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Chronic Cough and Asthma Symptom Associated with Conifer Pollen in Fukuoka, Japan
Abstracts S223
J ALLERGY CLIN IMMUNOL VOLUME 121, NUMBER 2
corticosteroids with symptoms of esophagitis should be investigated for esophageal candidiasis. Funding: FMUSP
CONCLUSIONS: There exists cross-reactivity between latex and tobacco allergens. Smoker patients with IgE response to tobacco may be a risk population for latex sensitisation.
856
858
857
Cross-reactivity Between Tobacco and Latex in Asthmatic Sensitive Patients A. Armentia1, B. Bartolome2, J. Garcia Ortiz1, M. Sanchis1, R. de la Fuente1, J. Vega1, A. Fernandez1; 1HOSPITAL RIO HORTEGA, VALLADOLID, SPAIN, 2LABORATORIOS BIAL ARISTEGUI, BILBAO, SPAIN. RATIONALE: Recently, allergen cross-reactivity was observed between tobacco and other species of Solanaceae family (tomato, potato, aubergine). We have recently studied IgE response to tobacco in asthmatic patients sensitised to Lolium perenne (rye grass pollen) and have found that 30% of tobacco responsive patients had also latex sensitisation. The aim of our study was to investigate the possibility of cross-reactivity among tobacco and latex in asthmatic patients with IgE response to latex. METHODS: We performed a study on tobacco and latex exposure in 15 patients suffered from asthma due to latex sensitisation that were randomly chosen from our data base of sensitive-latex patients. All these patients were tested in order to try to identify tobacco and latex as possible allergens that might cause clinical specific response (prick-tests, specific IgE to tobacco, latex and related allergens, bronchial challenge (BC), patch tests with tobacco, latex and nicotine, rubbing tests) and immunological response: immunoblotting and immunoblotting-inhibition. RESULTS: Positive prick and BC with specific IgE >0,35 kU/L to tobacco was demonstrated in 11 asthmatics that were also sensitised to rye grass. Tobacco IgE level was related with sensitisation to latex (p < 0.002), but not with other vegetables that belong to the Solanaceae family. Immunoblotting-inhibition showed the existence of cross-reactivity between tobacco and latex.
Chronic Cough and Asthma Symptom Associated with Conifer Pollen in Fukuoka, Japan R. Kishikawa, T. Shimoda, S. Shoji, M. Imaoka, N. Kamikawaji, H. Nogami, H. Aso, K. Yokota, S. Nishima; The Minami Fukuka Hospital Clinical Reserch Center, Fukuoka, JAPAN. RATIONALE: Japanese Cedar/cypress pollen is the important allergen which exacerbates seasonal allergic symptoms. To clarify the characteristics of conifer pollen allergy and notify the patients with cedar hypersensitivity for preventing and treating their symptoms. METHODS: We monitored atmospheric allergic conifer pollen by PAAA protocol at our hospital every year. We examined the chief complaints and consequence of the examinations of new patients with cedar hypersensitivity visited to our hospital suffering from the symptoms diagnosed by CAP-RAST from January to June for 4 years, 2004 to 2007. We investigated retrospectively in our hospital. RESULTS: The high to low concentration atmospheric conifer pollen was monitored from February to April mainly. The forty percent of total 1772 patients have positive Japanease cedar specific antibody. The chief complaints were asthma attack with pollinosis, dry cough, rhino-conjunctivitis, oral allergy syndrome, urticaria, sleep apnea syndrome and so on. After dispersing pollen about 20% of the patients have the prolonged symptoms and visited to our hospital as new patients suffering from severe chronic dry cough and sleep disturbance. CONCLUSIONS: We found the patients with the Japanese Cedar hypersensitivity have severe and persistent lower respiratory symptoms. We suggested it is important to know chronic cough symptom after conifer pollen dispersing for the patients and medical doctors to prevent and treat pollen allergy even after the pollination season in Japan.
859
Observed Subject Utilization of Electronic PEF Meters Integrated With an Electronic Diary in a Randomized Clinical Trial S. Raymond; PHT Corporation, Charlestown, MA. RATIONALE: Self-reported peak flow data are known to be inaccurate when entered in paper diaries. The integration of PHT’s eSenseä PiKo(R) devices was described at the 2004 AAAAI Annual Meeting, as a way to improve self-reported PEF data quality. In a study of subjects with persistent asthma that was utilizing electronic patient reported outcomes (ePRO) the sponsor planned a sophisticated implementation that would prevent inaccuracies and data collection failures in the field. METHODS: Subjects were provided with an electronic patient diary (eDiary), and a PEF meter equipped with wireless technology that automatically sends data to the eDiary. Subjects were also given the option to transcribe PEF readings manually into the eDiary, without the use of the wireless transfer feature. RESULTS: 110 subjects at 23 investigator sites throughout Europe were expected to have reported 12,195 individual PEF score measurements. 86.5% of the total expected scores were captured electronically and transferred automatically by the eSense PiKo, 12.5% of the PEF scores were manually transcribed into the eDiary, and 1.0% were skipped. CONCLUSIONS: By utilizing an ePRO system with a wirelessly integrated PEF meter, and a manual data entry mode for backup purposes, the sponsor captured a significantly higher quantity of verified data as compared to older methods. Frequent voluntary use of the eSense PiKo device, supported by a detailed process flow chart, has enabled the capture of timely and verified PEF data for safety and efficacy evaluations. Funding: AstraZeneca
TUESDAY
Bronchial Reactivity in Adolescents with Mild Allergic Asthma V. Tsybulkina1, O. Skorohodkina1, A. Luntsov1, N. Tsybulkin2, L. M. DuBuske3; 1Kazan State Medical University, Kazan, RUSSIAN FEDERATION, 2Kazan State Medical Academy, Kazan, RUSSIAN FEDERATION, 3Immunology Research Institute of New England, Gardner, MA. RATIONALE: Allergic asthma (AA) in adolescents is often mild. Bronchoprovocation tests (BPT) can verify the diagnosis in equivocal cases. Concomitant evaluation using different non-specific BPT may enhance the diagnosis of mild AA. METHODS: Male teenage patients with intermittent or mild persistent AA were assessed. Clinical exams and spirometry were normal. Skin tests with environmental allergens were positive in all patients. Allergenspecific BPT were positive in 15 patients (Group I) but negative in 22 patients (Group II). Further assessments included total IgE levels and nonspecific standard BPTs: 1) treadmill exercise, 2) histamine inhalation, and 3) hypertonic saline inhalation. The diagnostic FEV1 threshold for exercise BPT was 15% reduction, for histamine and hypertonic saline BPT was 20% reduction, with PC20 measurement. RESULTS: In Group I, 66.7% were positive upon BPT with exercise, 100% upon BPT with histamine and 53.4% upon BPT with hypertonic saline versus 45.5%, 81.8% and 18.2% respectively in Group II. The PC20 for BPT differed between Group I versus Group II with histamine PC20: 1.78 6 1.09 mg/ml versus 5.17 6 2.75 mg/ml (p < 0.05); and hypertonic saline PC20: 8.25 6 2.92 mg/ml versus 12.25 6 3.09 mg/ml (p > 0.05). Total IgE levels were similar in Group I (169.90 6 43.90 U/ml) and in Group II (134.20 6 28.20 U/ml). CONCLUSIONS: Adolescent AA patients having positive allergenspecific BPT react more frequently and at a lower reaction thresholds to all assessed non-specific BPT, with a near 3-fold lower histamine PC20 in this allergic asthma cohort. Specific and non-specific BPT may assist in diagnosis of mild adolescent AA reflecting both allergen specific and non-specific disease triggers.
J ALLERGY CLIN IMMUNOL VOLUME 121, NUMBER 2
corticosteroids with symptoms of esophagitis should be investigated for esophageal candidiasis. Funding: FMUSP
CONCLUSIONS: There exists cross-reactivity between latex and tobacco allergens. Smoker patients with IgE response to tobacco may be a risk population for latex sensitisation.
856
858
857
Cross-reactivity Between Tobacco and Latex in Asthmatic Sensitive Patients A. Armentia1, B. Bartolome2, J. Garcia Ortiz1, M. Sanchis1, R. de la Fuente1, J. Vega1, A. Fernandez1; 1HOSPITAL RIO HORTEGA, VALLADOLID, SPAIN, 2LABORATORIOS BIAL ARISTEGUI, BILBAO, SPAIN. RATIONALE: Recently, allergen cross-reactivity was observed between tobacco and other species of Solanaceae family (tomato, potato, aubergine). We have recently studied IgE response to tobacco in asthmatic patients sensitised to Lolium perenne (rye grass pollen) and have found that 30% of tobacco responsive patients had also latex sensitisation. The aim of our study was to investigate the possibility of cross-reactivity among tobacco and latex in asthmatic patients with IgE response to latex. METHODS: We performed a study on tobacco and latex exposure in 15 patients suffered from asthma due to latex sensitisation that were randomly chosen from our data base of sensitive-latex patients. All these patients were tested in order to try to identify tobacco and latex as possible allergens that might cause clinical specific response (prick-tests, specific IgE to tobacco, latex and related allergens, bronchial challenge (BC), patch tests with tobacco, latex and nicotine, rubbing tests) and immunological response: immunoblotting and immunoblotting-inhibition. RESULTS: Positive prick and BC with specific IgE >0,35 kU/L to tobacco was demonstrated in 11 asthmatics that were also sensitised to rye grass. Tobacco IgE level was related with sensitisation to latex (p < 0.002), but not with other vegetables that belong to the Solanaceae family. Immunoblotting-inhibition showed the existence of cross-reactivity between tobacco and latex.
Chronic Cough and Asthma Symptom Associated with Conifer Pollen in Fukuoka, Japan R. Kishikawa, T. Shimoda, S. Shoji, M. Imaoka, N. Kamikawaji, H. Nogami, H. Aso, K. Yokota, S. Nishima; The Minami Fukuka Hospital Clinical Reserch Center, Fukuoka, JAPAN. RATIONALE: Japanese Cedar/cypress pollen is the important allergen which exacerbates seasonal allergic symptoms. To clarify the characteristics of conifer pollen allergy and notify the patients with cedar hypersensitivity for preventing and treating their symptoms. METHODS: We monitored atmospheric allergic conifer pollen by PAAA protocol at our hospital every year. We examined the chief complaints and consequence of the examinations of new patients with cedar hypersensitivity visited to our hospital suffering from the symptoms diagnosed by CAP-RAST from January to June for 4 years, 2004 to 2007. We investigated retrospectively in our hospital. RESULTS: The high to low concentration atmospheric conifer pollen was monitored from February to April mainly. The forty percent of total 1772 patients have positive Japanease cedar specific antibody. The chief complaints were asthma attack with pollinosis, dry cough, rhino-conjunctivitis, oral allergy syndrome, urticaria, sleep apnea syndrome and so on. After dispersing pollen about 20% of the patients have the prolonged symptoms and visited to our hospital as new patients suffering from severe chronic dry cough and sleep disturbance. CONCLUSIONS: We found the patients with the Japanese Cedar hypersensitivity have severe and persistent lower respiratory symptoms. We suggested it is important to know chronic cough symptom after conifer pollen dispersing for the patients and medical doctors to prevent and treat pollen allergy even after the pollination season in Japan.
859
Observed Subject Utilization of Electronic PEF Meters Integrated With an Electronic Diary in a Randomized Clinical Trial S. Raymond; PHT Corporation, Charlestown, MA. RATIONALE: Self-reported peak flow data are known to be inaccurate when entered in paper diaries. The integration of PHT’s eSenseä PiKo(R) devices was described at the 2004 AAAAI Annual Meeting, as a way to improve self-reported PEF data quality. In a study of subjects with persistent asthma that was utilizing electronic patient reported outcomes (ePRO) the sponsor planned a sophisticated implementation that would prevent inaccuracies and data collection failures in the field. METHODS: Subjects were provided with an electronic patient diary (eDiary), and a PEF meter equipped with wireless technology that automatically sends data to the eDiary. Subjects were also given the option to transcribe PEF readings manually into the eDiary, without the use of the wireless transfer feature. RESULTS: 110 subjects at 23 investigator sites throughout Europe were expected to have reported 12,195 individual PEF score measurements. 86.5% of the total expected scores were captured electronically and transferred automatically by the eSense PiKo, 12.5% of the PEF scores were manually transcribed into the eDiary, and 1.0% were skipped. CONCLUSIONS: By utilizing an ePRO system with a wirelessly integrated PEF meter, and a manual data entry mode for backup purposes, the sponsor captured a significantly higher quantity of verified data as compared to older methods. Frequent voluntary use of the eSense PiKo device, supported by a detailed process flow chart, has enabled the capture of timely and verified PEF data for safety and efficacy evaluations. Funding: AstraZeneca
TUESDAY
Bronchial Reactivity in Adolescents with Mild Allergic Asthma V. Tsybulkina1, O. Skorohodkina1, A. Luntsov1, N. Tsybulkin2, L. M. DuBuske3; 1Kazan State Medical University, Kazan, RUSSIAN FEDERATION, 2Kazan State Medical Academy, Kazan, RUSSIAN FEDERATION, 3Immunology Research Institute of New England, Gardner, MA. RATIONALE: Allergic asthma (AA) in adolescents is often mild. Bronchoprovocation tests (BPT) can verify the diagnosis in equivocal cases. Concomitant evaluation using different non-specific BPT may enhance the diagnosis of mild AA. METHODS: Male teenage patients with intermittent or mild persistent AA were assessed. Clinical exams and spirometry were normal. Skin tests with environmental allergens were positive in all patients. Allergenspecific BPT were positive in 15 patients (Group I) but negative in 22 patients (Group II). Further assessments included total IgE levels and nonspecific standard BPTs: 1) treadmill exercise, 2) histamine inhalation, and 3) hypertonic saline inhalation. The diagnostic FEV1 threshold for exercise BPT was 15% reduction, for histamine and hypertonic saline BPT was 20% reduction, with PC20 measurement. RESULTS: In Group I, 66.7% were positive upon BPT with exercise, 100% upon BPT with histamine and 53.4% upon BPT with hypertonic saline versus 45.5%, 81.8% and 18.2% respectively in Group II. The PC20 for BPT differed between Group I versus Group II with histamine PC20: 1.78 6 1.09 mg/ml versus 5.17 6 2.75 mg/ml (p < 0.05); and hypertonic saline PC20: 8.25 6 2.92 mg/ml versus 12.25 6 3.09 mg/ml (p > 0.05). Total IgE levels were similar in Group I (169.90 6 43.90 U/ml) and in Group II (134.20 6 28.20 U/ml). CONCLUSIONS: Adolescent AA patients having positive allergenspecific BPT react more frequently and at a lower reaction thresholds to all assessed non-specific BPT, with a near 3-fold lower histamine PC20 in this allergic asthma cohort. Specific and non-specific BPT may assist in diagnosis of mild adolescent AA reflecting both allergen specific and non-specific disease triggers.