Annals of allergy最新文献

The efficacy of intranasal fluticasone propionate 200 micrograms once daily or 100 micrograms twice daily in treating perennial allergic rhinitis was evaluated in a randomized, double-blind, placebo-controlled study of 24 weeks' duration in 365 patients. Clinician-rated and patient-rated total nasal symptom severity scores were improved within 1 week of treatment with either regimen of fluticasone propionate and improvement was maintained over the 24-week treatment period. Clinician-rated overall evaluation indicated a significantly better response in the two fluticasone propionate groups compared with the placebo group. All efficacy evaluations indicated no difference in response between the fluticasone propionate 200 micrograms once-daily and 100 micrograms twice-daily groups. Patients in both fluticasone propionate groups had significantly less nasal obstruction upon awakening than the placebo group at all assessment periods. Fewer patients in either fluticasone propionate group used antihistamine rescue medication compared with the placebo group. The percentage of patients with nasal eosinophils and basophils at the end of the 24-week treatment period was significantly lower in both fluticasone propionate groups compared with the placebo group. Safety evaluations indicated that intranasal fluticasone propionate was as safe as placebo when given as 200 micrograms once daily or 100 micrograms twice daily. The incidence of drug-related adverse events was similar among the fluticasone propionate and placebo groups except for the incidence of epistaxis and blood in nasal mucus which was somewhat higher in the fluticasone propionate twice-daily group. There was no changes in the opthalmic examinations to suggest corticosteriod-induced posterior subcapsular cataract formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Two patients, who developed anaphylaxis to cisplatin, are described. This phenomenon was preceded by mild allergic symptoms, which were overlooked, in previous treatment courses. Intradermal skin tests were both sensitive and specific in the diagnosis of cisplatin allergy. Pretreatment with antihistamines and corticosteroids was ineffective in preventing recurrent anaphylaxis. Thus, a trial of desensitization is mandatory among those patients whose disease responds to the administration of this agent.

Exercise challenges were performed on 397 middle and high school athletes to detect unrecognized exercise-induced bronchospasm. All challenges were completed by a standard treadmill protocol and spirometry was performed prior to exercise and at 1, 10, 20, and 30 minutes after completion of the treadmill regimen. Using FEV1 as the diagnostic standard, we compared the number of students who had initial decreases of > or = 10%, > or = 15%, or > or = 20% at each of the four postexercise spirometric evaluations. FEV1 thresholds of > or = 10%, > or = 15%, and > or = 20%, when analyzed, identified 187, 125, and 90 subjects respectively with a positive response. The majority of those with a positive response were identified soon after completion of the exercise provocation; however, a larger than expected number of athletes had their initial drop in FEV1 > or = 20 minutes after cessation of exercise. This represented 9% to 14% of the total number of responders to exercise challenge. Protocols for evaluation of exercise-induced bronchospasm may need to be designed to include data points up to or beyond 30 minutes after exercise to avoid missing the late appearance of bronchospasm.

Tosyl arginine methyl ester induced bronchoconstriction in rabbit bronchial rings mounted in vitro with a calculated EC50 of 5.6 x 10(-5) M as compared with acetylcholine which induced sustainable constriction with an EC50 of 2.5 x 10(-6) M. Tosyl arginine methyl ester, however, had definite bronchoconstricting properties though less potent than acetylcholine. We concluded that our data support the hypothesis that tosyl arginine methyl ester could be a possible biochemical mediator of airway contraction.

We describe a patient with human immunodeficiency virus infection who developed the main clinical features of a serum sickness reaction while receiving treatment with daily therapeutic doses of tuberculostatic drugs. A decrease in complement titers as well as a detection of significant levels of circulating immune complexes were observed. A positive skin test result was observed six hours after an intradermal test with rifampicin. No immunoglobulin or complement deposition was observed by direct immunofluorescence of a punch biopsy specimen from the cutaneous lesion.

The Food and Drug Administration, Center for Biologics Evaluation and Research (CBER) has developed methodology to standardize both aqueous and freeze-dried (lyophilized) extracts. Thus far, it has not been determined whether or not this methodology can be used to standardize alum-adsorbed extracts. This study was designed to examine the in vivo and in vitro potency of selected Allpyral grass pollen extracts, including timothy, orchard grass, perennial ryegrass, sweet vernalgrass, and meadow fescue. Puncture testing was performed on highly grass-sensitive subjects with the concentrate of each of the five Allpyral grass extracts. Additionally, puncture testing was done on 22 subjects to compare Allpyral timothy grass with a lyophilized, standardized timothy grass extract. The ID50EAL (Intradermal Dilution for 50 mm sum of Erythema determines the Allergy Unit) skin test method was used to determine allergy units of the Allpyral extracts. Relative potency of the Allpyral timothy extracts to a timothy laboratory standard was determined using an ELISA-inhibition assay. Intradermal tests were also performed to examine the potency of the supernatant obtained after centrifugation of the whole Allpyral timothy extract. The puncture test responses to the Allpyral timothy extracts were less than those to the lyophilized extract. Those 10,000 PNU/mL Allpyral grass pollen extracts tested were determined to contain a calculated 10,000 BAU/mL. By ELISA inhibition, the Allpyral timothy extracts were determined to be approximately 1,000-fold less potent than the laboratory standard. The estimated concentration of the supernatant preparation to elicit a target response was notably (mean = 1,175 times) greater than that of the whole Allpyral timothy extract needed to elicit the same erythema response.(ABSTRACT TRUNCATED AT 250 WORDS)

A 4-week multicenter, double-blind, placebo-controlled, parallel-group trial was carried out with 416 adults with ragweed allergic rhinitis to compare 200 micrograms of fluticasone propionate once daily and 100 micrograms of fluticasone propionate twice daily with placebo. Compared with placebo, both groups receiving fluticasone propionate had greater number of symptom free days (P < .01), lower median symptom scores (P < .01), and greater number of days not requiring rescue medications (P < .001). No significant differences for individual symptoms were found between the two fluticasone propionate groups except that those taking the twice daily dosage used less antihistamine (P < .01) and had greater number of days free of rescue medications (P < .05). Adverse events were comparable between the three groups. These results indicate that topical intranasal fluticasone propionate 200 micrograms once daily and 100 micrograms twice daily are both efficacious and well tolerated.