Allergy proceedings : the official journal of regional and state allergy societies最新文献

Although health statistics in Ukraine are difficult to obtain, there does appear to be an increase in the occurrence of asthma. Overall reporting of asthma is less frequent than in Western Europe, perhaps due to insufficient diagnostic capabilities at the present time. Asthma therapy in the Ukraine tends toward the use of theophylline and beta 2-agonists, rather than inhaled corticosteroids. Asthma morbidity differs in various regions of Ukraine, perhaps as a consequence of increased environmental exposure in some areas.

Efforts at understanding the patterns and prevalence rates of various causes of anaphylaxis are needed. This report is a first effort to address the issue and review the experiences of one voluntary hospital emergency room, where records from 326 (1.4%) of 23,647 emergency room reports for 1992 were analyzed. These results are compared to other already published results. Further study, on a national basis, is clearly necessary. It was remarkable that only 13/48 (27%) bee sting allergic patients were given self-injectable epinephrine and only 6/48 (12.5%) of these patients were referred to an allergist. Further, none of 165 other patients was referred to an allergist.

The molecular and cellular mechanisms of action of synthetic polyions on immunogenesis are reviewed. The results of studies of principal properties of polyionic immunostimulators and of the cell responses to the action of these stimulants have been used to construct artificial antigen-polyion complexes with enhanced immunogenic properties. The immunizing properties of such macromolecular complexes, constructed with the use of bacterial or viral antigens, are analyzed.

Several conjugates of model allergen ovalbumin (OA) and the copolymer of N-vinyl pyrrolidone and maleic anhydride (VMA) modified with epsilon-aminocaproic acid (Acp) were prepared in different OA/Acp-VMA ratios. All conjugates were separated by ultrafiltration and analyzed by HPLC. Their compositions were determined by amino acid analysis and UV spectrometry. To detect immunogenicity, all conjugates were injected intraperitoneally into (CBAxC57BL/6)F1 mice three times in 3-week intervals in OA doses equivalent to 0.5, 10, and 100 micrograms/mouse. Only the conjugate containing 20%OA (OA(20%)-Acp-VMA) did not induce significant quantities of anti-OA IgE, but did induce anti-OA IgG antibodies in dose-dependent manner comparable to that of unmodified OA. Mixtures of OA and Acp-VMA or OA modified only with VMA without Acp activation with Acp induced dose-dependent anti-OA IgE and IgG antibody formation comparable to that of OA. Using passive cutaneous anaphylaxis, RAST inhibition and leukocyte histamine release, a significant reduction of allergenicity was noted using OA(20%)-Acp-VMA. This conjugate stimulated activation of the OA-specific T-cell hybrid 3DO-548 comparable to that of unconjugated OA. During experimental allergen-specific hyposensitization with OA(20%)-Acp-VMA, suppression of anti-OA IgE response and elevation of anti-OA IgG responses were noted when compared with unmodified OA. Selective blockade of B-cell epitopes of allergen may occur using the carrier Acp-VMA to reduce allergenicity while not affecting T-cell epitopes, thereby preserving immunogenicity. This approach of chemical modification of allergen suggests new opportunities in the creation of preparations for allergen-specific immunotherapy.

The regulation of breathing is dependent on the complex interaction of three components of the respiratory system: 1) the control centers, 2) the sensors, and 3) the effector organs. The control centers reside in the brainstem and are responsible for the automaticity of breathing. Input into these respiratory centers can be initiated from higher brain centers in order to produce voluntary breathing efforts. Afferent neural signals also come to the central control system from the respiratory sensors, which are divided into two categories: chemoreceptors and sensory receptors. The chemoreceptors respond to changes in the blood oxygen, carbon dioxide, and hydrogen ion concentration by sending impulses to the control center to alter the ventilatory pattern by affecting the effector organs--the respiratory muscles. The sensory receptors are located in the upper and lower airways, the lung, and the muscles of respiration. They also can have a marked effect on the respiratory pattern. It is believed that stimulation of these receptors is important in the initiation of hyperventilation and cough in lung diseases such as asthma. There is also recent evidence that respiratory chemoreceptor responsiveness is abnormal in patients with asthma who have a history of near-fatal attacks.

A 41-year-old woman with known food allergy to avocado was treated for anaphylaxis after eating a meal containing avocado. This prompted a study to determine the prevalence of avocado induced symptoms and skin reactivity in a group of atopic patients. One hundred consecutive atopic patients with allergic rhinitis undergoing skin testing before initiation of immunotherapy were also prick skin tested to avocado. Patients with symptoms upon avocado ingestion were also assessed for specific serum IgE antibodies to avocado. Of the 100 atopic patients not selected for avocado sensitivity, 21 had positive prick skin tests to avocado. Eight of the 21 avocado skin test positive patients reported that symptoms repeatedly followed the ingestion of avocado; two reported systemic reactions, but six noted oral symptoms only. Serum IgE antibodies to avocado were elevated in seven of the eight patients reporting symptoms after eating avocado. Seven of the eight patients also reported oral symptoms following cantaloupe ingestion. Four reported similar symptoms upon eating banana. Avocado-induced symptoms occurred in 8% of 100 consecutive atopic allergic rhinitis patients unselected for avocado reactivity. Oral, and less frequently systemic, allergy symptoms appear to be more common among the atopic population than previously appreciated.