Results from two in vitro assays, Pharmacia CAP system(CAP) and fluoroallergosorbent test(FAST), for detecting serum specific IgE to three allergens, mugwort, Derraatophagoides pteronyssinus, and eat epithelium, were compared with skin prick test(SPT) results in 53 atopie dermatitis patients with positive SPT and 25 non-atopic controls. Using SPT results as the reference standards, CAP achieved higher sensitivity than FAST in determination of three allergens. CAP for measuring total IgE and eosinophil cationic protein(ECP) was also compared with FAST and ECP radioimmunoassay(RIA), respectively. In comparison of two assays for total serum IgE, the values obtained with CAP were significantly higher than those with FAST. In comparison of CAP and RIA for measuring ECP, the values obrained with CAP were significantly higher than those with RIA and the differences between ECP values of two assays were significant in high ECP group(>8.3 micro gram/1). These results suggest that CAP is the preferred test and seems to be more appropriate method for detection of specific IgE and ECP in patients with allergic digeases.
Allergens ; Artemisia ; Dermatitis ; Eosinophil Cationic Protein* ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Radioimmunoassay* ; Skin

A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

In this study, clinical effectiveness of Pharmacia CAP system for determination of allergen specific IgE was evaluated depending on the results of Bencard skin prick tests in 100 atopic and 18 nonatopic asthmatics. The Pharmacia CAP specific IgE positive rates were higher as the SPT grades were increased : negative (n=623) (17.8%); + (n=81) (34.6%); 2+ (n=223) (56.5%); 3+ (n=106) (70.8%); and 4+/-< (n=127)3+ (92.1%), respectively. The overall concordant rate between Bencard SPT and Pharmacia CAP system was 81.7% with range of 70.7~92.1%. The Overall sensitivity of Pharmacia CAP system was 80.7%. The sensitivities for 10 allergens, which ranged from 57.5% to 100 %, were as followed; D.pteronyssinus (96.1%), D.farinae (96.7%), cat dander (61.5%), cockroach (65.2%), Aspergillus fumigatus (57.1%), ragweed (62.5%), mugwort (75.0%), Meadow fescue (100%), birch (62.4%), and oak (80.0%), respectively. Overall specificity of Pharmacia CAP system was 82.2%. The specificity of CAP system in nonatopic subjects (n=18, 160 test) was 94.4% which was quite different with the 77.6% of atopic subjects (n=100, 463 test). SPT A/H ratios were significantly correlated with Pharmacia CAP specific IgE concentration (KU/L) in D.pteronyssinus (r=0.520, p<0.001), D.farinae (r=0.490, p<0.001), A.fumigatus (r=0.315, p<0.01), mugwort (r=0.210, p<0.05), ragweed (r=0.213, p<0.05), birch (r=0.232, p<0.05), M.fescue (r=0.410, p<0.001). But, in cockroach (r=0.192, p<0.1), cat dander and oak pollen, SPT A/H ratios were not correlated with the concentration of specific IgE. These results suggest that Pharmacia CAP system is useful for etiologic evaluation of immediate hypersensitivity and quantitative evaluation of specific IgE in atopic asthma.
Allergens ; Ambrosia ; Animals ; Artemisia ; Aspergillus fumigatus ; Asthma* ; Betula ; Cats ; Cockroaches ; Dander ; Evaluation Studies as Topic ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Pollen ; Sensitivity and Specificity ; Skin

To evaulate the possible pathogenetic significance of allergen-specific IgA antibody in respiratory secretion from asthmatics, we measured house dust mite(HDM)-specific IgA antibody in 3% saline-induced sputum from 23 HDM-sensitive asthmatics, 4 atopic asthmatics without mite-sensitivity, 6 non-atopic asthmatics, and 13 non-atopic, non-asthmatic controls (including 6 non-atopic healthy controls, 4 patients with chronic bronchitis, and 3 patients with rheumatoid arthritis) by ELISA. We also measured HDM-specific IgA antibody in serum and numbers of eosinophils in sputum. 1) Levels of HDM-specific IgA antibody in sputum from mite-sensitive asthmatics were significantly higher than those from non-atopic, non-asthmatic controls and non-atopic asthmatics(p<0.05). Levels of HDM-specific IgA antibody in sputum from atopic asthmatics without mite-sensitivity were significantly higher than those from non-atopic, non-asthmatic controls (p<0.05), however HDM-specific IgA/albumin raito was not significantly different between two groups (p>0.05). 2) The ratio of HDM-specific IgA antibody to albumin in sputum was not significantly different in mite-sensitive asthmatics with sputum eosinophila (> or = 5% of 200 counted leukocytes) and those without sputum eosinophilia (p>0.05). 3) The ratio of HDM-specific IgA to albumin in sputum from asthmatics was higher than that of serum. 4) There was no significant correlation of HDM-specific IgA/albumin ratios between serum and sputum (p>0.05). 5) When comparing sputum and saliva samples from 7 mite-sensitive asthmatics, levels of HDM-specific IgA antibody in sputum were significantly higher than those in saliva (p<0.05). In conclusion, HDM-specific IgA anti-body was increased in sputum from HDM-sensitive asthmatics, and it might be locally produced from bronchial mucosa. To evlauate the pathogenetic significance of allergen-specific IgA antibody in respiratory secretion from asthmatics, further studies might be needed.
Bronchitis, Chronic ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin A* ; Mucous Membrane ; Saliva ; Sputum*

We have studied male patients with cosmetic allergy in patch test during 5 years from September, 1982 to August, 1986 (Group A) and during 7 1/2 years from March, 1988 to August, 1995 (Group B). The results are as follows. 1. In Group A, 7 patients were diagnosed as contact allergy due to cosmetics. In Group 13, 30 patients were diagnosed as contact allergy to cosmetics. 2. Sixteen patients were positive to only cosmetic related allergens. Two patients were positive to only their own cosmetic products. Nineteen patients were positive to both cosmetic related allergens and their own cosmetic products. 3. The age of patients with cosmetic allergy ranged from 10 to 70 years with a peak in the fifties. The patients more than 50 years were about 40% of all patients. 4. The most frequently, affected area was face(n=31) followed by neck(n=6) and scalp (n = 6 ). 5. Twenty four patients with cosmetic allergy had eczematous skin lesions. Thirteen patients had pigmented skin lesions and pigmented contact dermatitis was suspected. Two out of 13 patients with pig men ted skin lesions were positive in photopatch test. 6. Cosmetic related allergens showing frequent positive reactions were paraphenylene-aliamine, fragnance mix, balsam of Peru, benzyl salicylate, amerchol L101, oakmoss absolute, musk muskene. 7. Cosmetic products showing frequent positive reactions were skin care products, hair dye, soap, after shave lotion, shampoo and toothpaste. In conclusion, cosmetic allergy in men seems to increase in our society.
Allergens ; Dermatitis, Contact ; Hair ; Humans ; Hypersensitivity* ; Male* ; Patch Tests ; Peru ; Scalp ; Skin ; Skin Care ; Soaps ; Toothpastes

32 year-old male patient has experienced the repeated swelling of the skin on the eyelid, both hand, foot, lower and upper extrimities and testicle spontaneously without any trauma since 17 years old. This happening has subsided with or without treatment after 2-3 days. His great grandfather had suffered from the same events but grandfather or father or even his two brothers and one sister didn't have any swellings like him. Two days after this attack, he visited emergency room, his serum complement level was decreased such as C1q 9.7mg/dl (10-20mg/dl), C3 52mg/dl (55-120mg/dl), C4 4mg/dl (20-50mg/dl) measured by single radial immunodiffusion (SRID), but two weeks after full recovery, C1q 11.2mg/dl, C3 79mg/dl, C4 5mg/dl. The level of C1 esterase inhibitor was decreased upto 8.1 mg/dl (> 11 mg/dl) measured by nephlemeter(Mitshibishi Co., Japan). Now he is just under the close observation without androgen treatment because the attack of HAE(hereditary angioedema) happens much less and less severe after adolescence.
Adolescent ; Adult ; Angioedemas, Hereditary* ; Complement C1 Inhibitor Protein ; Complement System Proteins ; Emergency Service, Hospital ; Eyelids ; Fathers ; Foot ; Hand ; Humans ; Immunodiffusion ; Male ; Siblings ; Skin ; Testis

Glucocorticoid hormones have been identified as one of the B cell activating signals necessary in IgE synthesis in the presence interleukin 4(IL-4). One question to be addressed in IgE synthesis is whether there is difference between atopics and non-atopics. In the present study, we aimed at looking the different effects of interleukin 4(IL-4) and hydrocortisone(HC) in IgE synthesis by peripheral blood monounclear cells (PBMCs) from 12 atopic patients and 6 non-atopic controls. PBMCs were cultured with IL-4 and/or HC for 14 days, and net IgE production was measured in the supernatant. Significant spontaneous IgE production by PBMCs was oberserved only in atopics. IL-4 increased net IgE synthesis by PBMCs from both atopics and non-atopics by similar amounts, whereas HC had that effect only in some atopics who showed high spontaneous IgE production. HC acted synergically with IL-4 in a narrow range of concentration which is individually different. This effect was more remarkable in subjects with low total serum IgE levels. These data suggest that atopic patients may have larger numbers of B cells committed to produce IgE, and that the effect of HC on IgE synthesis in vitro may be due to the priming effect of IL-4 in vivo.
Antibodies* ; B-Lymphocytes ; Humans ; Hydrocortisone* ; Immunoglobulin E* ; Interleukin-4* ; Interleukins*

OBJECTIVES: Allergen is closely related with local features and cultural environment and a new approach method regarding causes triggering aggravation is especially required due to complex and variety of ordinary residence and pollution of living environment recently. We, therefore, performed this study to inspire the necessity of identification of causative afeuts in aothmatic patients in pusan area. METHODS: We measured serum specific IgE antibody by means of chemiluminescent analyzer employing MAST, classified the level from class 0 to 4 and interpreted the result in order to identify allergen on total 262 patients consisted of inpatients and outpatients who had been presumed as extrinisic asthma and treated in this hospital during 2 and a half years from June of 1994 to December of 1996. RESULTS: 1. With regard to sex and age distribution, the rate of men versus women was 1 : 1.3, while in the distribution by age, the twenties and the thirties were the most as 29% and 26% respectively. 2. The result of interpretation of the test showed positive in 75%, 78% of which showed positive reaction compounded of 2 kinds or more. 3. If we take a look at the distribution of total IgE class in the positive area, we can find that ; Class III and class II showed the highest frequency as 47% and 37% respectively. 4. If we take a look at the distribution by age and allergen, the twenties(32%) and the thirties(30%) showed the highest frequency, the fifties, the forties and the teens showed middle frequency as 10~13% and the sixties and the seventies showed the lowest frequency as about 1%. The causative allergen appeared in the order of pollen(40%), dust(20%), food(18%), fungus(13%) and epidermis(8%). 5. The distribution of allergen by season generally showed high rate of positive appearance in spring and fall as pollen appeared in spring(44%) and fall(27%), dust appeared in fall(32%) and summer(23%), food appeared in spring(34%) and fall(29%), fungus appeared in fall(30%) and spring(28%) and epidermis appeared in spring(30%) and fall(28%). 6. With regard to the allergen: (1) In pollen allergens, trees showed higher positive frequency than weeds and trees were in the order of birch(14%), alder(13%) and hazelnut mix(12%) and weeds showed similar positive values. (2) In dust allergens, mite(D. pteronyssinus and D. farinae) showed high positive rate as 39% each. (3) In epidermal allergens, it also showed relatively even positive value among which cat's halr-dandruff was the highest as 40%. (4) In food allergens, shrimp showed the highest as 22% and others were similar as evenly positive values. (5) In fungus allergens, Candida and Stemphylium showed the highest value as 19% each. CONCLUSION: The analysis of allergen by means of MAST could be used as a valuable guide post for identifing cousative antigens for active treatment of extrinsic asthma.
Adolescent ; Age Distribution ; Allergens ; Asthma* ; Busan* ; Candida ; Corylus ; Dust ; Epidermis ; Female ; Fungi ; Humans ; Immunoglobulin E ; Inpatients ; Male ; Outpatients ; Pollen ; Seasons ; Trees

To detect causative allergens in type I hypersensitivity diseases, several methods have been used. Among those, skin prick test is easy to perform and sensitive. Several criteria presenting positive reactions have been used. Therefore, we tried to find out more sensitive and specific criteria for deciding a positive reaction on skin prick test in 57 patients(allergic rhinitis; 39, bronchial asthma ; 5, acute urticaria ; 2, chronic urticaria ; 11) with 69 allergens and compared the reproducibility between each positive criteria. We calculated the ratio of wheal size caused by each allergen to that of histamine and defined as "A" in case of it's ratio was over 0.5, "B" in case of over 0.7, "C" in case of over 1.0. The results were as follows, 1. The positive rate of house dust on skin prick test was the highest, and D. farinae, cat fur, D. pteronyssinus, mixture of cat fur, house dust, horse hair, dog hair in order. 2. Mean reproducibilities of four common allergens in each positive criteria were 91% in criteria A, 88% in criteria B, and 82% in criteria C. 3. Comparing between mean reproducibilities by earth positive criteria, in positive criteria between 0.5 and 0.7 and positive criteria between 0.7 and 1.0, there were no significant differences, but in positive criteria between 0.5 and 1.0, statistical significant difference was noted. In conclusion, it was suggested that the ratio of wheal sizes of allergen to histamine greater than 0.7 might be ideal for a positive skin prick test.
Allergens ; Animals ; Asthma ; Cats ; Dogs ; Dust ; Hair ; Histamine ; Horses ; Hypersensitivity, Immediate* ; Rhinitis ; Skin Tests* ; Skin* ; Urticaria

It has been suggested that Alternaria is the most prevalent fungal allergen based upon previous reports of airborne spore survey and allergy skin prick test. In order to observe the clinical features of Alternaria-sensitive asthmatic patients, and to evaluate a diagnostic value of allergy skin prick lest, serum specific IgE antibody, and bronchoprovocation test to Alternaria antigen, we performed allergy skin prick test with two sources of Alternaria antigens as well as 80 common inhalant and food allergens, and serum specific IgE antibody was determined by Ala-STAT(DPC, USA). To confirm bronchial sensitization, bronchoprovocation test with Alternaria alternata antigen from Allergophama (Germany) was performed on 15 asthmatic subjects sensitized to any of Alternaria spp. antigen, and compared between positive and negative responders. Eleven among 15 patients showed early (7) or dual (4) asthmatic responses. Four (36.4%) of 11 positive responders showed an positive response to one kind of Alternaria antigen on skin prick test. Four (36.3%) of them had a positive response to only Alternaria antigen with all negative responses to other fungal allergens. Seven (63.6%) of them showed positive responses to other fungal allergens such as Fusarium spp., Cladosporium spp., Aspergillus spp. All except one of 11 positive responders had high specific IgE antibody to Alternaria alternata on AlaSTAT. These results suggest that more than two sources of Alternaria spp. antigen should be used for screenig a causative fungal allergen. Determination of serum specific IgE can be helpful to complete the sensitivity of skin prick test in case of asthmatic patients sensitized to Alternaria antigen. Further studies will be needed to evaluate allergenic relationships with other fungal allergens appearing cocurrently on skin prick test.
Allergens ; Alternaria* ; Aspergillus ; Asthma* ; Cladosporium ; Fungi* ; Fusarium ; Humans ; Hypersensitivity ; Immunoglobulin E ; Skin ; Spores