Allergie et immunologie最新文献

Because of some divergences between the pathologics of Aix and the pollinic accounts found by the spore-trap of Marseilles, a spore-trap has been installed since the beginning of 1997 in Aix hospital to prove that these two sites are specific for pollen identification and dates of pollinisation as well. After three years of measures, the correlation between the vegetation of Aix and the pathological symptoms is established. They are coherent with those published in other sound European countries and confirm the "mediterreean" feature of Aix.

Immediate-type hypersensitivity to latex allergens has resulted in anaphylactic shock and death in numerous reported cases. The allergenic proteins of latex are contained within the natural rubber extract of Hevea brasiliensis and are eluted into the final product during the manufacturing process. The quantity and types of latex allergens found in different latex products depends on the manufacturing process. Not all of these allergens are available for use in the latex prick skin test, and as a result, such tests may not be conclusive. Furthermore, application of such allergens to the skin of undiagnosed hypersensitive individuals may have harmful effects on their health. Therefore, it is important to be able to utilize in vitro methods, which reliably identify latex allergy without placing hypersensitive individuals at risk. We have developed a relatively simple and new enzyme immuno-assay (EIA) method for the detection of latex allergy. This in vitro method is quantitative and allows for the classification of allergy to latex in a short time. In comparative studies, ninety-nine serum specimens with documented clinical history of latex allergy were tested by this method, and the results paralleled those of the skin prick test performed by an independent group. The data showed that the specificity and sensitivity of our assay approaches 97.5% and 100%, respectively. We conclude that, by using a simple assay, the detection of specific IgE to latex proteins may be valuable for screening individuals and for the diagnosis of allergy to latex.

The epidemiology of environmental allergens and their role in respiratory pathology remains poorly understood in sub-Sahara Africa. The aim of this work was to measure the frequency of sensitivity to cockroach allergens of subjects with chronic respiratory affections in the Ivory Coast. We recruited consecutively 140 patients, adults and infants, who had asthma, rhinitis or sinusitis over a period of 20 months, in a hospital environment. The patients were prepared by a clinical questionnaire on atopy (personal and familial antecedents), systemic prick tests for common environmental allergens (cockroaches, mites, moulds). Our results indicated that the mean age of the children was 8 years and that of the adults 26 years (with extremes of 3 and 53 years). The proportion of patients with positive prick tests to cockroaches was 30.7% (43 cases). In asthmatics it was 16.5%. When asthma was associated with an ORL focus, 41.9% was found and in isolated ORL pathology 19.5%. Existence of familial atopy was found in 72% of cases. Discomfort from domestic dust was shown on questioning by 88.4% of cases. In 81.4% of cases positivity of the prick test to cockroaches was accompanied by a positive reaction to mites. Those who were only sensitive to cockroaches were less than 10%. Types II and III asthma were 2/3 in the asthmatic patients. In conclusion, the cockroaches were in the second rank of pneumoallergens that are implicated in sensitization and in the perpetuation of allergic respiratory symptoms, after the mites. These two factors were often associated in our patients and are consequently seen with a strong allergenic potential that is exercised by the interior environment.

Some drugs regularly used in the treatment of asthma (beta-agonists and corticosteroids) are registered on the list of drugs forbidden in sport, because they have a doping action. To avoid penalizing asthmatic sportsmen, some beta-agonists (Salbutamol, Salmeterol, Terbutaline) and corticosteroids are allowed only in inhaled form, with written notification from the prescribing physician, a pneumologist or the team doctor. Considering the increase of doping with increasing involvement of physicians, good and up to date notions about the current rules of prescription in asthmatic sportsmen are needed.

Blood-sucking insects and other arthropods may occur allergic reactions when stinging. Usually, inflammatory symptoms are mild with a locoregional extension. Pruritus may be painful and sometimes patients experienced a functional impotency. Systemic reactions are possible. Anaphylaxis is rare and rather observed with ticks (Ixodes and Argas) and kissing-bugs. The circumstances and mechanisms of the sting related to the knowledge of the insect biology elicit the clinical symptoms. Skin prick-tests are usually not practicable. Indeed, the diagnosis remains based upon anamnestic and entomological data because the poor sensibility of in vitro tests. However, some immunological investigations gave signs of interest for prospective studies. Symptomatic drugs and prevention advices must be purchased for exposed patients.

Individual protection against Plasmodium falciparum malaria is based on a simultaneous observance of a preservation from mosquitos bites during the night and an adapted chemioprophylaxis. It is suitable to personalize chemioprophylaxis advices according to the ground (intolerance to anti paludic drugs, drugs interactions, pregnancy...) to the context of the transmission (visited countries, seasons, resistance level of malaria strains) and at last the local way of the medical assistance under taken against this disease. Nevertheless, it is good to remind that there is no preventive mean which gives full protection by itself. All fever that happens after a trip in an endemic zone for malaria has to be considered firstly as due to malaria and investigations have to be made under this condition.

Immunobiological diagnosis of allergy by measurement of total and specific IgE (by the technique of the CAP System on UNICAP) remains very valuable, especially if it is possible to repeat the measurements to follow the development of the patient. Concerning an observation of one patient who presented a rhinotracheitis that developed over 10 years and was linked clinically to guinea pig hair, the measurement of total and specific IgE confirmed the diagnosis and favourable clinical development was corroborated by the significant parallel diminution of total and specific IgE.

The diagnosis of drug allergy is mainly based upon a detailed clinical history, positive skin tests (ST) and detection of specific IgE. In case of discrepant results, in vitro investigations to identify the responsible drug are needed. The histamine release test (HR) is usually performed. Nevertheless, its clinical benefit remains controversial. Flow cytometric methods (FCM) for the study of allergen induced basophil activation have been recently described. We assessed their usefulness in the diagnosis of drug allergy in comparison to HR results. Eighteen patients were included and 24 drugs (mainly antibiotics and muscle relaxant drugs) were tested. On the basis of clinical signs, 15 patients were classified as allergic (18 drugs). Sensitivity of biological investigations were found as follows: 71% (ST), 71% (FCM) and 24% (HR). This suggests performing FCM rather than HR. In addition, HR is more costly in terms of both reagents and laboratory technician time. Thus, CD63 detection by FCM seems to be a more reliable method in the clinical immunology laboratory. Additional data are needed to validate these preliminary results (sensitivity and specificity, especially in atopic patients) and to assess the interest of the method to investigate drug allergy due to other types of molecules.

Urticaria has many etiology and during its exploration, it's important to mind about parasitic disease. The authors present briefly ten of them potentially associated with this eruption. For each disease (ascaridiosis, trichinellosis, fasciolosis, giardiosis, toxocarosis, anisakidosis, cercarial dermatitis, schistosomiasis, strongyloidosis, hydatidosis), they precise epidemiological situation for contamination and simple diagnosis approach.

Background: In the past 25 years the United Arab Emirates (UAE) have experienced a socioeconomic boom. The once nomadic Bedouin population of Al Ain, in the emirate of Abu Dhabi, now lives in modern air-conditioned accommodation, and huge desalination plants have allowed afforestation and farming.

Objective: To evidence responsible airborne allergens in an UAE population.

Patients and methods: 263 UAE Nationals who attended Tawam Hospital (Al Ain, UAE) with a respiratory disease suspected of being of allergic origin, were submitted to SPT and RAST. The choice of pollinic allergens was made in accordance with the local flora and market availability. All patients were SPTed with at least the same battery of 15 pollinic and indoor allergens. Most patients were submitted to at least 4 RAST, viz Cynodon dactylon, Salsola kali, Prosopis juliflora and Dermatophagoides pteronyssinus.

Results: 71.8% patients were positive for at least one allergen. Pollen accounted for 61.6% of positive patients, with 45.2% positive to chenopodiaceae, 33% to gramineae and 23.5% to P. juliflora. Indoor allergens were positive in 30.4% of patients with 17.9% positive to D. pteronyssinus and D. farinae, 11% to Blatella germanica, 8.3% to Cat fur, 4.9% to Goat hair, 0.7% to Rat hair and Mouse hair and 1.5% to Candida albicans.

Conclusion: Pollen was the prominent allergen. There is room, however, for further epidemiological studies possibly with new extracts and RAST specifically designed after the species of the Gulf region.