Annals of allergy最新文献

We examined effects of six oral anti-allergy drugs used to treat bronchial asthma on fMet-Leu-Phe (N-formyl-methionyl-leucyl-phenylalanine)-induced superoxide (O2-) generation and mobilization of intracellular free calcium ([Ca2+]i) in human neutrophils. We also evaluated the direct action of these drugs on NADPH (reduced nicotinamide-adenine dinucleotide phosphate)-oxidase activity in cell lysate (cell-free system). Ketotifen (25 approximately 200 microM) enhanced fMet-Leu-Phe-stimulated O2- generation and [Ca2+]i mobilization, although it directly inhibited NADPH oxidase in the cell-free study. Low concentrations of oxatomide (5-20 microM) enhanced O2- generation, but concentrations > 25 microM inhibited O2- generation. In concentrations below 20 microM, oxatomide had no effects on fMet-Leu-Phe-stimulated [Ca2+]i mobilization, but at concentrations above 25 microM, it inhibited [Ca2+]i mobilization. Oxatomide inhibited NADPH oxidase activity at all concentrations examined. Azelastine, pemirolast, tranilast, and repirinast inhibited O2- generation and [Ca2+]i mobilization. Azelastine and pemirolast directly inhibited NADPH oxidase, but tranilast and repirinast did not. Our results indicated that except for ketotifen and low concentration of oxatomide, oral anti-allergy drugs used to treat bronchial asthma inhibited fMet-Leu-Phe-induced O2- generation in human neutrophils. Based on IC50 values, potency of drugs was as follows: oxatomide > azelastine > tranilast > pemirolast > repirinast.

Hay fever, or allergic rhinitis, affects a significant proportion of the US population. The current analysis focuses on the question of estimating both the direct and indirect costs of hay fever in the US for 1990. The basic data used for this analysis derive from continuing national probability surveys of 1) the US civilian noninstitutionalized population and 2) patient visits to offices of nonfederal practicing physicians who are not in hospital-based specialties. The analysis is based on current methods of estimating the costs of illness. The two major components of the estimates are the direct costs of physician visits, diagnostic tests, and medications; and the indirect costs associated with work absences or other reduced productivity for those employed both in and outside the home. For the most part where data were unavailable or potentially unreliable, cost estimates were not imputed. As a result, these estimates should be considered to be biased downward. In spite of these relatively conservative assumptions, the estimates of annual illness costs for 1990 totalled $1.8 billion.

A 7-year-old boy with recurrent otitis media, bronchitis, pneumonia, asthma, and sinusitis was found to have primary ciliary dyskinesia. It was important to rule out other systemic diseases such as immune deficiency and cystic fibrosis. Electron microscopy of a properly obtained and prepared biopsy of the mucosal surface of the nose, trachea, or bronchus is essential.

Specific induction of IL2-responsiveness by ovalbumin-stimulated lymphocytes was studied in patients with hen egg allergy. Fluorescence-activated cell sorter analysis of the cells showed that the IL2-absorbing and IL2-responding cells mainly consisted of CD3+2+4+8-45RA+ cells that may act as helper cells for IgE production and/or as effector cells for delayed type hypersensitivity. beta-Chains (P75) of IL2 receptors were involved in ovalbumin-induced IL2 responsiveness of the patients' lymphocytes, whereas the alpha-chains (p55) were expressed on normal lymphocytes stimulated with ovalbumin as well. Adhering mononuclear cells from patients allergic to ovalbumin but not to Dermatophagoides farinae (Df) were pulsed with ovalbumin antigen then added to a T cell-rich population. After five days of culture, we evaluated cell growth for IL-2 sensitivity during an additional 3-day culture in the presence of IL-2. Responder cells from the patients, which were cocultured with ovalbumin-pulsed autologous adhering cells, acquired IL2 responsiveness; whereas, those cultured with Df-pulsed adhering cells did not. This reaction was specific for antigen. The monoclonal antibody to HLA-DQ (Leu 10) and HLA-DP (HLA-DP) frameworks, but not the one to the HLA-DR framework (OKIa1), blocked the antigen presenting cells ability to induce responses. T Cell-rich responder cells depleted of CD4+ cells did not acquire IL2-responsiveness, whereas the depletion of CD8+ cells had no effect. As a whole, the results indicate that DQ-bearing and/or DP-bearing adhering cells have a key function in presenting ovalbumin-antigen to allergen-specific responder T cells that very likely belong to CD4+ subsets.

Evaluation of therapy for Stevens-Johnson syndrome was initiated as a retrospective analysis and then extended to a prospective series of patients treated with corticosteroids. This report extends the initial prospective study of patients with Stevens-Johnson syndrome treated with corticosteroids and evaluates the total series of 41 patients relative to outcome and the presumptive etiology. We propose that management of Stevens-Johnson syndrome requires corticosteroid therapy and that the survival of patients with Stevens-Johnson syndrome may depend on this therapy. No fatalities or adverse effects due to corticosteroids were noted. Stevens-Johnson syndrome due to a drug, a drug metabolite or viral infection may mimic a graft-versus-host reaction in which the patient rejects skin, mucous membrane, kidney or liver cells to which the drug, drug metabolite, or virus has bound. Corticosteroids suppress the inflammatory rejection until the activating agent has been eliminated.

The purposes of this open study were to evaluate the anesthetic properties of eutectic mixture of local anesthetics (EMLA) prior to intradermal skin testing and to evaluate the possible effect of EMLA on the extent of wheal and flare reaction. Subjects included 40 patients, ranging from 1 to 9 years of age. The eutectic mixture of local anesthetics was applied in a 2-mm thickness to the upper outer arm, covered with a dressing, and allowed to remain in place for one hour. Complete anesthesia was obtained in 36 of the 40 cases (90%), and partial anesthesia occurred in two additional patients. There were no significant differences in wheal or flare reactions between treated and untreated skin. Side effects were minimal. This preliminary report indicates that EMLA cream appears to be a safe and effective means of achieving local anesthesia prior to intradermal skin injection. It does not jeopardize the validity of test results.

The discriminant ability of six provocation doses of histamine, PD10, PD15, PD20, PD10T, PD20C, and PD40 has been reported. The subscript connotes -%delta SGaw (PD40), -%delta FEV1 > or = 10% (PD10T), -%delta measured with the lowest (PD20C) or the best FEV1 (PD10, PD15). To explain the differing discriminant ability of the six provocation doses (PD20 = PD15 > PD10T = PD40 > PD20C > PD10), this study analyzed the role of % delta/variability, log dose-response curve, airway hysteresis and the test itself in the original group of 20 normal and 20 asthmatic subjects. For provocation doses measured with the best FEV1, the discriminant ability was related to the ratio %delta/variability and the frequency with which various provocation doses were located on the steep portion of the log dose-response curve; these two parameters and the steepness of the latter were similar in normal and asthmatic subjects. The low discriminant ability of PD20C did not depend on %delta/variability or steepness of the log dose-response curve but on its high rate of false positive results. The lower discriminant ability of PD40 than PD20 or PD15 could not be related to any of the factors analyzed. In conclusion, the factors influencing the calculation of provocation doses affect differently the discriminant ability of these endpoints: (1) %delta/variability and steepness of log dose-response curve influence the provocation doses based on best FEV1. (2) Airway hysteresis reduced the proportion of normals with asthmatic provocation doses, increasing the rate of false positive results with PD20C, based on the smallest FEV1. (3) The nature of the tes, SGaw versus FEV1, affects the discriminant ability of PD40 in a still obscure way.

During peak ragweed season, 86 patients with seasonal allergic conjunctivitis participated in a 9-week, multicenter, double-masked, placebo-controlled, group-comparative study testing the efficacy and safety of bid nedocromil sodium, 2% ophthalmic solution. The clinical effectiveness of nedocromil sodium was measured by analyzing the means of patient daily symptom scores and eye examinations after 1, 3, 5, and 8 weeks of treatment. The use of nedocromil sodium during peak ragweed pollen season reduced symptom scores with statistically significant treatment differences as compared with the placebo for itchy eyes, tearing, overall eye condition, and symptom summary score. Clinician assessments also favored the use of nedocromil sodium as indicated by significant improvements in tearing, conjunctival injection, and conjunctival edema. No significant side effects were reported by the patients, allergists, or ophthalmologists. We conclude that nedocromil sodium, 2% ophthalmic solution, administered bid is more effective in the relief of symptoms of seasonal allergic conjunctivitis than placebo and causes no major side effects.