[Show abstract][Hide abstract]ABSTRACT: We report a new case of rhinitis and asthma caused by sea fishing baits. The results showed exposure to Sipunculus nudus (Phylum Sipuncula; order Sipunculida: Sipunculidae) to be the main cause of the allergic symptoms. The intervention of IgE was demonstrated, with the presence of cross-reactions with allergenic extracts from other worm species used as baits, belonging to different orders of Annelida.
Full-text Article · Feb 2005 · Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunología
[Show abstract][Hide abstract]ABSTRACT: The inhalation of Parietaria judaica pollen is a common cause of allergic respiratory diseases in the Mediterranean area. The objective of this study was to investigate the safety and clinical efficacy of a chemically modified (depigmented and glutaraldehyde-polymerized) vaccine of Parietaria judaica.
Thirty patients with a well-documented clinical history of seasonal rhinitis and clinical sensitivity to Parietaria judaica pollen were included in a randomized trial during 12 months. The study was conducted following good clinical practices and appropriate consent forms were signed. Patients were divided into 2 groups of 15 individuals; group A received the modified extract and group C did not receive specific immunotherapy. Any adverse event was recorded to assess safety. Symptom scores, symptomatic medication use and the results of specific nasal challenges (before and after 12 months of treatment) were recorded to evaluate clinical efficacy. The treatment schedule consisted of an incremental phase of 5 injections and a maintenance dosage of 0.5 ml per month. Each patient received 14 injections during this period. All the patients completed the trial and no adverse reactions related to immunotherapy were recorded. A significant difference (p < 0.001) in symptom scores and overall use of symptomatic medication was observed between the two groups, being both scores lower in group A. No significant differences in nasal sensitivity existed before treatment among the 2 groups. However, after 12 months, a significant difference (p < 0.05) was observed only in group A patients, who showed a significant improvement in specific nasal challenges.
Immunotherapy with depigmented and glutaraldehyde-polymerized extract of Parietaria judaica pollen is safe and effective to treat patients with allergic rhinitis and clinical sensitivity to this pollen.
Article · Dec 2003 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: The purpose of this study was to evaluate the clinical efficacy over a period of three years (1988-90) of two preseasonal dosage regimens of a Parietaria allergoid (Bencard Tyrosine Parietaria) in patients who were only sensitive to this pollen. Fifty patients were included (14 men and 36 women, age: mean, 28 years; range, 14-47 years). Twenty five patients (group A) were treated each january with the basic course of Bencard Tyrosine Parietaria. This consisted of injecting subcutaneously 0.5 ml from each of three vials, with one week between each injection. A further injection using the vial with the highest dose was given one week later. Each january and february, twenty five patients (group B) were treated with the basic course of Bencard Tyrosine Parietaria, repeating the last dose five times, with one week between each injection. Immunotherapy with a tyrosine-adsorbed Parietaria judaica allergoid is an effective method for mitigating nasal (p < 0.0001), bronchial (p < 0.005), conjunctival (p < 0.001) and palatal itching symptoms (p < 0.0001) in patients who are sensitive to this pollen. Sensitivity to Parietaria pollen, as verified by skin test and nasal challenge, decreased during immunotherapy (p < 0.001). Histamine release by peripheral blood basophils decreased during the course of the study, falling from 43.5 ng/ml to 12.3 ng/ml in group A and from 42.9 ng/ml to 10.0 ng/ml in group B; during the second and third years, IgG levels were increased one and four months after starting treatment with the extract, while this was not the case after ten months; IgE levels were also increased. Finally, overall tolerance to this immunotherapy product was good in almost all patients.
Article · May 1999 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: Background: Pistachio, cashew nut, and mango belong to the Anacardiaceae family. The increasing consumption of these fruits in recent years has determined an increase in the frequency of sensitization to these foods. Methods: Ten patients (5 women and 5 men) with history of food allergy to Anacardiaceae were studied by means of in vivo and in vitro techniques. The presence of specific IgE against Anacardiaceae was determined by prick test and RAST. The allergic profile to pistachio, mango, and cashew nut was assessed by SDS-PAGE followed by immunoblotting. RAST-inhibition test was performed in order to evaluate cross-reactivity among members of the Anacardiaceae family. Results: Prick tests against pistachio were positive in 8 patients, against cashew nut in 1, and against mango skin in 7, mango pulp in 5 and mango seeds in 3. Proteins of these products were detected by SDS- PAGE: in pistachio the most common proteins were found around 14,30,40, and 55 kDa; in cashew nut around 30 and 50 kDa; in mango skin around 10,12,43, and 45 kDa; and in mango pulp five proteins of 30, 41, 43, 70 and 80 kDa, respectively, were detected. RAST-inhibition test showed different cross- reactivities among members of the Anacardiaceae family and it was observed that mango seed extract inhibited all other extracts. Conclusions: This study confirms the presence IgE-mediated sensibivity to pistachio, mango, and cashew nut. Different allergens in this family were recognized, as well as cross-reactivity among these allergens.
[Show abstract][Hide abstract]ABSTRACT: Histamine is a major mediator of the allergic reaction, and histamine H1-receptor antagonists have a long history of clinical efficacy in a variety of allergic disorders. The pathogenesis of allergic disease is complex, involving not only histamine and mast cell-derived tryptase, but also eosinophil and neutrophil derived mediators, cytokines, and intercellular adhesion molecules (ICAM-1). A number of "in vitro" and "in vivo" studies have been performed to assess the clinical effectiveness of antihistamines in inhibiting the allergen-induced inflammatory process in the skin and mucosa. In vitro human studies have shown that high concentration of second generation antihistamines can block inflammatory mediator release from basophils and mast cells, and reduce ICAM-1 expression in epithelial cell lines. In vivo studies have also shown an effect on the allergen-induced inflammatory reaction; both oral and intranasal antihistamines cause a reduction in nasal symptoms and inflammatory cell influx. Analysis of secretory fluids and tissues after challenge indicates that antihistamines interfere with mediator release. Recruitment of inflammatory cells to the site of the allergic insult is also disturbed by antihistamines of second-generation, suggesting that these drugs may inhibit upregulation of molecules involved in cell adhesion and migration, and perhaps they may interfere with the cytokine cascade through their ability of stabilizing mast cells and of limiting the incursion of inflammatory cells. This article reviews available human data on the antiallergic effects of antihistamines.
Article · Jul 1996 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: The vast majority of clinicians in Europe now prescribe beta-2 agonists as first-line therapy for patients with asthma. Inhaler devices may deliver rapidly acting (beta-2 sympathomimetics) and more slowly acting (anticholinergic) bronchodilator therapy as well as prophylactic medication (sodium cromoglycate and topical corticosteroids). The metered dose inhaler (MDI) is most often prescribed, but at least 50% of patients cannot use this device efficiently and 10-15% of those who can, develop an inefficient technique. The vast majority of those patients are able to use a single-dose dry power inhaler. Recent studies have shown that a multidose dry power system can be used by most patients and is preferred to the MDI by over two-thirds of patient. The large volume spacer systems have been shown to be as good as the MDI and nebulizer systems in the management of asthma, and they are easier to use than the MDI. Nebulisers are of value in chronic asthma in children who cannot use other delivery systems. The role of nebulisers for the domiciliary treatment of asthma in adults, however, remains controversial.
Article · Jul 1996 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: The eosinophils of asthmatic patients release greater amounts of eosinophil cationic protein (ECP) than those of normal control subjects upon stimulation with Sephadex particles. In pollenosis patients, eosinophils release more ECP during the pollination season than at other times. A greater amount of eosinophils is seen in the airway mucosa in patients who have died of asthma than in other causes of death; furthermore, 40% of these eosinophils are activated. In most studies, serum ECP levels in asthmatics have been found to be elevated, and these levels correlate with the activity of the asthmatic disease. Steroid therapy lowers the ECP levels in parallel with the improvement in the disease. Serum ECP has been noted to increase upon antigenic challenge both in pollenosis patients and in those with mite allergy. Increased levels of ECP have also been documented in sputum and in bronchoalveolar lavage (BAL) fluid from asthmatics, correlating with the severity of asthma and with the lung function tests (inversely with the FEV1 and directly with airway resistance). A decrease of the ECP levels in sputum has also been noted in association with clinical improvement of the disease. Patients with exertional asthma evidence serum pre-exercise ECP levels which are higher than those of patients without this condition. After the exercise challenge test, and although the ECP levels initially increase in some patients, those levels are seen to be reduced after 60 minutes. The ECP in sputum and BAL fluid of asthmatic patients are significantly higher than those of chronic bronchitis ones, and this finding may be used as a differential diagnosis criterion between both diseases. Increased serum ECP levels have been reported in children and adults with atopic dermatitis. The ECP levels may be a useful instrument for monitoring disease activity in this ailment. In patients with pollen allergy, specific immunotherapy prevents the increase of the ECP levels which is otherwise observed during the pollination season.
[Show abstract][Hide abstract]ABSTRACT: Inhaled steroids have rendered an undoubtful benefit in the control of airway inflammation of the asthmatic patients. Our objective was to compare clinical efficacy between budesonide (BUD) and beclomethasona depropionate (BDP), when administered at equal doses (800 micrograms/24 hours). A two ways crossed open clinical trial was designed. Thirty-three steroid dependent chronic asthmatic patients (18 females, 15 males) were included. Ages ranged from 29 to 73 years (mean = 52.5 +/- 11.7). All subjects suffered a severe asthma, with several years of activity (mean = 11.7 +/- 7.8), insufficiently controlled by inhaled steroids and bronchodilators, who required regular systemic steroids supply. The parameters compared were: the patients subjective symptoms punctuation (cough, expectoration, thoracic noises, exercise induce dyspnea and dyspnea at rest), salbutamol needs (number of inhalations/day), additional prednisone needs, sputum eosinophil counts, FEV1 measurement and inespecific bronchial reactivity control (PD20 methacoline). After a baseline week patients received one of the drugs for 6 weeks and, after a lavage week, the other drug was administered for another 6 weeks. All patients improved with both therapies. We got the following conclusions: 1) a significative decrease in salbutamol (p < 0.05-0.001) and prednisone needs (p < 0.05-0.001); 2) this decrease has been more important during BUD therapy, although without significative differences; 3) no significant variations in sputum eosinophils, FEV1 or bronchial reactivity were observed; 4) both drugs, when administered at equal doses, have probed to be equally effective in severe steroid dependent asthma control.
Article · Sep 1995 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: Antihistamines are the drugs of choice in the symptomatic relief of chronic idiopathic urticaria; however, the usefulness of classic antihistamines has been limited by side effects. In the 1980s a new class of antihistamines has been developed that maintains effectiveness and produces less side effects (eg anticholinergic side effects, daytime sedation, etc). This review analyzes each of the new nonsedating antihistamines commercially available in Spain (astemizole, ebastine, cetirizine, loratadine and terfenadine) and evaluates its clinical efficacy and safety in the treatment of chronic idiopathic urticaria.
Article · May 1995 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: To determine serum levels of IgE and sCD23 and lymphocyte subpopulations, we studied 37 control subjects and 84 patients (27 with allergic rhinitis, 27 with extrinsic asthma, and 30 with intrinsic asthma). A rise in surface CD23 on B and monocyte cells and sCD23 serum levels was exhibited by patients with rhinitis and extrinsic asthma. Unexpectedly, in intrinsic asthmatic patients, high CD23 expression on monocytes and high sCD23 levels were seen that did not result in IgE production. It appears that CD23, in its soluble form, could be a good disease marker, especially in asthma. Atopic patients yielded a significantly lower proportion of CD4+ T cells than intrinsic asthmatic patients and normal persons. Otherwise, CD4+CD29+CD45RA- and CD4+CD29-CD45RA T-cell subsets were significantly decreased in all patient groups.
[Show abstract][Hide abstract]ABSTRACT: There is a wide evidence that food additives may precipitate adverse reactions. Some of these have catastrophic potential such as sulfite sensitivity in asthmatic patients. Fortunately, asthmatic responses to a variety of additives are certainly not as prevalent as once feared, and are probably unusual. In contrast to asthma, urticarial or other cutaneous reactions to food additives are more common. A restricted diet for a few months duration may be beneficial, although the mechanism through which this is achieved is unclear. It may be argued that the improvement is a consequence of the natural course of the disease and not from the diet. Results are similar in both children and adults. Despite a large number of studies evaluating the role of food additives in hyperkinesis, results are not unform. Evidence does suggest that there is a small subset of preliminary younger children in whom additives will impact on behavior. It is not easy to predict which children with hyperactivity will benefit from a dye and preservative free diet, although this is likely to be a younger child. Suspected food additive sensitivities are best documented by oral challenges, preferably in a double blind challenge way. In subjects with chronic urticaria, an adequate baseline of urticarial activity needs to be established before the challenges in order to avoid false-positive. Challenges in asthmatic patients need to be carried out with patients under their routine medications to avoid false positives. All care should be taken to titrate the doses and schedule the doses appropriately, since several of these agents could provoke large drops in pulmonary function.
[Show abstract][Hide abstract]ABSTRACT: Our patients with seasonal allergic rhinoconjunctivitis usually present severe clinical symptoms. A single daily dose of cetirizine 10 mg might be insufficient for these patients. To investigate this hypothesis we compared clinical efficacy and adverse side effects between two daily doses of cetirizine, 10 and 20 mg. We designed a comparative open randomized study, including 38 patients, with hay fever sensitized to local pollens (grass, olive, parietaria judaica, chenopodium album, artemisia vulgaris and plantago lanceolata) diagnosed by clinical history and a positive skin prick test (wheal > 3 mm), 20 women and 18 men, aged 17 to 57 years (x: 31.32 +/- 9.73), living in the same geographic area. Randomly, after a week run in period, 21 subjects received a daily dose of cetirizine 10 mg during 2 weeks, and the other 17 received 10 mg twice a day. The symptomatic score used was based on: sneezes number, nasal itching, nasal secretion, nasal congestion, ocular itching, lacrimation, weight gain, sedation and additional methylprednisolone usage. All symptoms were scored on a 0-3 scale (0: absent; 1: mild; 2: moderate; 3: severe). A mean 8 points daily score during the previous week was required for recruitment. Nasal eosinophilia was determined at baseline and at the end of treatment. The study was conducted in may 1992. We did not find significant differences between the two groups, except in sneezes number and sedation. Both groups improved their symptoms, in comparison with the basal week (p < 0.01) and reduced their oral steroid use (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Article · Sep 1993 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: This study was undertaken for two reasons: 1) It is more difficult to diagnose hypersensitivity to molds than to other allergens, so an evaluation of diagnostic tests was needed. 2) Alternaria is the principal cause of mold sensitization in our area. Sixty-six patients (20 +/- 4 years) were selected and divided into two groups. Group A was made up of patients with rhinitis and/or asthma due to Alternaria sensitization. Group B consisted of patients sensitized to other allergens and patients with nonrespiratory allergic disorders. Skin tests (prick and intradermal), challenge tests (conjunctival, nasal, and bronchial), and specific IgE determination were performed for all patients. A biologically standardized extract of Alternaria tenuis (Alergia e Inmunología Abelló, S. A., Madrid, Spain) obtained from a single batch was used for all tests. Our diagnostic criterion was a clinical history of rhinitis or asthma that coincided with the results of nasal/bronchial challenge. The diagnostic value of the other tests was compared to this criterion. In the group of rhinitic patients, skin tests and conjunctival challenge were more sensitive than specific IgE determination. In asthmatic patients, the most sensitive techniques were nasal and conjunctival challenges, followed by prick and intradermal skin tests, and, lastly, serum specific IgE determination. When rhinitis and asthma were considered jointly, the most sensitive test was conjunctival challenge, followed by skin-prick and intradermal tests. All tests had the same specificity, regardless of disorder. Nasal challenge was positive in all patients. Skin tests are easy to perform, cheap, non-traumatic for the patient, and sufficiently specific and sensitive for the diagnosis of Alternaria hypersensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)
Article · Jul 1993 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: This study was motivated by the discrepancy in the results of published studies on the amount of histamine released following the intravascular administration of iodinated contrast media (ICM) in humans. From a group of patients due to undergo cardiac catheterization, we selected 45 subjects with no history of atopy. A central blood sample (left ventricle) was taken from each subject before and at various times following the administration of the ICM. We determined total and basal histamine levels in every sample. We did not find any significant difference in the total histamine concentration between the samples taken before and after the administration of the ICM; but the basal histamine concentration rose from 5.32 ng/ml to 11.26 ng/ml (p less than 10(-9)). This increase was inversely proportional to the time that had elapsed between the administration of the ICM and the taking of the sample (p less than 0.01). We believe that the inconclusiveness of the results from studies on histamine release following the administration of ICM may be explained by the dilution and inactivation of histamine in the systemic circulation.
Article · Nov 1989 · Allergologia et Immunopathologia
[Show abstract][Hide abstract]ABSTRACT: Various works have been published, mainly by Scandinavian authors, in which a partial immunological identity has been found to exist between birch pollen and hazelnut and apple. However, our attention has been particularly drawn to the high proportion of people who are allergic to the apple and other fruits, which in some cases has been as much as 50 and 70%, and in whom an oral pruritus alone is considered sufficient a symptom of allergies to certain foodstuffs. However due to the fact that the incidence of allergies to fruit in patients who suffer from pollen-related allergies is much lower in this area, being in the order of 7%, and because of the absence of birch, we decided to carry out our investigation in the opposite direction to that chosen by the Scandinavian researchers. That is to say, from the point of view of patients suffering from allergies to fruits and vegetables (these being the foodstuffs which most frequently produce allergic reactions in our own particular environment) we decided to investigate: 1) which foodstuffs, according to clinical history, are most frequently responsible for producing allergies; 2) their possible co-existence with pollen related allergies; 3) which pollens are responsible for producing a higher rate of positive results in patients; 4) and finally, by means of the RAST inhibition technique, to discover it a cross-reactivity might exist between these pollens and the peanut or the pea. We chose 40 patients (19 females and 21 males), between the ages of 5 and 49 years old, whose clinical history showed beyond a shadow of a doubt that they displayed symptoms of immediate hypersensitivity after the ingestion of certain fruits and/or vegetables. The technique employed in the skin tests was that of scratch of the skin from the backs of the patients (in a prone position), systematically using fresh natural foodstuffs, and at the same time trying to ensure that they were of the same type as those that had originally produced the above-mentioned symptoms in the patients. On 193 occasions we carried out passive transfers (the Prausnitz-Küstner method or P.K.), and on 13 patients we carried out oral provocative tests (cases with positive scratch and uncertain clinical histories). With regard to the pollens, we used glycerine-based antigens of the type: Lolium perenne, Olea europeae, Artemisia vulgaris and Parietaria officinalis of Dome/Hollister-Stier, and the Bencard gramineae.(ABSTRACT TRUNCATED AT 400 WORDS)
Article · May 1985 · Allergologia et Immunopathologia