and continuous feeding schedule. In this study, continuously exposed dogs did not develop immunotolerance, and ricin did not enhance the development of FAD.

Animals↗
PubMed2005

DNA vaccination against Japanese cedar pollinosis in dogs suppresses type I hypersensitivity by controlling lesional mast cells.

Sensitization to allergens of Japanese cedar pollen is known to cause canine atopic dermatitis as approximately 10% of atopic dogs in Japan were positive to the pollen allergen. Among the two major allergens of Japanese cedar pollen, since Cry j 1 is more important than Cry j 2 as an antigen to increase IgE in atopic dogs sensitized to Japanese cedar pollen, Cry j 1 can be a target for immunotherapy. In our study, efficacy of DNA vaccination with a plasmid containing the gene of a major allergen of Japanese cedar (Cryptomeria japnonica, CJ) pollen, Cry j 1, was examined using a dog model experimentally sensitized to CJ pollen allergen. Cry j 1 DNA plasmid and a vector plasmid (pCAGGS) were injected into six dogs and three dogs, respectively, five times with an interval of 1.5 month. After the treatment with Cry j 1 DNA plasmid, production of IgE against Cry j 1 decreased in four of the six dogs in the treatment group, whereas it increased in the three dogs of the control group. The reactivity to the pollen allergen in intradermal testing and provocation testing were obviously reduced in the treatment group, but not in the control group. The number of mast cells in alveolar area of the lung in the treatment group was smaller than that in the control group. Cry j 1 DNA plasmid was also injected into three atopic dogs sensitive to Cry j 1, resulting in improvement of clinical signs in the pollination season. These findings indicated that Cry j 1 DNA plasmid could regulate mast cell-mediated reaction against Cry j 1, which could be an alternative and effective treatment for CJ pollinosis.

Allergens↗
PubMed2004

Immunogenicity of recombinant Omp31 from Brucella melitensis in rams and serum bactericidal activity against B. ovis.

Detergent-extracted recombinant Omp31 (rOmp31 extract) from Brucella melitensis produced in Escherichia coli was previously identified as a protective immunogen against B. ovis in mice. In this study, we evaluated the immunogenicity of rOmp31extract in rams. This immunogen was emulsified in an oil adjuvant and administered three times with 4 and 8 weeks intervals. Antibody response was measured in serum by whole B. ovis ELISA. Specific antibodies to purified rOmp31 (pET-Omp31) were detected by Western blotting and indirect ELISA. In addition, isotype specific antibodies were measured in tears. Serum bactericidal activity against B. ovis in the presence of complement was measured in vitro. Cellular immune response was explored by intradermal testing with purified rOmp31. Immunization with rOmp31 extract induced IgG specific antibodies in serum able to bind to whole B. ovis cells. Furthermore, strong inhibition in a competitive ELISA (with an Omp31-specific monoclonal antibody) suggested that a proportion of Omp31-specific antibodies were directed against a loop containing a protective epitope. Serum antibodies killed efficiently B. ovis in vitro in the presence of either guinea pig or ovine serum. Tears had both IgG and IgA antibodies to equivalent titers. Finally, immunized rams showed skin reactivity to Omp31. These data demonstrate that B. melitensis Omp31, a protective antigen identified in the mouse model, induces antibody and cellular immune mechanisms in sheep.

Animals↗
PubMed1988

Thymostimulin treatment in AIDS-related complex.

Thirty-four patients with AIDS-related complex (ARC) were treated for 6 months with thymostimulin, a thymic hormone. Clinical and immunological findings after a 1-year follow-up were compared with those in 24 age- and sex-matched controls receiving no immunotherapy. Statistical evaluation after 6 and 12 months showed significant differences in the two groups. The thymostimulin-treated group had higher leukocyte and lymphocyte counts, more positivity in intradermal tests with multiple recall antigens, and less lymphadenopathy and weight loss. The number of OKT3+ and OKT4+ lymphocytes decreased significantly in the control group, but did not change in the thymostimulin-treated patients. Finally, after 18 months of follow-up, no progression to AIDS was seen among the treated subjects, whereas 3 of the controls developed the disease. We conclude that thymostimulin, alone or in combination with antiviral drugs, may be helpful in the management of ARC patients.

AIDS-Related Complex↗
PubMed1986

An investigation of the H1-receptor antagonist triprolidine: pharmacokinetics and antihistaminic effects.

A single oral dose of triprolidine hydrochloride, 0.04 mg/kg (mean dose 2.7 +/- SD 0.4 mg) was administered to seven healthy, fasting adult volunteers who had never been treated previously with H1-receptor antagonists. Blood sampling and intradermal tests with 0.01 ml of histamine phosphate (0.1 mg/ml) were performed at -0.25, 1, 2, 3, 4, 5, 6, 7, 8, and 12 hours after the dose. Wheal-and-flare circumferences were traced, and the areas were measured by planimetry. Pruritus was quantitated by use of a clinical score. Urine was collected in 6-hour pooled aliquots for a total of 24 hours. Serum and urine triprolidine concentrations were measured by high-performance liquid chromatography. Wheal-and-flare areas and pruritus decreased after the triprolidine dose. Suppression of mean flare size was statistically significant at 2, 3, 6 and 8 hours. Suppression of mean wheal size was not statistically significant at any time compared to predose values. The mean triprolidine serum half-life was 2.1 +/- 0.8 hours. The mean peak serum triprolidine concentration of 15.4 +/- 8.3 ng/ml occurred 2 hours after ingestion. No triprolidine was detected in the serum after 12 hours. The mean urinary excretion of unchanged triprolidine during 24 hours was 1.3 +/- 1.0% of the dose administered.

Adult↗