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52 Differences in mite-specific immune responses in atopic patients with asthma or rhinitis
Abstracts
J ALLERGY CLIN IMMUNOL VOLUME 97, NUMBER 1, PART 3
49
Tryptase Provocation
Release Tests
After
Nasal
51
in Parietaria a l l e r g y . M . L . Palma Carlos PharmD. PhD. M. (2. Santos PharmD, PhD.E. Pedro MD, A. S p i n o l a MD. F. Ferreira MD. A. G. Palma Carlos MD. PhD, Lisbon, Portugal. In 14 patients allergic to Parietaria (Pellitory wail) was confirmed by (clinical history, skin tests and specific IgE Cap Rast Feia) nasal provocation tests with different c o n c e n t r a t i o n s of pollen extract have been s e q u e n c i a l l y done. A s t a n d a r d i z e d extract (Bayer D.H.S.) was used in increasing dosages of 1, 10, 100, 1000 PNU, and tryptase assayed in nasal washings at 10, 20, and 30 rain. after provocation. A clear-cut increase on mean tryptase concentration in nasal lavage liquid has been observed after provocation with 1000 U. (Basal-2,9U/l, Dil.-3.1U/I, 1U-8,4U/I, 10U.-12,6U/I, 100U-21,6U/I, 1000U.-120,7U/I. Tryptase mean levels significantly decreased 20 and 30 rain. after provocation (20min.89,2U/1, 30min.-18,2U/l). These data suggest that tryptase assays in nasal washings could be an useful addition for the diagnosis of pollen allergy. Provocation must be probably done for this purpose with a higher concentration of pollen extract (1000PNU) and evaluation of tryptase release will be more relevant at 10 or 15 rain. after provocation.
50
o f e x o g e n o u s n e u r o p e p t i d e Y on nasal r e s p o n s e to a l l e r g e n c h a l l e n g e i n a t o p i c patients. B e r n a r d . L. M o s i m a n n M D & J. S v l v a i n L a c r o i x M D . L a u s a n n e & G e n e v a , Switzerland. Intranasal administration of neuropeptideY (NPY) in humans reduces nasal airways resistance (NAR) and vascular permeability without affecting submucosal gland secretion.The aim of this study was to determine wether exogenous NPY could i n f l u e n c e t h e r e s p o n s e to a l l e r g e n n a s a l c h a l l e n g e . 13 a l l e r g i c p a t i e n t s w e r e c h a l l e n g e d w i t h g r a s s pollen (10,000 SQ) in a randomized double-blind 3-way crossover study after pretreatment with Effects
saline, oxymetazoline(20 nmol) or NPY (20 nmol), and NAR was measured by anterior rhinometry. NAR increase was significantly (p< 0.01) reduced after NPY when compared to saline or oxymetazoline pretreatment. Conclusion: local pretreatment with exogenous NPY reduces nasal obstruction in allergic patients and could be of interest in the treatment of allergic rhinitis.
195
Children with allergic rhinitis have low mucosal IgA, a longitudinal cohort study Ludviksson BR. MD*.Thorarensen O, Ardal B.MD** and Valdimarsson H, MD, FRC Path*. Dept.lmmunology* and Pediatrics**, National University Hospital, Reykjavik, Iceland. Previously we have shown that infants (18-23 months) with low normal IgA had increased cumulative incidence of severe atopy. In this study we have followed randomly selected Icelandic children from birth until the age of 42 - 48 months. Of the 179 infants evaluated at the age of 18 - 23 month we were able to re-evaluate 161 (90%). Moderate or severe atopic eczema was seen in 12% and 2% of the children compared to 19% and 7% 2 years earlier, respectively. Asthma continued with surprisingly high cumulative prevalence of 16%. Of the 65 children who were atopic at the age of 4, 55 (77%) had atopy 2 years earlier. Moreover, the children that became healthy were more likely to have suffered from less severe atopy as infants. Children with allergic rhinitis had significantly lower mucosal IgA (mlgA) (median concentration 0.032 mg/ml) compared with unaffected (median concentration 0.052 mg/ml, p=0.008). Furthermore, children with positive skin test to one ore more allergens had lower serum IgA than children with negative testing (0.76 mg/ml vs. 1 mg/ml; p=0.014). Children who developed atopic eczema had lower mlgA than the children that improved, median concentration 0.036 mg/ml vs. 0.054 mg/ml respectively (p=0.017). These findings strongly support our belief that an intact secretory immunity in children has a major role in preventing the development of atopy in early childhood.
52
Differences in Mite-Specific Immune Responses in Atopic Patients with Asthma or Rhinitis. MB Sherman MD. K Chen. D Fo~elman. Z Liao MD. Y Chen. DL Rosenstreich MD, Bronx, NY Allergy to dust mites is common throughout the developed world and is thought to be responsible for both chronic asthma and rhinitis. However, it is not clear why among mite allergic individuals some patients develop only rhinitis why others develop more severe lower airway disease (asthma). In order to determine if immunologic differences in mite-specific responses were associated with the development of asthma, a group of patients with either rhinitis or asthma were studied. Eighteen age-matched individuals were analyzed. Immunologic comparisons included serum levels of mite-specific IgG, IgA, IgE, and IgM, mite-induced lymphocyte proliferation in vitro, and quantitative skin responsiveness to mite allergen. There were two significant differences between these patient groups. Mite-specific IgA was higher in the asthmatics than in the rhinitis group (156 U/mI:L-.40 vs 71 U/ml+17, p=0.03). Quantitative skin testing (mean concentration of dust mite antigen producing a 5 nun wheal) was lower in the asthmatics (1.64 BAU/mI+I.21 vs 5.40 BAU/mI+l.67, p=.059) than the rhinitis patients. The finding of increased skin reactivity to dust mite in the presence equal serum mite IgE levels (1.93 U/ml vs 1.95 U/ml) suggests that there are additional mite-specific immune or inflammatory mechanisms responsible for the development of asthma other than mite-specific IgE. These findings suggests that mite-spccifie lgA may be one of these, but additional factors remain to be determined.
J ALLERGY CLIN IMMUNOL VOLUME 97, NUMBER 1, PART 3
49
Tryptase Provocation
Release Tests
After
Nasal
51
in Parietaria a l l e r g y . M . L . Palma Carlos PharmD. PhD. M. (2. Santos PharmD, PhD.E. Pedro MD, A. S p i n o l a MD. F. Ferreira MD. A. G. Palma Carlos MD. PhD, Lisbon, Portugal. In 14 patients allergic to Parietaria (Pellitory wail) was confirmed by (clinical history, skin tests and specific IgE Cap Rast Feia) nasal provocation tests with different c o n c e n t r a t i o n s of pollen extract have been s e q u e n c i a l l y done. A s t a n d a r d i z e d extract (Bayer D.H.S.) was used in increasing dosages of 1, 10, 100, 1000 PNU, and tryptase assayed in nasal washings at 10, 20, and 30 rain. after provocation. A clear-cut increase on mean tryptase concentration in nasal lavage liquid has been observed after provocation with 1000 U. (Basal-2,9U/l, Dil.-3.1U/I, 1U-8,4U/I, 10U.-12,6U/I, 100U-21,6U/I, 1000U.-120,7U/I. Tryptase mean levels significantly decreased 20 and 30 rain. after provocation (20min.89,2U/1, 30min.-18,2U/l). These data suggest that tryptase assays in nasal washings could be an useful addition for the diagnosis of pollen allergy. Provocation must be probably done for this purpose with a higher concentration of pollen extract (1000PNU) and evaluation of tryptase release will be more relevant at 10 or 15 rain. after provocation.
50
o f e x o g e n o u s n e u r o p e p t i d e Y on nasal r e s p o n s e to a l l e r g e n c h a l l e n g e i n a t o p i c patients. B e r n a r d . L. M o s i m a n n M D & J. S v l v a i n L a c r o i x M D . L a u s a n n e & G e n e v a , Switzerland. Intranasal administration of neuropeptideY (NPY) in humans reduces nasal airways resistance (NAR) and vascular permeability without affecting submucosal gland secretion.The aim of this study was to determine wether exogenous NPY could i n f l u e n c e t h e r e s p o n s e to a l l e r g e n n a s a l c h a l l e n g e . 13 a l l e r g i c p a t i e n t s w e r e c h a l l e n g e d w i t h g r a s s pollen (10,000 SQ) in a randomized double-blind 3-way crossover study after pretreatment with Effects
saline, oxymetazoline(20 nmol) or NPY (20 nmol), and NAR was measured by anterior rhinometry. NAR increase was significantly (p< 0.01) reduced after NPY when compared to saline or oxymetazoline pretreatment. Conclusion: local pretreatment with exogenous NPY reduces nasal obstruction in allergic patients and could be of interest in the treatment of allergic rhinitis.
195
Children with allergic rhinitis have low mucosal IgA, a longitudinal cohort study Ludviksson BR. MD*.Thorarensen O, Ardal B.MD** and Valdimarsson H, MD, FRC Path*. Dept.lmmunology* and Pediatrics**, National University Hospital, Reykjavik, Iceland. Previously we have shown that infants (18-23 months) with low normal IgA had increased cumulative incidence of severe atopy. In this study we have followed randomly selected Icelandic children from birth until the age of 42 - 48 months. Of the 179 infants evaluated at the age of 18 - 23 month we were able to re-evaluate 161 (90%). Moderate or severe atopic eczema was seen in 12% and 2% of the children compared to 19% and 7% 2 years earlier, respectively. Asthma continued with surprisingly high cumulative prevalence of 16%. Of the 65 children who were atopic at the age of 4, 55 (77%) had atopy 2 years earlier. Moreover, the children that became healthy were more likely to have suffered from less severe atopy as infants. Children with allergic rhinitis had significantly lower mucosal IgA (mlgA) (median concentration 0.032 mg/ml) compared with unaffected (median concentration 0.052 mg/ml, p=0.008). Furthermore, children with positive skin test to one ore more allergens had lower serum IgA than children with negative testing (0.76 mg/ml vs. 1 mg/ml; p=0.014). Children who developed atopic eczema had lower mlgA than the children that improved, median concentration 0.036 mg/ml vs. 0.054 mg/ml respectively (p=0.017). These findings strongly support our belief that an intact secretory immunity in children has a major role in preventing the development of atopy in early childhood.
52
Differences in Mite-Specific Immune Responses in Atopic Patients with Asthma or Rhinitis. MB Sherman MD. K Chen. D Fo~elman. Z Liao MD. Y Chen. DL Rosenstreich MD, Bronx, NY Allergy to dust mites is common throughout the developed world and is thought to be responsible for both chronic asthma and rhinitis. However, it is not clear why among mite allergic individuals some patients develop only rhinitis why others develop more severe lower airway disease (asthma). In order to determine if immunologic differences in mite-specific responses were associated with the development of asthma, a group of patients with either rhinitis or asthma were studied. Eighteen age-matched individuals were analyzed. Immunologic comparisons included serum levels of mite-specific IgG, IgA, IgE, and IgM, mite-induced lymphocyte proliferation in vitro, and quantitative skin responsiveness to mite allergen. There were two significant differences between these patient groups. Mite-specific IgA was higher in the asthmatics than in the rhinitis group (156 U/mI:L-.40 vs 71 U/ml+17, p=0.03). Quantitative skin testing (mean concentration of dust mite antigen producing a 5 nun wheal) was lower in the asthmatics (1.64 BAU/mI+I.21 vs 5.40 BAU/mI+l.67, p=.059) than the rhinitis patients. The finding of increased skin reactivity to dust mite in the presence equal serum mite IgE levels (1.93 U/ml vs 1.95 U/ml) suggests that there are additional mite-specific immune or inflammatory mechanisms responsible for the development of asthma other than mite-specific IgE. These findings suggests that mite-spccifie lgA may be one of these, but additional factors remain to be determined.