Curry powder is widely used in various dishes. It is a mixture of 20-50 kinds of natural spices made from the leaves and seeds of plants. Although there have been some reports of allergy caused by inhalation of spices in western countries, while there are no reports of occupational allergy caused by spices in our country. We report a patient with rhinitis and asthma induced by exposure to spice dusts in a curry industry. A 32-year-old man developed rhinorrhea, sneezing and coughing three years prior to visiting our hospital. Since 10 years ago, he has been involved in grinding and mixing spices in a curry industry. Total peripheral eosinophil count was 400/mm3 and serum total IgE level was 163 IU/ml. Allergy skin-prick test showed positive responses to mugwort (3+), D. farinae (3+) and celery (3+), while serum specific IgE detected by RIA (DPC, LA, CA) showed all negative results. Skin-prick test to four kinds of spice extractscelery seed, fennel, cumin and coriander-showed strong positive responses. Bronchoprovocation test with celery seed extract (1:10 v/v) showed an early asthmatic response. Specific IgE and IgG4 antibodies to celery seed and the other three spices were detectable by ELISA. IgE-ELISA inhibition test using each spice antigen showed significant inhibitions. In conclusion, IgE-mediated mechanism may be involved in the pathogenesis of curry powder-induced bronchoconstriction in an exposed worker. Further studies will be needed to investigate the role of specific IgG4 in pathogenesis of bronchoconstriction in curry powder-induced asthma.
Adult ; Antibodies ; Apium graveolens ; Artemisia ; Asthma ; Asthma, Occupational* ; Bronchoconstriction ; Cough ; Cuminum ; Dust ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Foeniculum ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Inhalation ; Rhinitis* ; Sneezing ; Spices

Common clinical manifestations in patients with IgG subclass deficiency include recurrent respiratory tract infection, recurrent otitis media and sinopulmonary infection by virus or bacteria. The administration of intravenous immunoglobulin (IVIG) has been regarded as the most effective therapy in these patients. We experienced a 22-year-old patient with IgG3 subclass deficiency and recurrent fungal infection of oral cavity and lips. IVIG was given at 0.2g/kg/dose twice a month for 6 months. After treatment with IVIG, the patient improved clinically.
Bacteria ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Immunoglobulins, Intravenous ; Lip ; Mouth* ; Otitis Media ; Respiratory Tract Infections ; Young Adult

BACKGROUND: It has been shown that severe asthmatic attacks are related to airway hyperresponsiveness (AHR). However, there has been no study on AHR measured just after control of acute severe asthma. OBJECTIVE: To determine the degree of AHR following acute severe asthma and to evaluate the safety of AHR measurement in patients just recovering from a severe attack. METHOD: In 23 consecutive asthma patients just recovering from a severe attack (10 severe, 13 near-fatal), all medications except inhaled or systemic steroids were withdrawn temporarily for more than each action time. Then a methacholine bronchoprovocation test was performed in patients with FEV1 > or = 75% of predicted or personal best value. RESULTS: Mean duration required to control asthma was 5.6+/-3.6 days, and methacholine provo- cation test was performed at 12.6+/-5.2 hospital days. The patients showed significantly lower methacholine-PC20 (geometric mean: 0.54 vs 1.64 mg/ml, p<0.05) and steeper slope of dose-response curve (p<0.01) compared to 62 outpatients. Initial FEV1 (r=0.470, p<0.05) and the duration required to control asthma (r=-0.623, p<0.01) were significantly related to methacholine-PC20. However, only 9 patients (39.1%) showed severe AHR, which was not significantly different from outpatients (25.8%). CONCLUSION: These results suggest that AHR is a risk factor of severe asthmatic attack and methacholine challenge just after control of acute asthma is relatively safe.
Asthma* ; Humans ; Methacholine Chloride* ; Outpatients ; Risk Factors ; Steroids

BACKGROUND AND OBJECTIVE: Studies indicate that humans infected with influenza virus manifest a post-virus increase in airway responsiveness. Therefore, whether influenza virus would cause airway hyperreactivity was investigated. SUBJECT AND METHOD: Rats were infected with rat-adapted influenza virus via nasal instillation. On days 1, 2, 3, 5, 7 and 9 post-virus inoculation, pulmonary mechanics were measured during an intravenous challenge with acetylcholine (ACh, 100-140 mg/ml saline). Cumulative dose-response functions were obtained by doubling the rate of the infusion every 2 minutes. RESULTS: ACh increased airway resistance and decreased dynamic compliance in a dosedependent manner. The airway responses to ACh was enhanced in most animals challenged 3 days after the inoculation. About half of the animals challenged 2 and 5 days after the virus inoculation showed hyperresponsiveness to ACh. No airway hyperresponsiveness was noted in animals on day 1 or 9 post-virus exposure. Tracheal muscle rings were isolated from infected, thus hyperresponsive animals and the contractile force to ACh and KCl was examined in vitro, where their dose-response characteristics were similar to those of muscles from controls. CONCLUSION: The rat model for influenza virus-induced airway hyperreactivity was developed, which manifested a post-virus increase in airway responsiveness.
Acetylcholine ; Airway Resistance ; Animals ; Bronchoconstriction ; Compliance ; Humans ; Influenza, Human* ; Mechanics ; Models, Animal ; Muscles ; Orthomyxoviridae ; Rats*

BACKGROUND AND OBJECTIVE: Specific IgE to food allergen is associated with atopic dermatitis, but it does not always show good clinical correlation. It has been suggested that IgG may be partly involved in allergen-induced reaction. This study was designed to investigate the clinical significance of specific IgG antibody to egg white (EW) in atopic dermatitis patients who showed improvement with egg elimination diet. METHOD: Eleven atopic dermatitis patients who responded to egg elimination diet were selected. They were classified into two groups; group I (n=5) with positive specific IgE to EW and group II (n=6) with normal levels of serum specific IgE. Two volunteers with no allergic diseases were enrolled in the control group. EW-specific IgG western blotting was performed with patient's serum and purified protein extracted from EW. RESULTS: IgG western blotting to EW in group I showed bands at 51.8 kD in two patients and bands at 35 kD in the others. In group II, two showed bands at 51.8 kD, and diffuse bands at 35 kD~51.8 kD were found in four patients. There were no bands in the control group. CONCLUSION: Regardless of the presence of specific IgE, specific IgG to EW was detected by western blotting in patients with egg-associated atopic dermatitis, suggesting that specific IgG may play a role in the pathogenesis of atopic dermatitis.
Blotting, Western* ; Child* ; Dermatitis, Atopic* ; Diet ; Egg White ; Humans ; Immunoglobulin E ; Immunoglobulin G* ; Ovum* ; Volunteers

BACKGROUND AND OBJECTIVE: Mahuangbujaseshintang (MBST) and soshihotang (SST) have been used for treatment of chronic disease of respiratory tract. It is necessary to clarify the mechanism of anti-allergic effects and to standardize the extracts. MATERIALS AND METHODS: The effects of MBST and SST were evaluated on histamine release in rat mast cells ex vivo. Several hours after administration of the extracts, mast cells were stimulated by DNP-ascaries and histamine contents were measured. Time course structural change of the cells was examined by dynamic study. In order to evaluate the effect of the extracts on the nasal patency, acoustic rhinometry was performed after administering of leukotriene D4 to both nasal cavities of guinea pig (GP). We examined the effects of the extracts with double-blind study, and also studied change of nasal patency after challenge of antigen by acoustic rhinometry in patients with allergic rhinitis. RESULTS: MBST at 4 hr and SST at 3 hr after oral administration remarkably inhibited histamine release from rat mast cells in a dose-dependent manner. MBST-treated GPs failed to show bi-phasic phenomena which indicated to reduce nasal volume at the time of early and late phases in allergic inflammation. Both groups of patients who took MBST and SST for 1 week or 2 weeks showed significant decreased symptom severity index (SSI) from treatment week 2 (p<0.05). The percent volume change after challenge of the antigen was decreased in 31 patients who took the extracts for 2 weeks. CONCLUSION: We can conclude that the herb medicine of MBST and SST may be effective for allergic rhinitis.
Administration, Oral ; Animals* ; Chronic Disease ; Double-Blind Method ; Guinea Pigs ; Histamine ; Histamine Release ; Humans ; Inflammation ; Leukotriene D4 ; Mast Cells ; Models, Animal* ; Nasal Cavity ; Rats ; Respiratory System ; Rhinitis* ; Rhinometry, Acoustic

BACKGROUND: Angiotensin converting enzyme (ACE) is heavily expressed in the lung and plays a role in the metabolism of angiotensin II, bradykinin and substance P. Nitric oxides, including those produced by endothelial nitric oxide synthase (ecNOS), may regulate vascular and airway tone in the lung and influence various aspects of airway homeostasis. They are potentially involved in the pathogenesis of asthma, but the role of ACE and ecNOS gene in bronchial asthma is not completely understood. OBJECTIVE: To examine the possible involvement of ACE and ecNOS genes in the genetic basis for bronchial asthma, we investigated the association between genetic polymorphism and bronchial asthma, and its severity. METHOD: We determined the ACE and ecNOS genotypes by the polymerase chain reaction in 160 patients with bronchial asthma and 121 healthy subjects. Severity of asthma was classified by the guideline of NHLBI/WHO workshop. RESULTS: The frequency of the ID genotypes of ACE and bb genotype of ecNOS was highest in both groups, respectively. The distribution of ACE genotypes did not differ between the two groups (p=0.27). There was a higher frequency of the bb genotype of ecNOS in the asthma group than in the control population (p=0.004). In asthmatic patients, there were no differences in the distribution of ACE and ecNOS genotypes in different severity groups (p= 0.17, 0.06). CONCLUSION: These results suggest that the polymorphism of the ecNOS gene, not ACE gene, may be associated with development of asthma. But, the severity of asthma may not be influenced by polymorphisms of the ecNOS and ACE genes.
Angiotensin II ; Angiotensins* ; Asthma* ; Bradykinin ; Education ; Genotype ; Homeostasis ; Humans ; Lung ; Metabolism ; Nitric Oxide Synthase Type III* ; Oxides ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Substance P

BACKGROUND: It has been reported that Mentha arvensis water extract (MAWE) inhibited systemic anaphylaxis and histamine release from the rat peritoneal mast cells (RPMC) by compound 48/80. OBJECTIVE AND METHOD: This study was undertaken to determine the inhibitory effects of immunoglobulin E (IgE)-mediated anaphylactic reaction by MAWE. This paper deals with an evaluation of the effect of MAWE on the anti-dinitrophenyl (DNP) IgE antibody induced anaphylactic reaction in rats. We also investigated the influence of MAWE on anti-DNP IgE antibody-induced tumor necrosis factor-alpha (TNF-alpha) production. RESULTS: MAWE inhibited passive cutaneous anaphylaxis (PCA) when intravenously, intrap- eritoneally, and orally administered. MAWE dose-dependently inhibited histamine release from RPMC activated by anti-DNP IgE antibody. Moreover, MAWE had an inhibitory effect on anti-DNP IgE antibody induced TNF-alphaproduction from RPMC. CONCLUSION: These results suggest that MAWE inhibits the IgE-mediated anaphylactic reaction in rats.
Anaphylaxis* ; Animals ; Histamine Release ; Immunoglobulin E ; Immunoglobulins ; Mast Cells ; Mentha* ; Passive Cutaneous Anaphylaxis ; Rats* ; Tumor Necrosis Factor-alpha ; Water

BACKGROUND AND OBJECTIVE: The cysteinyl leukotrienes are bioactive lipid mediators that contribute to the pathophysiologic condition of asthma and rhinosinusitis. We tested whether the leukotriene receptor antagonist ONO-1078 (Pranukast) had steroid sparing effect on mode- rate to severe asthmatics with chronic rhinosinusitis. METHODS: Eighteen asthmatic patients with chronic rhinosinusitis who required more than 800 mcg/day of budesonide inhalation for the adequate control of asthma symptoms were recruited for this study. For the first 4 weeks, patients were treated with high dose (800-1200 mcg/day) budesonide inhalation. For the next 4 weeks, the dose of budesonide inhalation was decreased by 400 mcg/day and oral ONO-1078 (900mg/day) was administered. FEV1 was evaluated every 2 weeks, and PC20 on methacholine challenge, serum eosinophil cationic protein and blood eosinophil count were measured every 4 weeks. Diary cards were completed with morning and evening PEFR and symptom scores for asthma and rhinosinusitis during the treatment periods. RESULTS: Despite the reduction of the dose of inhaled corticosteroid by 400mcg/day, FEV1 and PEFR did not decrease with the addition of oral ONO-1078. The symptom scores of asthma and rhino-sinusitis did not change, and the need for beta2-agonist did not increase. CONCLUSION: These results suggest that ONO-1078 might have steroid sparing effect in moderate to severe persistent asthmatics with chronic rhinosinusitis who required high dose nhaled budesonide to control asthma symptoms.
Asthma ; Budesonide ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Inhalation ; Leukotrienes ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Receptors, Leukotriene

Fluoroquinolones are antimicrobial agents that have a broad range of activity against both gram-negative and gram-positive organisms. Anaphylactoid reactions have been sporadically reported with fluoroquinolones. There have been a few reports that describes cross-reactivity between fluoroquinolones. We experienced a case of ofloxacin-induced anaphylactoid reaction, and confirmed cross-reactivity between ofloxacin and ciprofloxacin with the oral challenge test. Cross-reactivity between fluoroquinolones may be important, and avoidance of any fluoroquinolones should be mandatory for patients with hypersensitivity reaction to one of these drugs.
Anti-Infective Agents ; Ciprofloxacin ; Fluoroquinolones* ; Humans ; Hypersensitivity ; Ofloxacin*