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748 Topical application of a platelet activating factor (PAF-) antagonist in atopic eczema
J ALLERGYCLIN IMMUNOL VOLUME 97, NUMBER 1, PART 3 745
Skin r e a c t i v i t y to Blomia t r o p i c a l i s a n d Euroelvphus m a y n e i in p a t i e n t s w i t h a t o p i c d e r m a t i t i s in P u e r t o Rico.
Abstracts
747
H u m a n l g E R e s p o n s e t o S c a b i e s . MS Morgan PhD. LG Arlian PhD. SA Estes MD. Dayton and Cincinnati, OH The scabies mite Sarcoptes scabiei (SS) and the Dermatophagoides house dust mites (HDM) are related phylogenetically and are the sources of several cross-reactive antigens. The purpose of this study was to investigate the IgE response to SS and HDM in scabietic patients. The study involved patients who had or previously had confirmed ordinary scabies. One group (A) included 9 subjects (4F+5M) ages 24-61, who had exhibited scabies symptoms for 3 wk - 3 mo before treatment and who had received successful treatment 3 wk - 1 yr prior to the study. Group B included 16 subjects with active scabies (6F+10M), ages 20-72, who had symptoms from 0 - 1 yr. Allergic histories were obtained, serum was collected and skin prick tests (SPT) were performed at enrollment. None of the individuals in either group reported a known sensitivity to HDM. Two patients cured of scabies (group A) were RAST and SPT positive to HDM and 1 of these showed circulating anti-SS IgE. Two of 16 patients with active scabies (group B) were SPT positive to SS only, 3 were positive to HDM only and 8 were positive to both. Five of 16 had circulating IgE (by CRIE) directed at both SS and HDM antigens while l subject was CRIE positive to SS only and another had IgE directed at HDM only. Except for 1, all patients that were CRIE positive to SS, HDM, or both were also SPT positive to the corresponding extract. This study indicated that about half of patients with active scabies had SS and HDM-specific circulating IgE while most patients cured of scabies lacked SS and HDM-specific serum IgE. This suggested that antibodies built to SS in scabietic patients also recognize HDM. Also, the data indicated that scabies infestation may or may not induce an atopic reaction.
748
Topical Application of a Platelet Activating Factor (PAF-) A n t a g o n i s t in Atopic Eczema.
..F. Montealeare, DVMt Ph.D., C. Quifiones, MT, W. Le6n~ Bs, K . G o t h , VA., J . Villa, M D . , a n d M . Garcfa~ RN___.Ponce, P u e r t o R i c o T h e purpose o f this study was to d e t e r m i n e the rate o f sensitization to the d o m e s t i c mites B l o m i a tropicalis (Bt) and Euro*,lvohus maynej (Era) in atopic dermatitis (AD) patients. The skin prick test was c o n d u c t e d in 365 A D patients and 238 healthy controls using extracts from these t w o domestic mites. In addition s t a n d a r d i z e d extracts o f D e r m a t o p h a g o i d e s pteronyssinus (Dp), D . farinae (Dr) and other c o m m o n aeroallergens were also tested. A wheal > 3 m m was considered a positive reaction. T h e analyses o f the results s h o w e d that 75.3% (n= 275) o f the A D patients had at least a positive reaction to one allergen, o f these 61.1% had positive reactions to at least o n e mite species, 49.9% to Bt and 41.5% to Era. Similar findings were o b s e r v e d for D p and Dr. A D patients reacted to B..tropicalis 3.16 and to E. maynei 4.86 times m o r e than the control group (p<00001). Our study strongly s u g g e s t that B. tropicalis and E. maynei are important risk factors for patients with A D and extracts from these species should be included in the allergen panel for the diagnosis and treatment o f A D .
746
T h e I n c i d e n c e o f A t o p y in Psoriasis. Providence, RI. Objective: To clarify the association of Asthma, Allergic Rhinitis, Atopic Eczema and Psoriasis. Design: Questionnaire sent to 2,000 members of the Psoriatic Association scattered across the United States. Subjects: 754 psoriatic patients, 322 males and 432 females, unmatched controls as found in the literature. The mean age group 22.1 years. Main Thrust of Questions Asked: Severity classification of Psoriasis, incidence of Allergic Rlfinitis, Asthma, Eczema. Hymenoptcra sensitivity, Drug allergy and Food allergy. Results: In the 754 patients with psoriasis, 107 males and 171 females gave a history, of Allergic Rhinitis, Asthma or Atopic Eczema for a total of 288 of 754 patiants or 38% of psoriaties with alopy. In addition there were 8 with Hymanoptera sensitivity, 68 with drug sensitivity and 51 with food sensitivities. Conclusion: There appears to be a mild increased incidence of atopy in the psoriatic patient.
369
S c h m i d t T M D '~, A b e c k D M D ~'2, Grosshans E M D s, Jablonska S M D s, Kragballe K M D 3, Valquist A M D 4, Dupuy P MD,,s, Ring J M D 1'2. H a m b u r g and Munich, Germany1'2; Aarhus, Denmark3; Link6ping, Sweden4; Strasbourg, FranceS; Warsaw, P o l a n d 6 Platelet activating factor (PAF-acether) is a lipid mediator with a potent proinflammatory activity. Results derived both from in vitro- and in vivo-studies claim a possible role of this substance in the pathophysiology of atopic eczema (AE). A double blind, randomized, multi-center, within-patient study was performed to evaluate the efficacy of a topically applied PAF-antagnnist (RO-24-0238) in patients with AE. Over a period of 28 days 0,25 ml of either the PAF antagonist or the placebo (vehicle control) were applied onto two grossly symmetrical lesions of AE (measuring 10 to 20 cm2 each) twice daily. The overall assessment of the therapeutic efficacy was unable to demonstrate a superior effect of the PAF-antagonist in comparison to placebo as this was the same with the individual study parameters erythema, scaling, induration and exsudation. For reducing pruritus as assessed by the patient using a visual analogue scale (VAS) a statistically significant action was documented during the first two weeks of the study (p< 0.04; Wilcoxan rank sum test) with a continued, yet not statistically significant efficacy after week 3 and 4. The exact role of pathological events of AE which are interfered by the PAF-antagonist remain to be determined but especially the anti-pruritic component of this substance deserves further scientific interest.
Skin r e a c t i v i t y to Blomia t r o p i c a l i s a n d Euroelvphus m a y n e i in p a t i e n t s w i t h a t o p i c d e r m a t i t i s in P u e r t o Rico.
Abstracts
747
H u m a n l g E R e s p o n s e t o S c a b i e s . MS Morgan PhD. LG Arlian PhD. SA Estes MD. Dayton and Cincinnati, OH The scabies mite Sarcoptes scabiei (SS) and the Dermatophagoides house dust mites (HDM) are related phylogenetically and are the sources of several cross-reactive antigens. The purpose of this study was to investigate the IgE response to SS and HDM in scabietic patients. The study involved patients who had or previously had confirmed ordinary scabies. One group (A) included 9 subjects (4F+5M) ages 24-61, who had exhibited scabies symptoms for 3 wk - 3 mo before treatment and who had received successful treatment 3 wk - 1 yr prior to the study. Group B included 16 subjects with active scabies (6F+10M), ages 20-72, who had symptoms from 0 - 1 yr. Allergic histories were obtained, serum was collected and skin prick tests (SPT) were performed at enrollment. None of the individuals in either group reported a known sensitivity to HDM. Two patients cured of scabies (group A) were RAST and SPT positive to HDM and 1 of these showed circulating anti-SS IgE. Two of 16 patients with active scabies (group B) were SPT positive to SS only, 3 were positive to HDM only and 8 were positive to both. Five of 16 had circulating IgE (by CRIE) directed at both SS and HDM antigens while l subject was CRIE positive to SS only and another had IgE directed at HDM only. Except for 1, all patients that were CRIE positive to SS, HDM, or both were also SPT positive to the corresponding extract. This study indicated that about half of patients with active scabies had SS and HDM-specific circulating IgE while most patients cured of scabies lacked SS and HDM-specific serum IgE. This suggested that antibodies built to SS in scabietic patients also recognize HDM. Also, the data indicated that scabies infestation may or may not induce an atopic reaction.
748
Topical Application of a Platelet Activating Factor (PAF-) A n t a g o n i s t in Atopic Eczema.
..F. Montealeare, DVMt Ph.D., C. Quifiones, MT, W. Le6n~ Bs, K . G o t h , VA., J . Villa, M D . , a n d M . Garcfa~ RN___.Ponce, P u e r t o R i c o T h e purpose o f this study was to d e t e r m i n e the rate o f sensitization to the d o m e s t i c mites B l o m i a tropicalis (Bt) and Euro*,lvohus maynej (Era) in atopic dermatitis (AD) patients. The skin prick test was c o n d u c t e d in 365 A D patients and 238 healthy controls using extracts from these t w o domestic mites. In addition s t a n d a r d i z e d extracts o f D e r m a t o p h a g o i d e s pteronyssinus (Dp), D . farinae (Dr) and other c o m m o n aeroallergens were also tested. A wheal > 3 m m was considered a positive reaction. T h e analyses o f the results s h o w e d that 75.3% (n= 275) o f the A D patients had at least a positive reaction to one allergen, o f these 61.1% had positive reactions to at least o n e mite species, 49.9% to Bt and 41.5% to Era. Similar findings were o b s e r v e d for D p and Dr. A D patients reacted to B..tropicalis 3.16 and to E. maynei 4.86 times m o r e than the control group (p<00001). Our study strongly s u g g e s t that B. tropicalis and E. maynei are important risk factors for patients with A D and extracts from these species should be included in the allergen panel for the diagnosis and treatment o f A D .
746
T h e I n c i d e n c e o f A t o p y in Psoriasis. Providence, RI. Objective: To clarify the association of Asthma, Allergic Rhinitis, Atopic Eczema and Psoriasis. Design: Questionnaire sent to 2,000 members of the Psoriatic Association scattered across the United States. Subjects: 754 psoriatic patients, 322 males and 432 females, unmatched controls as found in the literature. The mean age group 22.1 years. Main Thrust of Questions Asked: Severity classification of Psoriasis, incidence of Allergic Rlfinitis, Asthma, Eczema. Hymenoptcra sensitivity, Drug allergy and Food allergy. Results: In the 754 patients with psoriasis, 107 males and 171 females gave a history, of Allergic Rhinitis, Asthma or Atopic Eczema for a total of 288 of 754 patiants or 38% of psoriaties with alopy. In addition there were 8 with Hymanoptera sensitivity, 68 with drug sensitivity and 51 with food sensitivities. Conclusion: There appears to be a mild increased incidence of atopy in the psoriatic patient.
369
S c h m i d t T M D '~, A b e c k D M D ~'2, Grosshans E M D s, Jablonska S M D s, Kragballe K M D 3, Valquist A M D 4, Dupuy P MD,,s, Ring J M D 1'2. H a m b u r g and Munich, Germany1'2; Aarhus, Denmark3; Link6ping, Sweden4; Strasbourg, FranceS; Warsaw, P o l a n d 6 Platelet activating factor (PAF-acether) is a lipid mediator with a potent proinflammatory activity. Results derived both from in vitro- and in vivo-studies claim a possible role of this substance in the pathophysiology of atopic eczema (AE). A double blind, randomized, multi-center, within-patient study was performed to evaluate the efficacy of a topically applied PAF-antagnnist (RO-24-0238) in patients with AE. Over a period of 28 days 0,25 ml of either the PAF antagonist or the placebo (vehicle control) were applied onto two grossly symmetrical lesions of AE (measuring 10 to 20 cm2 each) twice daily. The overall assessment of the therapeutic efficacy was unable to demonstrate a superior effect of the PAF-antagonist in comparison to placebo as this was the same with the individual study parameters erythema, scaling, induration and exsudation. For reducing pruritus as assessed by the patient using a visual analogue scale (VAS) a statistically significant action was documented during the first two weeks of the study (p< 0.04; Wilcoxan rank sum test) with a continued, yet not statistically significant efficacy after week 3 and 4. The exact role of pathological events of AE which are interfered by the PAF-antagonist remain to be determined but especially the anti-pruritic component of this substance deserves further scientific interest.