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

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.

Neurotransmitters released from sensory, parasympathetic, and sympathetic nerves regulate epithelial, vascular, glandular, and contractile processes in the human respiratory tract. The actions of these neurotransmitters are dependent upon the distribution and subtypes of their specific receptors expressed on the resident cells in the respiratory tract. The distributions of these receptors, and their potential activities in asthma, will be investigated with the hope of discriminating between the pharmacological and physiological actions of mediators and neurotransmitters in normal and asthmatic airways.

Over the last few years, many studies have been carried out in order to individualize which nonsteroidal anti-inflammatory drug (NSAID) can be tolerated in aspirin sensitivity. Imidazole salicylate (IS) is a new NSAID that inhibits Tromboxane A2 synthesis, without interferring with cyclo-oxygenase pathway, whose inhibition was demonstrated to cause asthma and/or urticaria/angioedema in aspirin-sensitive patients. We enrolled 67 subjects with documented intolerance to aspirin, pyrazolones or NSAIDs, clinically manifested as urticaria/angioedema (68%), asthma, and/or rhinitis (32%). A challenge with IS was carried out in every patient in single-blind fashion, reaching a cumulative dosage of 1000 mg in the fourth session. No appearance of urticaria or bronchospastic reactions was registered in any subject, confirming the safe use of IS in aspirin-sensitive patients.

Increasing prevalence and severity of asthma has prompted the development and promulgation of various national and international guidelines for asthma management in adults and children. All of these guidelines agree that short-acting inhaled B2-agonists on demand represent the most appropriate initial bronchodilator therapy. However, there has been considerable debate as to the merit of maintenance bronchodilator therapy with regular inhaled B2-agonists, either the short acting agents, or the newer long-acting inhaled B2-agonist, salmeterol. Of concern is the possibility that there are detrimental effects of chronic B2-agonist bronchodilator treatment. Do these B2-agonists have the potential to worsen asthma control and thereby have an adverse impact by contributing to the increased prevalence and severity of asthma? This article will review the pertinent literature with regard to the safety of the B2-agonists, which are appropriate but not perfect medications for asthmatics. It will also put this information in perspective for the clinician and provide this author's recommendations for their use in managing the manifestations of chronic and recurrent asthma.

Bone marrow cells of various animal species and humans produce a group of bioregulatory peptides called myelopeptides (MPs). MPs have been isolated and purified, and their physico-chemical properties have been investigated. MPs have a wide spectrum of functional activities: immunoregulatory, differentiating, and opiate-like. A new immunocorrective drug, Myelopidum, which is used effectively in clinical practice for treating diseases accompanied by immunodeficiency, has been created on the basis of MPs. Administration of Myelopidum after surgery prevents 50% to 70% of postsurgical complications, particularly postsurgery pneumonia, and also normalizes the number and balance of T-helper cells, T-suppressor cells, and B-lymphocytes in patients with chronic pulmonary diseases, resulting in a beneficial clinical effect, including a significant prolongation of remission periods. Myelopidum is also used in veterinary medicine for prophylaxis and treatment of pneumonia and enteritis in newborn and young animals. The primary structure of several myelopeptides is established. The functional activities of two, MP-1 (Phe-Leu-Gly-Phe-Pro-Thr) and MP-2 (Leu-Val-Val-Tyr-Pro-Trp), are being investigated.

New forms of allergen immunotherapy are proposed employing modified allergens that induce T-cell responses without associated increased IgE-related responses. Synthetic polyelectrolytes attached to an analyte amy modulate T- and B-cell function, producing effective desensitization and altering immunoglobulin production dependent on the physico-chemical nature of the carrier molecule.