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Relation between objective measures of asthma and atopy
J ALLERGY CLIN IMMUNOL VOLUME 111, NUMBER 2
(BPT) are of special importance for the diagnosis of rare allergen induced occupational asthma. METHODS: The lumbrokinase is the proteinase extracted from a kind of earthworm (Eisenia foelide) and is widely used in thrombosis patients for thrombolysis. SPT was performed using the saline solution of lumbrokinase with concentration of 0.001 ug/ml. Lung function test was performed before inhaling and ten minutes after inhaling of the air modeling the aerosol in the workshop. Two workers who participated lumbrokinase manufacturing (patient A) and quality control (patient B) developed sniff, watery nose, cough and asthma while working. They received SPK and BPT as well as the routine inhaled allergen intracutaneous test and serum CAP Phadiatop test. RESULTS: The routine allergen intracutaneous test and serum Phadiatop was negative in both patients, while the SPT was positive in both with the areas of the wheal and flare being 63 mm 2 and 825 mm z in patient A, 48 mm z and 420 mm 2 in patient B separately. The BPT was positive in both patients with FEV1.0 declination more than 15%. The value of FEV1.0 before and after inhalation was 103% pred and 83% pred in patient A. In patient B the data was 115% pred and 91% pred. Symptoms of sniffing, watery nose, dyspnea and wheeze were provoked within 5 minutes in both patients. SPT was performed in three health volunteer with negative result. C O N C L U S I O N S : Inhalation of lumbrokinase aerosol could induce occupational allergic rhinitis and asthma.
Funding: Selffimded
214 Relation Between 0bjective Measures of Asthma and Atopy E, O. Corazalla; University of Minnesota, Minneapolis, MN. RATIONALE: This study investigates the relation between objective measures of asthma and atopy. METHODS: 100 asthmatics (56 M, 44 F), ages 5-51 with average age 22 yrs were selected for a hx of asthma. After informed consent, participants receive spirometry, a methacholine challenge, allergy skin tests and blood draw for total lgE, specific IgE and total peripheral eosinophil count (TPEC). Participants were sent home with a spirometer and asked to monitor pulmonary function am and pm for 2 weeks. RESULTS: The groups mean PC20FEV 1 was 3.9 CDUs. FEV 1% of predicted (38-127%, mean 89%) and the FEVIfFVC ratio (54-98%, mean 84%). FEVI variation (FVAR) during a 2 week period (8-68%, mean 25%) and average FEVI% predicted for 2 weeks (32%-107%, mean 80%.). TPEC (0.08-1.6 k/cmm, mean 0.50). Total IgE (2.4 to 2999 [U/mL, mean 392). 87% of the group had at least one reactive skin test (mean 5.65 tests reactive) with the remaining 13% showing elevated total lgE and/or specific IgE level, TPEC has a strong correlation to FVAR (R=.560 p<.000), and a significant relationship to PC20FEVI (R=-366 p<.000) and FEVI% predicted (R=-229 p< .021). No significant correlation was found between any measures of pulmonary function and skin test reactivity, total lgE or specific IgE level. CONCLUSIONS: This group of mild to moderate asthmatics was highly atopic. No definite relations were identified between any measure of pulmonary function and atopic parameters. There were significant correlations between TPEC and pulmonary function measures of asthma severity.
Funding: University of Minnesotu Allergy and Asthma Program
Abstracts
S123
1~~llT hdence e Effectiveness of Asthma Education on Reducing the Inciand Severity of Asthma Episodes During a Two-Week Period in Nricnn American Children Between the Ages of 7-12 J. R. EdwardsL D. Calloway ], M. Caprarola I, R. Hollander l, S. Ford2; IHealth Education, Howard University, Washington, DC, -~Pediatrics, Howard University Hospital, Washington, DC. RATIONALE: We examined the relationship of the effectiveness of asthma education on reducing the incidence and severity of asthma episodes during a two week period in African American children between the ages tb 7-12 at Chartered Health Plan. METHODS: The instrument that was used in this study was the Asthma Functional Severity Index which is a measure of functional impairment such as symptoms and restrictions due to asthma in school age children. The intervention that was used in this asthma education study was the Asthma Care Training for kids. RESULTS: Twenty-seven percent of the parents reported that their children had wheezing first thing in the morning after the asthma education session. The children reported 6.6% liewer episodes of wheezing first thing in the morning after the asthma education session. CONCLUSIONS: Asthma educational programs for children and their parents offer them the opportunity to increase their understanding about asthma and help them to manage their disease.
216 High-Resolution HLA Class II DNA Haplotyping in Allergic Fungal Rhinosinusitis and Hypertrophic Sinus Disease: The Role of HLA DQ3 M. S. Schubert I, P, S. Hutcheson 2, R. J. Graft2, R. G. Slavin2: 1Allergy Asthma Clinic, Phoenix, AZ, 2St. Louis University, St. Louis. MO. RATIONALE: We have extended our previous observations in allergic fungal rhinosinusitis (AFS) and hypertrophic sinus disease (HSD) by using high resolution HLA class II DNA haplotyping to assess allele frequencies and relative risk (RR). METHODS: 43 AFS patients were studied: all were atopic, 31 had asthma, 5 had ASA/NSAID hypersensitivity, 30 of 37 grew Bipolaris spicifera on fungal cultures. 31 HSD patients without AFS had chronic rhinosinusitis/nasal polyps: 22 were atopic, 26 had asthma, and 12 had ASA/NSAID hypersensitivity. RESULTS: Of the 43 AFS patients, 65% were HLA DQ3+ with DQB 1*0301 ( 16 patients) and DQB I *0302 ( 15 patients) being the most common alleles: combined RR=6,74. Of the 30 Bipolaris culture positive AFS patients, 67% were DQ3+ with DQBI*0301 (10 patients) and DQBI*0302 (10 patients) being the most common: combined RR=7.42. Of the 31 HSD patients, 52% were DQ3+ with DQBI*0301 (9 patients), DQBI*0302 (5 patients) and DQBI*0303 (5 patients) being the most common: combined RR=3.85. DQ3 polymorphisms did not correlate with specific allergy skin tests or atopic status, total serum lgE, fungal cultures, asthma, or ASA/NSAID hypersensitivity. CONCLUSION: Both AFS and HSD patients have polymorphic DQ3 alleles as a risk factor for disease, with AFS showing a higher RR. This suggests a role for DQ3 in disease pathogenesis,
(BPT) are of special importance for the diagnosis of rare allergen induced occupational asthma. METHODS: The lumbrokinase is the proteinase extracted from a kind of earthworm (Eisenia foelide) and is widely used in thrombosis patients for thrombolysis. SPT was performed using the saline solution of lumbrokinase with concentration of 0.001 ug/ml. Lung function test was performed before inhaling and ten minutes after inhaling of the air modeling the aerosol in the workshop. Two workers who participated lumbrokinase manufacturing (patient A) and quality control (patient B) developed sniff, watery nose, cough and asthma while working. They received SPK and BPT as well as the routine inhaled allergen intracutaneous test and serum CAP Phadiatop test. RESULTS: The routine allergen intracutaneous test and serum Phadiatop was negative in both patients, while the SPT was positive in both with the areas of the wheal and flare being 63 mm 2 and 825 mm z in patient A, 48 mm z and 420 mm 2 in patient B separately. The BPT was positive in both patients with FEV1.0 declination more than 15%. The value of FEV1.0 before and after inhalation was 103% pred and 83% pred in patient A. In patient B the data was 115% pred and 91% pred. Symptoms of sniffing, watery nose, dyspnea and wheeze were provoked within 5 minutes in both patients. SPT was performed in three health volunteer with negative result. C O N C L U S I O N S : Inhalation of lumbrokinase aerosol could induce occupational allergic rhinitis and asthma.
Funding: Selffimded
214 Relation Between 0bjective Measures of Asthma and Atopy E, O. Corazalla; University of Minnesota, Minneapolis, MN. RATIONALE: This study investigates the relation between objective measures of asthma and atopy. METHODS: 100 asthmatics (56 M, 44 F), ages 5-51 with average age 22 yrs were selected for a hx of asthma. After informed consent, participants receive spirometry, a methacholine challenge, allergy skin tests and blood draw for total lgE, specific IgE and total peripheral eosinophil count (TPEC). Participants were sent home with a spirometer and asked to monitor pulmonary function am and pm for 2 weeks. RESULTS: The groups mean PC20FEV 1 was 3.9 CDUs. FEV 1% of predicted (38-127%, mean 89%) and the FEVIfFVC ratio (54-98%, mean 84%). FEVI variation (FVAR) during a 2 week period (8-68%, mean 25%) and average FEVI% predicted for 2 weeks (32%-107%, mean 80%.). TPEC (0.08-1.6 k/cmm, mean 0.50). Total IgE (2.4 to 2999 [U/mL, mean 392). 87% of the group had at least one reactive skin test (mean 5.65 tests reactive) with the remaining 13% showing elevated total lgE and/or specific IgE level, TPEC has a strong correlation to FVAR (R=.560 p<.000), and a significant relationship to PC20FEVI (R=-366 p<.000) and FEVI% predicted (R=-229 p< .021). No significant correlation was found between any measures of pulmonary function and skin test reactivity, total lgE or specific IgE level. CONCLUSIONS: This group of mild to moderate asthmatics was highly atopic. No definite relations were identified between any measure of pulmonary function and atopic parameters. There were significant correlations between TPEC and pulmonary function measures of asthma severity.
Funding: University of Minnesotu Allergy and Asthma Program
Abstracts
S123
1~~llT hdence e Effectiveness of Asthma Education on Reducing the Inciand Severity of Asthma Episodes During a Two-Week Period in Nricnn American Children Between the Ages of 7-12 J. R. EdwardsL D. Calloway ], M. Caprarola I, R. Hollander l, S. Ford2; IHealth Education, Howard University, Washington, DC, -~Pediatrics, Howard University Hospital, Washington, DC. RATIONALE: We examined the relationship of the effectiveness of asthma education on reducing the incidence and severity of asthma episodes during a two week period in African American children between the ages tb 7-12 at Chartered Health Plan. METHODS: The instrument that was used in this study was the Asthma Functional Severity Index which is a measure of functional impairment such as symptoms and restrictions due to asthma in school age children. The intervention that was used in this asthma education study was the Asthma Care Training for kids. RESULTS: Twenty-seven percent of the parents reported that their children had wheezing first thing in the morning after the asthma education session. The children reported 6.6% liewer episodes of wheezing first thing in the morning after the asthma education session. CONCLUSIONS: Asthma educational programs for children and their parents offer them the opportunity to increase their understanding about asthma and help them to manage their disease.
216 High-Resolution HLA Class II DNA Haplotyping in Allergic Fungal Rhinosinusitis and Hypertrophic Sinus Disease: The Role of HLA DQ3 M. S. Schubert I, P, S. Hutcheson 2, R. J. Graft2, R. G. Slavin2: 1Allergy Asthma Clinic, Phoenix, AZ, 2St. Louis University, St. Louis. MO. RATIONALE: We have extended our previous observations in allergic fungal rhinosinusitis (AFS) and hypertrophic sinus disease (HSD) by using high resolution HLA class II DNA haplotyping to assess allele frequencies and relative risk (RR). METHODS: 43 AFS patients were studied: all were atopic, 31 had asthma, 5 had ASA/NSAID hypersensitivity, 30 of 37 grew Bipolaris spicifera on fungal cultures. 31 HSD patients without AFS had chronic rhinosinusitis/nasal polyps: 22 were atopic, 26 had asthma, and 12 had ASA/NSAID hypersensitivity. RESULTS: Of the 43 AFS patients, 65% were HLA DQ3+ with DQB 1*0301 ( 16 patients) and DQB I *0302 ( 15 patients) being the most common alleles: combined RR=6,74. Of the 30 Bipolaris culture positive AFS patients, 67% were DQ3+ with DQBI*0301 (10 patients) and DQBI*0302 (10 patients) being the most common: combined RR=7.42. Of the 31 HSD patients, 52% were DQ3+ with DQBI*0301 (9 patients), DQBI*0302 (5 patients) and DQBI*0303 (5 patients) being the most common: combined RR=3.85. DQ3 polymorphisms did not correlate with specific allergy skin tests or atopic status, total serum lgE, fungal cultures, asthma, or ASA/NSAID hypersensitivity. CONCLUSION: Both AFS and HSD patients have polymorphic DQ3 alleles as a risk factor for disease, with AFS showing a higher RR. This suggests a role for DQ3 in disease pathogenesis,