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PubMed1995

Routine intraoperative application of high-dose aprotinin in open heart surgery in adults: antibody formation after first exposure.

High-dose aprotinin is now routinely used in cardiac surgery to reduce postoperative blood loss and transfusion requirements, although several cases of anaphylactic reactions to the proteinase inhibitor have been reported. As part of a multi-centre study to evaluate the immunological response to aprotinin after first exposure 61 cardiac surgical patients were treated with the Hammersmith regimen. Patients with previous aprotinin exposure were excluded from the study. To determine specific IgG and IgE antibodies blood samples were taken pre-operatively, within 3 to 4 weeks and 6 to 7 months after operation. Determinations were made by using Western Blot and ELISA methods. Fifty-six patients were followed up for a 6-month period, 26 (46.4%) of them developed IgG antibodies to aprotinin determined by Western Blot, whereas only 14 (26.8%) patients with IgG antibodies were found by the ELISA. IgE antibodies were not found in any of the patients. On hospital admission and 6 months post-operatively additional intradermal prick tests were performed. No clear-cut positive reaction to the skin test was found in any patient.

Aprotinin↗

PubMed1998

Fluorescein-induced allergic reaction.

BACKGROUND: Adverse reactions following intravenous sodium fluorescein are very unusual and their mechanism is still uncertain. We report the case of a patient who suffered an adverse reaction during a fluorescein ocular angiography. Positive allergy tests to fluorescein suggest an IgE-mediated mechanism. OBJECTIVE: Report the allergy evaluation performed in a patient who suffered an adverse reaction during an intravenous fluorescein administration. METHODS: We selected the case of a patient who suffered dizziness, diaphoresis, generalized pallor, nausea, sphincter relaxation, hypotension, and intense malaise during a fluorescein ocular angiography and compared the results to other nonreactive subjects. Allergy evaluation: Prick and intradermal skin tests and serial determinations of serum tryptase were performed on the patient and four control subjects who underwent and tolerated the same procedure as well as on a patient who developed an intense vagal reaction during blood extraction. RESULTS: Positive skin tests and dramatic increase of serum tryptase (67U/I) were observed in our patient. The rest of the patients had negative skin tests and did not have any variation in their serum tryptase. CONCLUSIONS: An IgE-mediated mechanism is suggested as responsible for this adverse reaction. We recommend that a complete allergy evaluation should be performed in all patients who have adverse reactions to fluorescein in order to differentiate true allergic reactions from other types of reactions.

Aged↗

PubMed1998

Feline immunoglobulin E: induction of antigen-specific antibody in normal cats and levels in spontaneously allergic cats.

Sera from 10 cats with symptoms consistent with atopy, from 15 normal household cats and from 11 laboratory maintained cats were assessed for allergen-specific IgE and IgG to Dermatophagoides farinae (DF) by enzyme-linked immunosorbent assay (ELISA). In addition, 10 normal cats were immunised with DF and intradermal skin tests (IDST) were performed weekly. Sera from the latter were also assessed for DF-specific IgE by ELISA and using Prausnitz-Küstner (PK) tests. Although DF-specific IgE was detectable in all the atopic cats, there was no significant difference between the levels in this group and in the clinically normal household cats. However levels in both these groups were significantly higher than those in the laboratory maintained cats. Detectable DF-specific IgE was induced in all of the 10 cats, but the levels were not correlated with the development of positive IDSTs, nor with the level of IgE as assessed by PK tests. These findings are consistent with a possible heterogeneity of IgE antibody in cats.

Allergens↗

PubMed1991

[An enzyme-linked immunosorbent assay (ELISA) for the quantitation of sugi pollen and Dermatophagoides mite allergens and its application for standardization of allergen extracts].

A simple enzyme-linked immunosorbent assay (ELISA) has been developed for the quantitation of the major allergens of sugi pollen, Cry j I and of Dermatophagoides mites, Der I (Der p I/Der f I) and Der II (Der p II/Der f II) for use in the in vitro standardization of allergen extracts. Polystyrene microplates coated with a IgG fraction of rabbit antiserum were incubated first with allergen extracts and then with biotinylated antiserum IgG. The bound allergen-biotinylated antibody complex was detected with commercially available streptavidin-enzyme conjugate followed by the addition of colorimetric substrate. The assay was very sensitive (-0.2 ng/ml) and reproducible (CV% = 1.9-13.8%). The ELISA was compared with the radioimmunoassay previously described, and the results showed a very good correlation between the assays (r = 0.967-0.990). The allergen content in three sugi pollen and three house dust extracts measured by the ELISA also demonstrated a good agreement with the relative potency of these extracts as determined by the intradermal skin test. These results indicate that the ELISA could be useful in the standardization of allergen extracts.

Allergens↗

PubMed1980

Breed-specific dog hypersensitivity in humans.

The contribution of allergenic components of dander and serum from individual dog breeds in human hypersensitivity and the different responses to the various breeds in vivo and in vitro were examined. Differences in IgE antibodies directed against 13 individual dog breed danders and five different breed-specific sera were measured in groups sensitive and nonsensitive to dogs by the radioallergosorbent test (RAST). Cross-reactivity between dander extracts and sera was examined by RAST inhibition. Mean RAST binding to dog danders and sera was 15.9% and 14%, respectively, for the dog-sensitive group versus 0.6% for both danders and sera in the nonsensitive group. The mean difference in binding between groups was statistically different for all dander extracts and sera. The variances in binding were statistically greater for danders than sera in six of eight dog-reactive subjects. RAST binding and intradermal skin tests at a 1:10,000 w/v dilution correlated well (p < 0.05) for seven of nine breed-specific extracts. RAST inhibition studies showed that dog serum proteins were relatively poor inhibitors of dander extracts, and vice versa. Variability of skin test and RAST responses to different dog breed dander extracts support the existence of breed-specific allergens.

Animals↗

PubMed2000

Comparison of histopathologic and clinical evaluations of pathergy test in Behçet's disease.

BACKGROUND: The pathergy test, an important test in the diagnosis of Behçet's disease, is currently applied with disposable/sharp needles and evaluated only clinically (no histopathologic evaluation). In this study, the usefulness of the pathergy test conducted intradermally and intravenously with disposable/sharp needles in the diagnosis and determination of the activation of the disease is studied in comparison with the test conducted with nondisposable/blunt needles. In addition, histopathologic evaluation of the pathergy test is compared with the clinical evaluation. METHODS: The study group consists of 43 Behçet's disease patients together with 15 patients with dermatosis as the control group. The pathergy test was applied to the Behçet's disease patients and the control group intradermally and intravenously with disposable/sharp and nondisposable/blunt needles. RESULTS: The results of the pathergy test on the patients and the control group were evaluated clinically and histopathologically. CONCLUSIONS: Clinical evaluation of the pathergy test conducted intradermally with nondisposable/blunt needles is sufficient for both the diagnosis and determination of the activation of Behçet's disease. Histopathologic evaluation of the test is not found to be more sensitive than the clinical evaluation.

Adult↗

PubMed1988

Treatment of allergy to heterologous monocomponent insulin with human semisynthetic insulin. Long-term study.

Eight type II (non-insulin-dependent) diabetic subjects (7 women, 1 man, aged 42-61 yr), initially treated with oral hypoglycemic agents and intermittently treated with conventional insulins, were identified as developing allergic reactions to porcine and mixed-species monocomponent insulin. Allergy was systemic (urticaria and nonthrombocytopenic purpura) and local delayed in two subjects and local immediate or biphasic in six subjects. Lipoatrophy was present in two subjects. After treatment with human semisynthetic insulin (Monotard HM and Actrapid HM), systemic allergy disappeared. Local allergy disappeared in five subjects and was reduced in three subjects. No lipoatrophy occurred in new injection areas. The clinical results were accompanied by a significant decrease in serum insulin-specific IgE after 6, 12, 18, 24, 30, and 36 mo. Insulin-specific IgG showed an evident decrease in five of eight patients, but the difference in mean values was not significant after 6, 18, 24, 30, and 36 mo. With one exception, intradermal skin tests were positive to human, bovine, and porcine insulin before and after human insulin treatment.

Adult↗

PubMed1989

[A preliminary study on isolation, purification and identification of penicillium chrysogenum allergen].

Penicillium chrysogenum crude extract was prepared in our laboratory. The protein concentration of this allergen assessed by coomassie blue G250 stain was 44-48 mg/ml. Three protein bands P1, P2a and P2b, were obtained by PAGE. Molecular weights of the bands were 94,000, 43,000 and 25,000 respectively as compared with standard molecular weight markers. Gel filtration through sephadex G200 revealed two peaks. These fractions were monitored for absorbance at 280 nm and combined into 3 pools according to the results of PAGE. Tube 1(T1), T2 and T3 were obtained. The average size of wheals developing after intradermal skin testing showed that T2 induced the strongest reaction. Since the main component of T2 was P2a, it is supposed that P2a of P. chrysogenum extract contains the protein with the highest allergenicity.

Adult↗

PubMed1975

Lymphocyte stimulation in hepatitis B infections.

Cell-mediated responses in patients with acute and chronic forms of Type B hepatitis were tested by lymphocyte transformation to purified hepatitis surface antigen (HBS Ag) and to phytohemagglutinin, by dinitrochlorobenzene sensitization and by response to skin-test antigens. Although absent during acute Type B hepatitis, lymphocyte transformation by HBS Ag appeared during early convalescence and remained detectable for six years after recovery. Patients with Type B chronic active hepatitis with increased serum transaminase levels showed a partial lymphocyte transformation with HBS Ag, whereas those with normal transaminase values demonstrated no transformation. Patients with Type B chronic persistent hepatitis and carriers of HBS Ag did not have lymphocyte transformation. Normal responses to dinitrochlorobenzene, intradermal skin tests and phytohemmaglutinin were found in all patients with acute, chronic active or chronic persistent hepatitis and carriers. These results indicate that recovery from Type B hepatitis is associated with the ability to elicit a specific lymphocyte response to HBS Ag.

Acute Disease↗

PubMed1979

[Parasitological results of a medico-anthropological research-work at the Azande in northeast-Zaire (author's transl)].

Among 165 examined Azande 118 (71.5%) were found with intestinal helminthic infections: Hookworm (69.1%), Schistosoma mansoni (13.9%), Trichuris trichiura (4.2%), Ascaris lumbricoides (1.2%), Strongyloides stercoralis (0.6%). The intradermal Schistosoma test with a commercial antigen preparation was positive in 63.3% of 147 examinees. Protozoa-excretions were found in 62.2% of 151 examines: E. histolytica (27.2%), E. hartmanni (13.2%), E. coli (24.5%), Jodamoeba buetschlii (7.3%), Endolimax nana (1.3%), Lamblia intestinalis (17.2%). Microfilariae were found in 87 of 165 blood-smears (52.7%). The positive diagnoses increased with the age of the examinees. 73.8% of 141 examinees showed an increase of eosinophilic granulozytes up to 11-29%, and 7.8% up to more than 30%. The reliability of the methods used to conserve the test material under extreme conditions as well as the connection between ethnographical situations and the detected parasites are discussed.

Adolescent↗

PubMed1994

Effect of hypnotic suggestion on the delayed-type hypersensitivity response.

OBJECTIVE: To determine whether individuals selected for good general health, high hypnotizability, and the ability to alter skin temperature under hypnotic suggestion can influence the delayed-type hypersensitivity (DTH) response to varicella-zoster (VZ) antigen under hypnotic suggestion. DESIGN: A blinded clinical trial using a repeated measures design with subjects serving as their own controls. Subjects were randomly assigned to undergo a predetermined sequence of four different experimental conditions, occurring at weekly intervals, with each condition including VZ skin testing: (1) hypnosis with suggestions to enhance the DTH response to VZ antigen; (2) hypnosis with suggestions to suppress the DTH response; (3) hypnosis with suggestions for relaxation only; and (4) skin testing without hypnosis. SETTING: A National Institutes of Health-supported clinical research center in a teaching hospital. SUBJECTS: A stratified sample of 24 ambulatory, healthy, highly hypnotizable, volunteer college students selected for their above-average ability to alter skin temperature after hypnotic suggestions and their positive baseline responses to VZ antigen. There were 11 males and 13 females with a mean +/- SD age of 22 +/- 6 years. The mean +/- SD hypnotizability score (Harvard Group Scale of Hypnotic Susceptibility) was 11 +/- 1. INTERVENTIONS: Intradermal skin testing with VZ antigen (Mantoux method) and hypnotic suggestion. MAIN OUTCOME MEASURES: Areas of induration of the DTH response measured at 24 and 48 hours after injection of antigen. RESULTS: The area of the DTH response was not affected by the experimental interventions. The area of erythema was likewise unaffected. CONCLUSIONS: Our subjects were unable to alter their DTH responses using hypnotic suggestion.

Adult↗

PubMed1989

Immunotherapy decreases skin sensitivity to cat extract.

In 22 patients with cat asthma who were highly sensitive to cat, we compared, double-blind, the effects of immunotherapy with cat-hair and dander extract (11 patients) with effects of placebo (11 patients). Patients matched by intradermal skin test titration, leukocyte histamine release, and the doses of both cat extract and methacholine required for 20% fall in FEV1 were randomly assigned to one of the two treatment groups. Immunotherapy doses were increased to a maintenance dose of 4.56 Food and Drug Administration (FDA) units of Fel d I or if maintenance dose was less, to the highest tolerated dose. Before and during immunotherapy, we measured by intradermal titration the dose of cat extract, in FDA units of Fel d I equivalents, required for (1) 2+ end point (wheal diameter, greater than or equal to 10 mm; erythema diameter, 20 to 30 mm) and (2) 20 mm end point (erythema diameter, 20 mm). By prick skin test, we measured (1) the dose of cat extract that produced a wheal equal in area to that produced by histamine, 1 mg/ml, (2) the doses of cat extract that produced a wheal 22 mm2 in area, and (3) the sum of the wheal areas produced by five prick tests to 23.8, 7.1, 2.4, 0.7, and 0.2 FDA units per milliliter of Fel d I, respectively. After 1 year of treatment, in comparison to control patients, treated patients had significant increases in the ratio 1 year value/pretreatment value for the doses of cat extract required for intradermal test end points 1 and 2 (p less than 0.01), for prick test end point 1 (p less than 0.01), for end point 2 (p = 0.015), and significant decreases in this ratio for prick test end point 3 (p = 0.015). Treated patients also had significant increases in cat extract required for a 20% fall in FEV1 (p less than 0.01), in IgG antibodies toward whole cat extract, Fel d I and cat albumin (p less than 0.001), and in IgE antibodies toward whole cat extract, (p less than 0.01). Thus, a decrease in skin sensitivity to cat extract demonstrated by both intradermal and prick methods occurred in patients after 1 year of immunotherapy with cat extract at a time when bronchial sensitivity to cat extract was decreased and IgG and IgE antibodies toward cat extract were increased.

Allergens↗

PubMed1990

Serial immunological investigations in a patient who had a life-threatening reaction to intravenous protamine.

Reactions to intravenous protamine include rash, urticaria, bronchospasm, hypotension, and/or pulmonary artery pressure elevation. We have previously shown that in diabetic patients receiving daily protamine-insulin injections, the presence of anti-protamine IgE or IgG antibodies are significant risk factors for acute, life-threatening reactions when protamine is given intravenously. To study protamine reactions further, we measured serum anti-protamine IgE and IgG antibody levels, in-vitro basophil histamine release and intracutaneous skin testing to protamine serially in an NPH-insulin dependent diabetic who had a severe, protracted anaphylactic reaction to protamine. At the time of his protamine reaction, his serum contained 8.5 ng/ml of anti-protamine IgE and 1.3 micrograms/ml of anti-protamine IgG antibody. One month following the reaction both anti-protamine IgE and IgG increased to 16 ng/ml (twofold rise) and 90.5 micrograms/ml (70-fold rise), respectively. With time, both anti-protamine IgE and IgG antibody declined. Serial intradermal skin tests using protamine sulphate did not discriminate between the protamine reactor and nine normal control subjects who had no prior exposure nor any demonstrable serum IgE antibody to protamine. In-vitro basophil histamine release to protamine sulphate was inconclusive in discriminating between the protamine reactor and normal control subjects. We postulate that protamine may be an incomplete or univalent antigen that must first combine with a tissue macromolecule or possibly heparin to become a complete multivalent antigen capable of eliciting IgE antibody-dependent mediator release.

Aged↗

PubMed1993

Analysis of perchloric-acid-soluble Mycobacterium bovis bacille bilié de Calmette-Guérin antigen.

The perchloric-acid-soluble Bacille bilié de Calmette-Guérin (BCG) antigen (BCG-P) was investigated for the diagnosis of tuberculosis. Monoclonal antibodies against BCG-P were produced. After SDS-PAGE, silver staining and immunoblotting were done. Pathological specimens of pulmonary tuberculosis, BCG organism itself and atypical mycobacterium were stained using the indirect immunofluorescent technique with the strongest one among these monoclonal antibodies. Intradermal skin test and ELISA were also done with BCG-P. BCG-P was composed of a major 65-kD protein and a minor 61-kD protein. Fourteen monoclonal antibodies were produced which were all IgM. These antibodies reacted with the 65-kD protein which also showed cross-reactivity with Mycobacterium tuberculosis in pathologic tissues and atypical mycobacterium. BCG-P did not react with the sera of patients with active pulmonary tuberculosis. However, intradermal skin test with BCG-P showed positive reactions in the patients with a positive purified protein derivative of tuberculin skin test. This antigen could be a good antigen to evaluate the success of BCG vaccination.

Antibodies, Monoclonal↗

PubMed2002

[Study of cockroach allergen in adult asthmatics in Japan].

To study the clinical significance of cockroach allergen in adult asthmatics in Japan, we performed intradermal skin test to four commercial base cockroach extracts. The specific IgE antibody to cockroach was measured in sera by CAP-RAST. Positive rates of immediate intradermal skin response to cockroach extracts were 10.2-12.6%. Positive rate of CAP-RAST to cockroach was 12.6%. We performed bronchial provocation test on 6 cockroach sensitive asthmatics. Immediate asthmatic response was provoked in 2 cases and late asthmatic response was provoked in one case. Positive histamine release from peripheral leukocytes (HRT) to cockroach was shown in cockroach sensitive asthmatics. RAST-inhibition studies of cockroach showed several inhibition patterns and indicated partial cross-reactivity between cockroach species and mite. These results indicate that there is a possibility that cockroach is one of the important inhalent allergens in Japan.

Adult↗

PubMed2000

[First description of concomitant infection with tuberculosis and paratuberculosis in dairy sheep in Argentina].

The authors present the results of a comparative intradermal tuberculin test performed on dairy sheep to determine rates of reaction to bovine and avian purified protein derivative (PPD). Test reactions were interpreted by palpation and measurement with a calliper. Results were analysed by plotting the values obtained. Agar gel immunodiffusion tests, growth in culture and histopathological examinations were also performed to allow differential diagnosis between tuberculosis and paratuberculosis. In the first tuberculin test, performed on 288 sheep, 74 animals showed a positive reaction to avian PPD (25.69%), two animals showed a positive reaction to bovine PPD (0.69%), and one animal was positive with respect to both tuberculins (0.34%). In the second test, involving 247 sheep, 55 demonstrated a positive reaction to avian PPD (22.26%), whilst none reacted to bovine PPD. The presence of Mycobacterium avium subsp. paratuberculosis was confirmed by culture and serological testing. In addition, lesions compatible with those caused by M. bovis were found by histopathological examination. These findings highlight the importance of the accurate diagnosis of tuberculosis and paratuberculosis for the effective control of both diseases.

Animals↗

PubMed1984

[Anaphylactoid accidents during general anesthesia. Apropos of 55 cases].

Analysis of fifty-five anaphylactoid accidents during general anesthesia (GA) in fifty patients shows significant female predominance (70%), relatively frequent allergic predisposition (34% as compared to 14.3% in a normal population) and fairly frequent responsibility of suxamethonium and succinylcholine. One or more, even recent, previous GAs do not seem to enhance the risk. 50% of intradermal skin tests to different anesthetics were negative, 40% were positive and consistent with clinical history, and 10% were positive but inconsistent clinically. Biological tests (basophil degranulation, lymphoblast rosettes, in vitro consumption of complement) were negative. Physiopathological mechanisms remain uncertain, whether they involve IgE allergy or complement activation. The frequency and severity of these unpredictable accidents must stimulate clinical and biological research in this field.

Adult↗

PubMed1988

Familial allergic rhinitis in cattle.

A group of Angus X Holstein cattle were determined to have allergic rhinitis. Clinical signs included nasal discharge, tearing, sneezing, and nasal pruritus. The diagnosis was made on the basis of intradermal skin testing of affected and clinically normal cattle. The affected cattle had positive test results to various tree, grass, weed, and mold allergens. The clinical signs and seasonal occurrence were similar to those features for allergic rhinitis in man. Breeding data indicated an inherited mode of transmission, although only females were affected.

Animals↗