No abstract available.
Asthma, Occupational*

No abstract available.
Asthma*

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

BACKGROUND AND OBJECTIVE: House dust mites have been known as the most important allergens in respiratory allergic disease. Since environmental factors may have influences on the pathogenesis of allergic disease, the study using Korean house dust mites for immune and biologic reactions in house dust mite-sensitive allergic disease is considered as significant. MATERIAL AND METHOD: We made two in-house allergenic extracts of Korean house dust mites (D. farinae and D. pteronpsssinus) and performed this study for the allergen standardization by in vivo methods and for the evaluation of the reliabilities for clinical applications. RESULT: As a results of biologic standardization using skin prick test teachnique, the activity of 1: 1,500w/v of D. farinae extract was estimated 1,000 biology unit(BU), concentration that elicits a wheal of the same size as that of histamine dihydrochloride 1mg/ml. The activity of 1: 1,000w/v of D. pteronyssinus was condiered as 1,000BU. The activity of 1:100w/v of both D. farinae and D. pteronpssiuns extracts were considered as 100,000 Allergy Unit(AU), based on intradermal skin testing of 30 subjects with strong sensitive reaction. The concordant rates between results of skin prick test done with 5,000BU/ml concentration of in-house allergenic extracts and thoae with the commercially available allergen(Bencard Co., UK) were 84.6% and 81.0% for D. farinae and D. pteronpssinus, respectively. The wheal erythema size and A/H ratios induced by in-house extracts were significantly correlated with those induced by Bencard allergen. CONCLUSION: This results suggest that in-house extracts of the whole bodies of two house dust mites have good allergenic activities in vivo. It is considered to be clinically useful and reliable allergenic extracts.
Allergens ; Biology ; Dust* ; Erythema ; Histamine ; Hypersensitivity ; Pyroglyphidae* ; Skin ; Skin Tests

OBJECTIVE: We evaluated the clinical implications of serum ECP and peripheral blood eosinophil counts as indices of airway inflammation during the follow-up of asthmatics (BA). METHODS: We repeatedly measured the serum ECP, peripheral blood eosinophil counts and peak expiratory low rate (PFR) during the follow up of 24 symptomatic BA. RESULTS: Mean serum ECP level of BA at uncontrolled status of airflow limitation was significantly higher than that of controlled state (24.5i3.7 ng/ml rs. 16.2+1.9 ng/ml, p<0.05) and the ECP levels of controlled and uncontrolled status were significantly higher than that of health control subjects (n=10, 10.1+/-2.0 ng/ml, p<0.01 respectively). Pe ripheral blood eosinophils were also significantly increased in uncontrolled status than in controlled status of BA (535.7+/-81.0/1tL vs. 300.4+33.4/micro liter, p < 0.05). In controlled status, 8 BA had higher circulating ECP levels than in uncontrolled status, but with peripheral blood eosinophil counts, only 3 BA had higher levels in controlled status than in uncontrolled status. Variations of PFR correlated with the variations of serum ECP level (r=-0.5370, p<0.01) and variations of peripheral blood eosinophil count (r=-0.6215, p<0.001). CONCLUSION: Measurement of serum ECP and peripheral blood eosinophil count would be useful tools for monitoring the disease activity of asthma, but we could not obtain any more informations from the measureinert of serum ECP levels than from the peripheral blood eosinophil counts.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Follow-Up Studies ; Humans ; Inflammation

Heterogeneity in clinical features and pathogenesis of non-steroidal anti-inflammatory agent (NSAIDs) hypersensitivity have been reported. NSAIDs can cause bronchial constriction in asthmatics or hives and angioedema in patients with chronic urticaria, in which case causative drugs show cross-reactivity with other NSAIDs. Normal subjects without allergic diseases may develop urticaria angioedema or anaphylaxis after ingestion of a specific NSAID. In this type of reaction, cross-reactivity between causative drugs and other NSAIDs does not occur. We experienced a case of acetaminophen anaphylaxis without aspirin sensitivity in a 38-year-old male, which was confirmed by oral provocation test. An oral challenge with 150mg of acetaminophen induced urticaria in lower legs, and erythema, with febrile sensation in ears. With a dose of 600mg acetaminophen, urticaria developed in trunk and extremities with facial angioedema. An oral provocation test with 650mg of aspirin was well tolerated without any adverse reactions. We report acase of acetaminophen anaphylaxis, which occurred in a normal individual at a small dose(150mg) without cross-reactivity with aspirin. This type of reaction supports heterogenei~ty of NSAIDs hypersensitivity and it may be caused by an other mechanism, not by cyclooxygenase inhibition.
Acetaminophen* ; Adult ; Anaphylaxis* ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin* ; Bronchoconstriction ; Ear ; Eating ; Erythema ; Extremities ; Humans ; Hypersensitivity ; Leg ; Male ; Population Characteristics ; Prostaglandin-Endoperoxide Synthases ; Sensation ; Urticaria

OBJECTIVE: The aim of this study was to investigate the usefulness of serum ECP as a marker of the severity of asthma and extent of airway inflammation. METHOD: We investigated 108 patients suffering from bronchial asthma, who were classified as mild intermittent(n=19), mild persistent(n=27), moderate persistent(n=42), and severe persistent(n=20) and 10 healthy controls. Atopy was defined as those who showed >2+ responses on skin prick test. Serum ECP, peripheral blood eosinophil, sputum eosinophil, and PEFR were measured on the same date and meth~acholine PC20 were determined within 2 weeks. RESULTS: Serum ECP levels were 10.1+- 2.0 ug/L in controls, and 29.1+- 23.6 ug/L in asthmatic patients. According to symptom severity, serum ECP levels were 22.9 +- 15.6 ug/L, 28. 6 +- 24.1 ug/L, 29.5 +- 22.2 ug/L, and 34.6 +- 31.2 ug/L in mild intermittent, mild persistent, moderate persistent and severe persistent asthmatic patients, respectively and there were no significant differences among four groups(p>0.05). Serum ECP levels correlated with peripheral blood eosinophil counts(r=0.48, p<0.01), but not with sputum eosinophil, PEFR, and methacholine PC20 levels. There was no significant difference in serum ECP level between atopic and non-atopic asthma(p>0.05). CONCLUSION: Single measurevment of ECP level at clinic could not represent the severity of asthma.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Skin ; Sputum

To study the immediate effects of high-dose intravenous methylprednisolone pulse therapy on the immune mechanisms in the absence of other immunosuppressive agents, we treated ten patients with active systemic lupus erythematosus, six with renal and three with central nervous system involvement with three daily 1 gram intravenous doses of methylprednisolone and measured the immune response before and just after discontinuation of the drugs. After the treatment, the mean seum IgG, IgA and IgM levels were essentially unchanged. Likewise, serum C3 and C4 levels were not changed significantly. In nine of ten patients, methylprednisolone pulse therapy reduced the levels of circulating immune complexes (p < 0.05). Thus the immediate clinical improvements with methylprednisolone pulse therapy are suggested to be the result of depression of the circulating immune complex levels.
Adolescent ; Adult ; Antigen-Antibody Complex/*analysis ; Case Report ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Human ; Immunoglobulins/*analysis ; Infusions, Intravenous ; Lupus Erythematosus, Systemic/*drug therapy/immunology ; Male ; Methylprednisolone/*administration and dosage ; Support, Non-U.S. Gov't

Hypersensitivity to the stings of the Hymenoptera has been described since antiquity. The hypersensitive reactions to insect stings vary from minor skin reactions to severe and sometimes fatal anaphylaxis. Concerns about sting hypersensitivity have been increasing because of many incidents of allergic reactions of patients to the fire ant in the southern area of the United States as well as the harvester ant in some areas. We experienced one unique case with severe allergic reactions by ant of the Ectomomyrmex spp. of the subfamily Ponerinae, which is not a harvester ant. For three years the patient had been suffering from generalized allergic reactions such as anaphylaxis after the ant stings four-five attacks in a year. We determined that her reactions were due to specific IgE mediated type I hypersensitivity by the detection of a high level of specific IgE to the ant venom in her serum. The high level of specific IgG4 to the ant venom was also noted in her serum, however, the role of ant venom IgG4 was not clearly determined.
Adult ; Anaphylaxis/*etiology ; Ant Venoms/*immunology ; Case Report ; Enzyme-Linked Immunosorbent Assay ; Female ; Human ; Immunoglobulin E/*analysis ; Immunoglobulin G/*classification ; Support, Non-U.S. Gov't

To investigate the role of specific IgE and IgG in the various types of asthmatic reaction, we measured specific IgE and IgG levels to Dermatophagoides farinae (D.farinae) using the D. farinae-radioallergosorbent test (RAST) and Phadebas IgG-RAST in 39 house dust asthmatics (11 early responders, 21 dual responders and 7 isolated late responders) and 12 negative responders on house dust bronchoprovocation. There were significant differences in the D. farinae-specific IgE level and skin reactivity to D. farinae and house dust among the 4 groups (p less than 0.05) and the specific IgE level of dual asthmatic responders was the highest and was significantly higher than that of early responders (p less than 0.05). The specific IgG level showed no differences among the 4 groups. These results suggested that the types of asthmatic reaction in house dust asthmatics were closely related to specific IgE level to D. farinae and the specific IgG level seemed not to be related to an isolated late response.
Adolescent ; Adult ; Animal ; Antibody Specificity ; Asthma/etiology/*immunology ; Bronchial Provocation Tests ; Dust/adverse effects ; Female ; Human ; Immunoglobulin E/metabolism ; Immunoglobulin G/metabolism ; Male ; Middle Age ; Mites/*immunology