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Intravaginal desensitization in a woman with seminal fluid allergy.

Jun Gu LEE ; Shi Hwan KO ; Jung Sik SONG ; Jae Ha HWANG ; Yong Han PARK ; Yoon Soo JANG ; Dae Jung KIM ; Sang Wook BAE ; Jung Woon PARK ; Chein Soo HONG

Journal of Asthma, Allergy and Clinical Immunology.1998;18(3):518-523.

Human seminal fiuid (HSP) hypersensitivity is rare, but possibly a life-threatening disease. The pathogenesis of seminal plasma hypersensitivity and the exact nature of the HSP allergens remains to be clarified. We report a case of 25-year-old female patient who complained of severe itching sensation, flushing and edema of external genitalia, facial edema and dyspnea after sexual intercourse. The diagnosis was established by skin pr ick test with her husbands diluted semen. Intravaginal desensitization was performed by modified Matloffs method. Dilutions was made with sterile human serum albumin(0.2%) and 0.4% pheno1-0.9% saline solution. Two ml each of progressively greater concentrations of semen dilutions(1: 100,000 v/v, 1: 10,000 v/ v, 1:1,000 v/v, 1:100 v/v, 1:10 v/v) were inserted intravaginally at 45-min intervals, followed by an undiluted specimen. The patient was successfully desensitized and could have unprotected intercourse without anaphylaxis.
Adult ; Allergens ; Anaphylaxis ; Coitus ; Diagnosis ; Dyspnea ; Edema ; Female ; Flushing ; Genitalia ; Humans ; Hypersensitivity* ; Pruritus ; Semen ; Sensation ; Skin ; Sodium Chloride ; Spouses

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A case of occupational asthma induced by latexin a hospital personnel.

Byung Jae LEE ; Yoon Keun KIM ; Kyung Up MIN ; You Young KIM

Journal of Asthma, Allergy and Clinical Immunology.1998;18(3):510-517.

IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria

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A case of drug - induced linear IgA bullous dermatosis.

Sang Hee HAM ; Seog Jun HA ; Young Min PARK ; Sang Hyun CHO ; Jin Wou KIM ; Baik Kee CHO

Journal of Asthma, Allergy and Clinical Immunology.1998;18(3):504-509.

Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal blistering disease characterized on direct immunofluorescence of perilesional skin by the linear deposition of IgA at the basement membrane zone. The pathogenesis of LABD is not known, but rar ely some cases of LABD have been reported in association with drug exposure. We report a case of drug-induced LABD showing linear deposits of IgA and IgG at the basement membrane zone on direct immunofluorescence of perilesional skin as well as typical clinical and histologic characteristics, although the causative agent could not be specified.
Basement Membrane ; Blister ; Fluorescent Antibody Technique, Direct ; Immunoglobulin A ; Immunoglobulin G ; Linear IgA Bullous Dermatosis* ; Skin

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A case of cold urticaria showing metachromasia in skin biopsy.

Soo In CHOI ; An Soo JANG ; Jae Hong PARK ; Hoon YOO ; Yoon Kyung KIM ; Young Cheol KIM ; Jeong Seog KIM ; Seong Hee OH ; Jee Shin LEE

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):250-254.

The patient was a 24-year-old male who complained of urticaria upon exposure to cold air and after showering in cold water. Allergic skin tests were positive for cockroach. To determine whether he had cold urticaria, we performed an ice cube test. The patient complained of pruritus, erythema, and wheals appeared at 10min. Skin biopsy specimens collected 10 minutes after ice-cube test showed perivascular mononuclear cell infiltration and edema in hematoxylin and eosin stains, and metachromatic cell and degranulation in toluidine blue stain.
Biopsy* ; Cockroaches ; Coloring Agents ; Edema ; Eosine Yellowish-(YS) ; Erythema ; Hematoxylin ; Humans ; Ice ; Male ; Pruritus ; Skin Tests ; Skin* ; Tolonium Chloride ; Urticaria* ; Water ; Young Adult

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Trichophyton and asthma: specific IgE, IgG1 and IgG4 determination.

Sun Sin KIM ; Soo Keol LEE ; Dong Ho NAHM ; Hae Sim PARK

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):241-249.

BACKGROUND AND OBJECTIVE: Trichophyton may be the causative allergen in patients with severe asthma. This study was performed in order to confirm Trichophyton as a causative antigen in asthmatic patients in Korea and to understand the pathogenic mechanism of Trichophyton- induced asthma. MATERIALS AND METHOD: Two groups of 33 asthmatic patients sensitized to Trichophyton anti- gen were enrolled. Group I included 12 patients showing positive results on Trichophyton bron- choprovocation test(BPT), group II included 21 patients showing negative results on Trichophyton-BPT, and group III included 19 controls showing negative results to Trichophyton antigen on skin prick test. Allergy skin prick test including Trichophyton as well as common inhalant allergens was done. To confirm bronchial sensitivity, BPT with Trichophyton extract was performed. Serum specific IgE, IgG1 and IgG4 antibodies by ELISA were done using Trichophyton mentagrophytes antigen and then compared with specific IgE results by RIA using Trichophyton tonsurans. RESULTS: Although there were no significant differences in asthmatic duration, total eosinophil count and skin reactivity(p>0.05, respectively), significant difference was noted in methacholine PC20 (p<0.05) between group I and II. There were no significant differences in specific IgE and IgG4 level between group I and group II (p<0.05). Specific IgE and IgG4 levels were significantly higher in group I than in group III (p<0.05, respectively). Two of group I patients had high specific IgG4 without specific IgE. There was no relationship between skin reactivity to Trichophyton mentagrophytes and specific IgE level. Positive predictive value of RIA for Trichophyton BPT was higher than that of ELISA. CONCLUSION: These results suggest that Trichophyton inhalation induces bronchoconstriction by IgE mediated mechanism. Trichophyton antigen should be included in skin prick test battery to screen causative agents for asthmatic patients. Further studies will be needed to evaluate the roles of specific IgG in Trichophyton-asthma.
Allergens ; Antibodies ; Asthma* ; Bronchoconstriction ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulin G* ; Inhalation ; Korea ; Methacholine Chloride ; Skin ; Trichophyton*

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IL-5 and IFN-gamma levels of bronchoalveolar lavage fluid (BALF) in patients with acute asthma and acute respiratory syncytial virus bronchiolitis.

Chang Keun KIM ; Soo Jeon CHOI

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):231-240.

INTRODUCTION: Our previous BAL study demonstrated that there were different implications of cell types between acute bronchiolitis and acute asthma. No data on airway cytokine responses in these two diseases is available. The aim of this study was to compare the pattern of cytokine response (Th1 or Th2) in the airways between these two diseases. MATERIALS AND METHOD: Using BAL, this study investigated the cytokine levels of BALF in children with acute asthma (n=12, median age 5.0 years) and infants with acute bronchiolitis caused by respiratory syncytial virus (RSV) (n=14, median age 1.4 years). Comparisons were made with normal controls (n=8, median age 5.1 years). BAL cell counts and differentials were determined. Interferon(IFN)-gamma (Th1), interleukin(IL)-4, and IL-5 (Th2) levels were measured in concentrated BALF by ELISA. RESULTS: The IL-5 levels were significantly increased in asthma group (p=0.000) and bronchiolitis group (p=0.023) compared with control group. The IL-5/IFN-gamma ratios were signifi- cantly increased in asthma group (p=0.000) and bronchiolitis group (p=0.039) compared with control group. The asthma group had significant elevations in IL-5 levels (p=0.001) and IL-5/ IFN-gamma ratios (p=0.046) compared to bronchiolitis group. IL-4 levels were at or below the level of detection in all subjects. The number of BAL eosinophils correlated (r=0.71, p=0.002) with the levels of BALF IL-5 in asthma group and bronchiolitis group. CONCLUSION: These findings suggest that RSV bronchiolitis results in Th2-type response as asthma, which could provide a valuable framework for explaining a link between RSV bron- chiolitis and asthma.
Asthma* ; Bronchiolitis* ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Cell Count ; Child ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Humans ; Infant ; Interleukin-4 ; Interleukin-5* ; Respiratory Syncytial Viruses*

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Role of IL-5-activated eosinophils on collagen gel contraction by lung fibroblasts.

Sang Hoon KIM ; Heung Woo PARK ; Sang Heon KIM ; Su Yeon LEE ; Soon Young JEON ; Yoon Seok CHANG ; Jae Won JEOUNG ; Byung Jae LEE ; Yoon Keun KIM ; Kyung Up MIN ; You Young KIM ; Sang Heon CHO

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):223-230.

BACKGROUND: Subepithelial fibrosis plays a major role in the development of irreversible airway obstruction in asthma. Eosinophils are major effector cells in allergic inflammation, and it has been suggested that eosinophil-derived mediators such as transforming growth factor-beta (TGF-beta) play a role in the pathogenesis of airway remodeling. OBJECTIVE: The aim of this study was to evaluate whether eosinophils activated by IL-5 plays a major role in the collagen gel contraction by lung fibroblasts. METHOD: Various cell numbers of lung fibroblasts were cultured in collagen gels to determine the appropriate numbers of fibroblasts. Purified human peripheral blood eosinophils were activated by IL-5 for 3 days, and TGF-beta mRNA expression was evaluated using semiquantitative RT- PCR. The cultured supernatants with or without TGF-beta were added to the collagen gel media with lung fibroblasts, and collagen gel diameter was serially measured to evaluate collagen gel contraction. RESULTS: The amount of collagen gel contraction was significantly associated with the number of fibroblasts (p< 0.05), and TGF-beta significantly contracted the collagen gel to contract in a dose-dependent manner (p< 0.05). However, supernatants derived from IL-5-activated eosinophils did not contract the collagen gel compared to controls (p> 0.05). Moreover, expression of TGF-beta mRNA in eosinophils was the same before and after stimulus of IL-5. CONCLUSION: Activated eosinophils by IL-5 may play a minor role in the collagen gel contraction by lung fibroblasts.
Airway Obstruction ; Airway Remodeling ; Asthma ; Cell Count ; Collagen* ; Eosinophils* ; Fibroblasts* ; Fibrosis ; Gels ; Humans ; Inflammation ; Interleukin-5 ; Lung* ; Polymerase Chain Reaction ; RNA, Messenger ; Transforming Growth Factor beta

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A comparative study of intranasal budesonide and oral terfenadine in perennial allergic rhinitics: effect on the symptom score and nasal secretion eosinophils.

Bong Jae LEE ; Yong Jae KIM ; Jae Ho KIM ; Hyun Soo SHIN ; Yoo Sam CHUNG

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):216-222.

BACKGROUND: Eosinophilia in the nasal secretion and mucosal tissues is the characteristic finding of allergic rhinitis. We compared the effects of nasal budesonide dipropionate and oral terfenadine on the symptom score and nasal secretion eosinophils in perennial allergic rhinitics. MATERIALS AND METHOD: Study subjects consisted of 81 patients with perennial allergic rhinitis and nasal eosinophilia. Fifty-seven patients were treated with nasal budesonide and 24 patients were treated with oral terfenadine for two weeks respectively. Nasal secretion eosinophils were measured as the percentage of total leukocytes under microscope. Symptom scores for sneezing, rhinorrhea, obstruction and itching were graded from 0 (no symptom) to 3 (severe symptom). RESULTS: In budesonide treatment group, symptom score reduction (total symptom score before treatment-total symptom score after treatment) was 5.1, while it was 2.3 in the terfenadine treatment group, which revealed a statistically significant difference (p<0.01). Reduction of eosinophils was 50% in the budesonide treatment group and 28% in terfenadine treatment group (p=0.045). There was statistically significant correlation between total symptom score and % eosinophils (r= 0.668 , p<0.01 ) CONCLUSION: Although both the nasal budesonide and oral terfenadine substantially reduced the proportion of eosinophils in the nasal secretion as well as symptoms in allergic rhinitics with eosinophilia, budesonide was superior to terfendine. Nasal eosinophils correlated with reduction of allergic symptoms in a statisticaly significant manner.
Budesonide* ; Eosinophilia ; Eosinophils* ; Humans ; Leukocytes ; Mucous Membrane ; Pruritus ; Rhinitis ; Sneezing ; Terfenadine*

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Changing patterns of skin reactivity to inhalant allergens in asthmatic patients.

Cheol Woo KIM ; Jae Hoon LEE ; Hye Won JUNG ; So Rae CHOI ; June Won CHEONG ; Jung Won PARK ; Chein Soo HONG

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):205-215.

BACKGROUND: Skin prick test has been the primary diagnostic tool used to recognize causative allergens, and there is some evidence that skin reactivity to allergens can be altered by changes in the environment. OBJECTIVE: We performed this study to evaluate whether there are changes in skin reactivity to inhalant allergens among patients with bronchial asthma. MATERIALS AND METHOD: We reviewed the skin prick test results of 384 bronchial asthmatics tested in the early 1990s (June 1992-May 1994) with 52 common inhalant allergens and compared the results of 500 asthmatics tested in the mid 1980s (Jan 1984 - May 1987) with the same kinds of allergens provided by the same manufacturer. RESULTS: Of the 384 subjects tested in the early 1990s, 276 subjects(71.9%) had positive reaction to one or more inhalant allergens and the positive rate was not different from that of the mid 1980s(74%). But, skin reactivity to pollens was significantly increased. In individual allergens, house dust mite(D. farinae and D. pteronyssinus) was the most reactive allergen (52.3%, 43.2% respectively) in the early 1990s. Significant differences in skin reactivity to ragweed (10.0% vs 22.1%, p<0.05) and cockroach (12.7% vs 25.0%, p<0.05) were found when the results of the 1980s and the 1990s were compared. CONCLUSION: House dust mite was the most important allergen in asthmatics from the mid 1980s to the early 1990s. There was increased sensitization to cockroach and ragweed allergen in the early 1990s. Further prospective immunologic and environmental studies are recommended for proper interpretation of the changes in skin reactivity.
Allergens* ; Ambrosia ; Asthma ; Cockroaches ; Dust ; Humans ; Pollen ; Pyroglyphidae ; Skin*

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Prevalence of atopic rhinitis and causative allergens in children living in rural areas of Cheju island.

Myung Hyun LEE ; Sung Chul HONG ; Yoon Keun KIM ; Sang Heon CHO ; Kyung Up MIN ; You Young KIM

Journal of Asthma, Allergy and Clinical Immunology.2001;21(2):198-204.

BACKGROUND: Atopic diseases have been increasing according to changes in life style and indoor environments. Atopic rhinitis is a prevalent atopic disease in children, but the prevalence has been reported differently according to geographic areas. OBJECTIVE: This study was conducted to elucidate the prevalence of childhood atopic rhinitis and to identify the distribution of causative allergens in total children living in rural areas of Cheju island. METHOD: A total of 7,145 subjects aged 7-15 years in South Cheju County was recruited in this study. They responded to an ISAAC questionnaire and underwent allergy skin prick test with common aeroallergens. Chronic rhinitis was positive in this respect if subjects experienced two or more rhinitis symptoms such as sneezing, runny nose, itchy nose and nasal blockage, which were not related to the common cold. Atopy was regarded as positive when the wheal caused by one or more of the common allergens was the same or larger than that caused by histamine. RESULTS: The prevalence of chronic rhinitis was 10.5%. The prevalence of chronic rhinitis was the same between girls and boys, but higher as the ages of the subjects were older (7-9 years: 7.7%; 10-12: 10.6%; 13-15: 12.3%, p< 0.001). The atopy rate was 59.7%, meaning that the prevalence of atopic rhinitis was 6.2% and non-atopic rhinitis 4.2%. The common sensitizing allergens in decreasing order were Dermatophagoides pteronyssinus (40.4%), D. farinae (36.3%), citrus red mite (16.4%), cockroach (14.4%), outdoor Fungi (9.8%), Hop Japanese (5.6%) and Japanese cedar (4.5%) pollens. CONCLUSION: The prevalence of atopic rhinitis was 6.2% and the causative allergens such as citrus red mite and Japanese cedar pollen were different from the Korean mainland area.
Allergens* ; Asian Continental Ancestry Group ; Child* ; Citrus ; Cockroaches ; Common Cold ; Cryptomeria ; Dermatophagoides pteronyssinus ; Female ; Fungi ; Histamine ; Humans ; Humulus ; Hypersensitivity ; Jeju-do* ; Life Style ; Mites ; Nasal Obstruction ; Nose ; Pollen ; Prevalence* ; Rhinitis* ; Skin ; Sneezing ; Surveys and Questionnaires

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