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A case of Tetranychus urticae - induced asthma in an inhabitant around pear orchard.

Hae Sim PARK ; Young Koo JEE ; Eui Chang HWANG ; Jae Suk PARK ; Kye Young LEE ; Keun Youl KIM

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):606-609.

There have been a few reports of occupational asthma caused by Tetranychus urticae in fruit farmers or greenhouse workers. We report a case of bronchial asthma induced by Tetranychus urticae from a pear orchard in Cheonan city. An 18-year-old female student living around a pear orchard suffered from intermittent cough, rhinorrhea, and dyspnea for the 3 years. Her PC20 -methacholine was 0.15mg/ml, and skin prick test done with 55 inhalant allergens showed negative responses except Tetranychus urticae extract which was prepared with highly parasitized pear leaves. Bronchial provocation test with Tetranychus urticae extract showed a dual asthmatic response. These findings indicate that Tetranychus urticae, which include parasites in fruit trees, herba,ceous plants, and greenhouse cultures, can cause IgE-mediated bronchoconstriction in Korea.
Adolescent ; Allergens ; Asthma* ; Asthma, Occupational ; Bronchial Provocation Tests ; Bronchoconstriction ; Chungcheongnam-do ; Cough ; Dyspnea ; Female ; Fruit ; Humans ; Korea ; Parasites ; Pyrus* ; Skin ; Trees

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A case of anaphylaxis to laminaria.

Mi Seon KIM ; Do Yun KIM ; Yun Hae CHANG ; Young Joo CHO

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):601-605.

Anaphylaxis is a life - threatening syndrome elicited in a hypersensitive individual on subsequent exposure to a sensitizing antigen with, reactions ranging widely in severity from mild pruritus and criteria to shock and death. Anaphylaxis occurs in the United States at rates estimated to be as high as one in every 3000 inpatients and may account for more than 500 deaths annually. Preparations of kelp Laminaria digitata are used as tents in gynecologic procedures to dilate the cervix, and the kelp consists principally of a glucagon carbohydrate called laminarin. Laminarin is thought to function as the active ingredient in dilatation by changing osmotic pressure or uterine prostaglandin metabolism. The tent is inserted into the cervix several hours before the procedure. As the cervix desiccates and dilates, the tent develops an hourglass shape. Recently, we experienced one patient with anaphylaxis to laminaria diagnosed by skin test and showing good response to treatment.
Anaphylaxis* ; Cervix Uteri ; Dilatation ; Female ; Glucagon ; Humans ; Inpatients ; Kelp ; Laminaria* ; Metabolism ; Osmotic Pressure ; Pruritus ; Shock ; Skin Tests ; United States

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Clinical significance of specific IgG and IgE antibodies to toluene diisocyanate ( TDi ) - human - serum albumin ( HSA ) conjugate in TDI - induceed occupational asthma.

Hae Sim PARK ; Hee Yeon KIM ; Jung Hee SUH ; Dong Ho NAHM ; Jee Woong SOHN ; You Young KIM

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):594-600.

BACKGROUND AND OBJECTIVE: TDI is known to be the most prevalent cause of occupational asthma ( OA ) in Korea. However, the pathogenesis of TDI - induced occupational asthma still remains to be further clarified. So, we evaluated clinical significance of serum specific IgG and IgE antibodies to TDI - HSA conjugate in TDI - induced occupational asthma. Subjects and METHODS: Serum specific IgG and IgE antibodies to TDI - HSA conjugate were measured by enzyme linked immunosorbent assay. Serum was collected from 50 TDI- induced OA patients ( classified as group I ), and was compared with that from 13 asthmatic subjects with negative TDI - bronchoprovocation test ( BPT, group II ), allergic asthmatics ( group III ), and unexposed healthy controls ( group IV ). RESULTS: The prevalence of specific IgG was significantly higher in group I than in group II (p = 0.01) or group III (p <0.01). No significant difference was noted between group II and group III (p> 0.05). However, the prevalence of specific IgE was not different between group I and group II (p> 0.05 ) or group II and group III( p> 0.05 ). There was no significant difference in prevalence of specific IgG according to the asthmatic response during TDI bronchoprovocation test ( p> 0.05 ). No statistical significance was noted between specific IgG and IgE antibodies in group I subjects ( p> 0.05 ). CONCLUSION: These findings demonstrate that presence of specific IgG to TDI - HSA conjugate is closely related to TDI - BPT results and it may contribute to the development of TDI - induced asthma.
Antibodies* ; Asthma ; Asthma, Occupational* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunoglobulin E* ; Immunoglobulin G* ; Korea ; Prevalence ; Serum Albumin* ; Toluene 2,4-Diisocyanate* ; Toluene*

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Cross - reactivity between pollens in patients sensitlzed to multiple pollens.

Jung Won PARK ; Chein Soo HONG ; Yeong Yeon YUN ; Si Hwan KO

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):584-593.

Objective : The aim of this study was to evaluate cross - reactivity between pollens in patients with strong skin reactivity to multiple pollens. METHODS: A pool of sera from 20 patients who showed strong skin responses( > or = 3+ ) to all three kinds of pollens ( tree, grass, and weed ) was used. Oak, ryegrass, mugwort, ragweed and hop Japanese pollens were chosen for the subject of study. The level and pattern of bound IgE to each pollen and cross - reactivity between pollens were investigated by ELISA and immunoblot experiments. RESULTS: In ELISA, the IgE of a pool of sera reacted to ryegrass and ragweed in 100%, to mugwort in 95%, to oak in 75%, and to hop Japanese in 65%, respectively. In inhibitory ELI - SA, more than 50% of bound IgE was mutually inhibited in oak vs ryegrass, oak vs mugwort, mugwort vs ryegrass and mugwort vs hop Japanese. In immunoblot, the IgE binding rate to major allergens of each pollen was 95% for hop Japanese, 75% for ragweed, 50% for ryegrass, 35% for mugwort, and 30% for oak, respectively. In inhibitory immunoblot, the mutually inhibited bound IgE could not be observed between major allergens of each pollen, but some minor allergens of oak pollen were mutually inhibited by ryegrass. CONCLUSION: Cross - reactivity between major allergens of oak, ryegrass, mugwort, ragweed and hop Japanese pollens was not observed at all, but some minor allergens of oak pollen cross-reacted with ryegrass and mugwort, and so did those of mugwort pollen with ryegrass and hop Japanese.
Allergens ; Ambrosia ; Artemisia ; Asian Continental Ancestry Group ; Enzyme-Linked Immunosorbent Assay ; Humans ; Humulus ; Immunoglobulin E ; Lolium ; Poaceae ; Pollen* ; Skin

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Prevalence of gastroesophageal reflux in infants with recurrent wheezing.

Chein Soo HONG ; Jung Yeon SHIM ; Bong Sung KIM ; Ki Young PARK ; Kyung Mo KIM

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):576-583.

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.
Apnea ; Asthma ; Bronchiolitis ; Cough ; Dermatitis, Atopic ; Esophageal pH Monitoring ; Gastroesophageal Reflux* ; Humans ; Hypersensitivity ; Infant* ; Lung Diseases ; Pneumonia ; Prevalence* ; Reference Values ; Respiratory Sounds*

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One Year result of Dermatophagoides farinae antigen - speciffic autologous antibody complex immunotherapy in respiratory allergic patients sensitized to house dust mite.

Jung Won PARK ; Chein Soo HONG ; Yeong Yeon YUN ; Si Hwan KO ; Cheol Woo KIM ; Kyung Sup KIM

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):566-575.

BACKGROUND: Although good clinical effects have been reported, immunotherapy with house dust mite ( HDM ) antigen - autologous specific antibody complex ( IC - IT ) is not yet accepted as an effective immunomodulating tool in HDM allergic diseases. We aimed to prove the clinical effect of IC - IT in HDM sensitized respiratory allergic subjects. Method : Six HDM sensitized respiratory allergic subjects were enrolled. Autologous D. farinae specific IgG was purified with DEAE ion exchange and affinity chromatography. After one year of IC - IT treatment the clinical effects were analyzed with symptom scores, methacholine PC20, ELISA assay of D. farinae specific antibodies and intradermal skin reactivity. Result : The rhinitis symptom score significantly improved after a one - year administration of IC - IT ( 1.23 +/- 0.30 vs. 0.37 +/- 0.15, p< 0.05), but no significant differences were found in asthma symptom score, intradermal skin reactivity to D. farinae and ELISA optic absorbances of D. farinae specific IgE, IgG, and IgG subclasses. Methacholine PC20 values improved in all 6 patients who were administered with IC - IT ( 0.35 vs. 1.66 mg/ml, p< 0.05 ). CONCLUSION: IC - IT may be efficient for management of HDM atopic asthma. Further studies are needed before clinical application of IC - IT in house dust mite atopic subjects.
Antibodies ; Asthma ; Chromatography, Affinity ; Dermatophagoides farinae* ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy* ; Ion Exchange ; Methacholine Chloride ; Pyroglyphidae* ; Rhinitis ; Skin

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IL - 5 and IL - 10 production of peripheral blood mononuclear cells by stimulation of D. farinae antigen in atopic asthmatics.

Jung Won PARK ; Chein Soo HONG ; Si Hwan KO ; Cheol Woo KIM

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):557-565.

BACKGROUND: IL - 5 has been recognized as a potent proeosinophilic cytokine and IL-10 has been reported as an important anti - inflammatory cytokine in allergic inflammation. But the clinical roles of these cytokines in allergic asthma are still unclear. Objectives : We studied the clinical implications of IL - 5 and IL - 10 secretions from stimulated peripheral blood mononuclear cells ( PBMC ) in Dermatophagoides farinae ( DF ) atopic asthmatics ( BA ). METHODS: Thirty - six DF sensitized BA and 9 non - atopic BA were enrolled for this study. Twenty - seven out of 36 subjects were challenged by inhalation of DF crude allergen. The isolated PBMCs were cultured for 6 days with DF antigen and the stimulatory index ( SI ) and secretions of IL - 5, IFN - y and IL - 10 from PBMC were measured. We analyzed these parameters with clinical parameters. RESULTS: SI (4.2 +/- 1.0 vs. 1.3 +/- 0.3, p<0.05) and secretions of IL - 5 ( 19.9 vs. 1.7 g/L, p< 0.001 ) and IL-10 ( 185.5 vs. 34.3 g/L, p(0.05 ) from the atopic BA were significantly higher than those of non-atopic BA, but the secretion of IFN - r was not different between the two groups ( 56.6 vs. 47.3 ug/L ). No significant difference in secretions of IL - 5, IL - 10, IFN - r and SI of PBMC was found between responder and non - responder of DF inhalation challenge test. Among responders to antigen challenge test ( n = 17 ), the production of IL - 5 correlated with the productions of IL - 10 (r = 0.773, p< 0.01 ) and methacholine PC20 ( r = 0.503, p< 0.05 ). Production of IL - 5 from the PBMC of atopic mild intermittent BA ( n = 10 ) was higher than that of atopic per'sistent BA ( n = 27 ) ( p< 0.01 ), but no difference in IL - 10, IFN - r and SI was found between the two groups. Conclusions : Allergen specific productions of IL - 5 and IL - 10 from the PBMC may be specific for atopic subjects and secretion of IL - 5 from the stimulated PBMC may contribute to the pathogenesis of atopic BA. The severity of BA may be more influenced by other factors.
Asthma ; Cytokines ; Dermatophagoides farinae ; Inflammation ; Inhalation ; Interleukin-10 ; Methacholine Chloride

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The difference of interieukin - 4 and interferon - r production of Der p I stimulated T cells and effects of immunomodulator in house dust mite sensitive atopic and non - atopic individuals.

Jae Won OH ; Ha Baik LEE ; Yong Hoon CHUNG ; Yong CHOI ; Mi Kyoung SONG

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):548-556.

BACKGROUND: Allergic diseases are characterized by immediate - and late - phase reactions to various allergens by the selective activation of a subset of CD4 + T cells. In response to allergen, T cells isolated from atopic donors are biased to low levels of IFN - y and high levels of IL - 4, and vice versa by T cells from non - atopic donor. Objective : The aim of this study was to evaluate the patterns of IL - 4 and IFN - y production after Der p I stimulation and the effect on the cytokine production from T cells by budesonide, disodium cromoglycate and cyclosporin A in atopic and non - atopic individuals. MATERIAL AND METHOD: Seven Der p I specific atopic and 7 non - atopic individuals were selected. We decided the 50% inhibiting concentration of each immunomodulator by lymphocyte proliferation assay, and measured their effects on the cytokine production in vitro by intracellular IL - 4, IFN - y staining and flow cytometry. Results and CONCLUSION: There was significant difference on stimulation index ( SI ) of production of IFN - y as well as IL-4 after Der p I stimulation between atopic and non-atopic individuals ( IL - 4 ; 1.57 +/- 0.7 : 0.98 +/- 0.2, p = 0.026, IFN - r : 1.45 +/- 0.5 : 0.95 +/- 0.2, p = 0.048 ). The synthesis of IL - 4, and IFN - r were significantly inhibited after the stimulation of every immunomodulators in atopic individuals, DSCG couldnt inhibit IL - 4 and IFN - r in nonatopic individuals. There was no significant difference in the inhibiting effect of these immunomodulators in both of them.
Allergens ; Bias (Epidemiology) ; Budesonide ; Cromolyn Sodium ; Cyclosporine ; Dust* ; Flow Cytometry ; Humans ; Immunologic Factors ; Interferons* ; Interleukin-4 ; Lymphocytes ; Pyroglyphidae* ; T-Lymphocytes* ; Tissue Donors

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Leukotriene C4 synthase promoter polymorphism in aspirin - induced asthma.

Jae Youn CHO ; Sang Yeub LEE ; Seon Ae HAN ; Se Hwa YOO ; Sun Sin KIM ; Hae Sim PARK ; Jung Won PARK ; Chein Soo HONG ; Kwang Ho IN

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):542-547.

BACKGROUND: Aspirin/NSAIDs can release cysteinyl-leukotriene (cys-LTs) into airways and precipitate asthmatic symptoms in aspirin - induced asthma(AIA). It has been reported that there is profound overexpression of LTC4 synthase in their bronchial mucosa, compared to aspirin-tolerant asthma. Objective : We observed whether genetic polymorphism of LTC4 synthase may be predisposed to LTC4 synthase overexpression in AIA. Subject and METHOD: Forty - four AIA patients having positive responses on lysin aspirin bron choprovocation tests and 47 non - aspirin induced asthma ( non - AIA ) patients having negative challenges and 32 healthy controls were enrolled. The genotypes of the promoter LTC4 synthase gene ( A,C transversion ) were determined by polymerase chain reaction and restriction fragment length polymorphism ( RFLP ) method. RESULTS: LTC4 synthase promoter polymorphism ( A444C btransversion) was not significantly different between non - AIA and AIA patients (p>0.05). Conclusion These findings suggest that genetic polymorphism of LTC4 synthase promoter may not be predisposed to LTC, synthase overexpression in AIA.
Aspirin* ; Asthma* ; Asthma, Aspirin-Induced ; Genotype ; Humans ; Leukotriene C4* ; Mucous Membrane ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

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Comparison of two in vitro assays for serum house dust mite - specific IgE with skin testiong in allergic subjects.

Jae Won OH ; Ha Baik LEE ; Jee Young JUNG

Journal of Asthma, Allergy and Clinical Immunology.1999;19(4):535-541.

BACKGROUND: The skin prick test and in vitro allergen-specific IgE assays are commonly used to diagnose atopic diseases. However, there is still a need for comparison of their diagnostic efficiency. Objective and METHOD: To evaluate their clinical efficiency, the results of UniCAP and multiple antigen simultaneous test (MAST) were compared with skin prick test results. After 51 allergic patients completed skin prick test (SPT), serum sample was collected and UniCAP and MAST were performed to determine specific IgE to house dust mite (Dermatophagoides pteronyssinus : Dp and D. farinae. Df). Result : When SPT was used as a reference standard, UniCAP depicted higher sensitivity of 88.8% to Dp IgE and 91.4% to Df - IgE, but lower specificity of 73.3% to Dp IgE and 75.0% to Df - IgE. However, MAST had lower sensitivity of 75.1% to Dp-IgE and 71.4% to Df - IgE, higher specificity of 93.3% to Dp-IgE and 93.7% to Df - IgE. The values of UniCAP and MAST were significantly correlated with the reactivity grade of skin prick test, respectively. Additionally, the response of SPT was not apparently associated with ECP levels. CONCLUSION: These study results may suggest that both UniCAP and MAST are generally feasible for measuring house dust mite - specific IgE and that they are both replicable.
Dust* ; Humans ; Immunoglobulin E* ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin*

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