- Improved asthma outcomes from allergy specialist care: a population-based cross-sectional analysis
Michael Schatz, Robert S. Zeiger and David Mosen, et al.
The journal of allergy and clinical immunology, Vol. 116,
No. 6, Dec 2005, pp. 1307-13. Epub: 2005 Nov 08.
BACKGROUND: Prior studies suggest that allergist care improves asthma outcomes, but many of these studies have methodological shortcomings. OBJECTIVE: We sought to compare patient-based and medical utilization outcomes in randomly selected asthmatic patients cared for by allergists versus primary care providers. METHODS: A random sample of 3568 patients enrolled in a staff model health maintenance organization who were given diagnoses of persistent asthma completed surveys. Of these participants, 1679 (47.1%) identified a primary care provider as their regular source of asthma care, 884 (24.8%) identified an allergist, 693 (19.4%) reported no regular source of asthma care, and 195 (5.5%) identified a pulmonologist. Validated quality of life, control, severity, patient satisfaction, and self-management knowledge tools and linked administrative data that captured medication use were compared between groups, adjusting for demographics and baseline hospital and corticosteroid use. RESULTS: Compared with those followed by primary care providers, patients of allergists reported significantly higher (P < .001) generic physical and asthma-specific quality of life, less asthma control problems, less severe symptoms, higher satisfaction with care, and greater self-management knowledge. Patients of allergists were less likely than patients of primary care providers to require an asthma hospitalization (odds ratio, 0.45) or unscheduled visit (odds ratio, 0.71) and to overuse beta-agonists (odds ratio, 0.47) and were more likely to receive inhaled steroids (odds ratio, 1.81) during their past year. CONCLUSIONS: Allergist care is associated with a wide range of improved outcomes in asthmatic patients compared with care provided by primary care providers.
- Extended histopathology in immunotoxicity testing: interlaboratory validation studies
D. R. Germolec, A. Nyska and M. Kashon, et al.
Toxicological sciences : an official journal of the Society of Toxicology, Vol. 78, No. 1, Mar 2004, pp. 107-15. Epub: 2003 Dec 22.
There has been considerable interest in the use of expanded histopathology as a primary screen for immunotoxicity assessment. To determine the utility of a semiquantitative histopathology approach for examining specific structural and architectural changes in lymphoid tissues, a validation effort was initiated. This study addresses the interlaboratory reproducibility of extended histopathology, using tissues from studies of ten test chemicals and both negative and positive controls from the National Toxicology Program's immunotoxicology testing program. We examined the consistency between experienced toxicologic pathologists, who had varied expertise in immunohistopathology in identifying lesions in immune tissues, and in the sensitivity of the individual and combined histopathological endpoints to detect chemical effects and dose response. Factor analysis was used to estimate the association of each pathologist with a so-called "common factor" and analysis-of-variance methods were used to evaluate biases. Agreement between pathologists was highest in the thymus, in particular, when evaluating cortical cellularity of the thymus; good in spleen follicular cellularity and in spleen and lymph node-germinal center development; and poorest in spleen red-pulp changes. In addition, the ability to identify histopathological change in lymphoid tissues was dependent upon the experience/training that the individual pathologist possessed in examining lymphoid tissue and the apparent severity of the specific lesion.
- Adverse Drug Reactions: Types and Treatment Options
M. A. Riedl and A. M. Casillas.
American Family Physician, Vol. 68, No. 9, 1 Nov 2003, pp. 1781-1794.
Drug hypersensitivity results from interactions between a pharmacologic agent and the human immune system. These types of reactions constitute only a small subset of all adverse drug reactions. Allergic reactions to medications represent a specific class of drug hypersensitivity reactions mediated by IgE. Immune-mediated drug reactions may be discussed generally in the Gell and Coombs classification system, a widely accepted conceptual framework for understanding complex immune reactions. However, some reactions involve additional, poorly understood mechanisms that are not easily classified. Identifiable risk factors for drug hypersensitivity reactions include age, female gender, concurrent illnesses, and previous hypersensitivity to related drugs. Drug hypersensitivity is a clinical diagnosis based on available data. Laboratory testing may be useful, with skin testing providing the greatest specificity. Treatment is largely supportive and includes discontinuation of the offending medication, symptomatic treatment, and patient education. Patients with penicillin allergy should avoid carbapenems, and caution should be used in prescribing cephalosporins in these patients. Reactions to radiocontrast media can be limited by pretreatment with prednisone, diphenhydramine, and either ephedrine or a histamine H sub(2)-receptor antagonist.
- Developmental immunology: clinical application to allergy-immunology
Joseph A. Bellanti, Jonathan Malka-Rais, Henry J. Castro, Julia Mendez de Inocencio and Aderbal Sabra.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, Vol. 90, No. 6 Suppl 3, Jun 2003, pp. 2-6.
BACKGROUND: An increase in prevalence of allergic diseases has been seen at an unprecedented rate in many countries throughout the world. Associated with this increase in allergic disease has been a disturbing increase in morbidity and mortality of such diseases as asthma despite the availability of several new therapeutic agents over the past 2 to 3 decades. The search for both environmental factors, eg, new allergens, as well as biologic markers of genetic susceptibility, eg, respiratory viruses, has yielded considerable promise for an explanation for this rising prevalence of allergic disease. OBJECTIVE: To present a central unifying hypothesis based upon recent knowledge concerning the developing human immune system and its interaction with external environmental factors, particularly viral infections, as a basis for a clearer understanding of the changing faces of the allergic diseases throughout the lifespan of the individual. DATA SOURCES: English language articles were selected from PubMed, as well as selected abstracts that would have immediate, practical clinical implications. RESULTS: Review of the current literature strongly suggests a relationship between delayed acquisition of Th1 function in the allergy-prone infant, not only as a predictive marker of susceptibility to the development of allergic disease but also as an explanation for the unique vulnerability of these infants to viral infection, eg, bronchiolitis. Furthermore, viral infection during early development in the allergy-prone infant appears to facilitate allergic sensitization in early infancy. This interesting triad of immune deficiency, viral infection, and atopic genetic susceptibility may provide a basis for early detection of allergic disease and may offer new intervention strategies for the prevention of allergic and infectious disease in the young infant.
- The future for computational modelling and prediction systems in clinical immunology
Nikolai Petrovsky, Diego Silva and Vladimir Brusic.
Novartis Foundation symposium, Vol. 254, 2003, pp. 23-32;
discussion 33-42, 98-101, 250-2.
Advances in computational science, despite their enormous potential, have been surprisingly slow to impact on clinical practice. This paper examines the potential of bioinformatics to advance clinical immunology across a number of key examples including the use of computational immunology to improve renal transplantation outcomes, identify novel genes involved in immunological disorders, decipher the relationship between antigen presentation pathways and human disease, and predict allergenicity. These examples demonstrate the enormous potential for immunoinformatics to advance clinical and experimental immunology. The acceptance of immunoinformatic techniques by clinical and research immunologists will need robust standards of data quality, system integrity and properly validated immunoinformatic systems. Such validation, at a minimum, will require appropriately designed clinical studies conducted according to Good Clinical Practice standards. This strategy will enable immunoinformatics to achieve its full potential to advance and shape clinical immunology in the future.
- Transglutaminase-mediated cross-linking of a peptic fraction of omega -5 gliadin enhances IgE reactivity in wheat-dependent, exercise-induced anaphylaxis
K. Palosuo, E. Varjonen and J. Nurkkala, et al.
Journal of Allergy and Clinical Immunology, Vol. 111, No. 6, Jun 2003, pp. 1386-1392.
Patients with wheat-dependent, exercise-induced anaphylaxis (WDEIA) experience recurrent anaphylactic reactions when exercising after ingestion of wheat products. We have identified omega -5 gliadin (Tri a 19) as a major allergen in WDEIA, but the role of exercise in eliciting the symptoms remains obscure. Objective: The aim was to examine whether tissue transglutaminase (tTG)-mediated cross-linking could be involved in modulating the IgE-binding ability and in vivo reactivity of digested omega -5 gliadin peptides in WDEIA. Methods: Purified omega -5 gliadin was digested with pepsin or with pepsin and trypsin and treated with tTG. The binding of IgE antibodies in pooled sera from 10 patients with WDEIA was studied by means of immunoblotting before and after tTG treatment of the digested peptides. The peptides derived from pepsin digestion were separated by means of gel-filtration chromatography, and IgE reactivity of 4 different peptide fractions was studied by immunoblotting before and after tTG treatment. The fraction showing the greatest degree of cross- linking by tTG was further studied by means of IgE ELISA, ELISA inhibition, and skin prick testing. Results: The IgE-binding ability of omega -5 gliadin was retained after pepsin and pepsin-trypsin digestion. tTG treatment of the whole peptic digest formed large peptide complexes, with molecular weights ranging from 40 to greater than 200 kd. These cross-linked aggregates bound IgE antibodies in immunoblotting more intensely than untreated, pepsin-digested, or pepsin-trypsin-digested omega -5 gliadin. A gel-filtration fraction of the whole peptic digest corresponding to the highest peak of the chromatogram and showing the greatest degree of tTG-mediated cross-linking showed an increase in serum IgE reactivity in ELISA after tTG treatment, as well as a shift of reactivity to cross-linked complexes. In the 20 patients with WDEIA, the mean skin prick test wheal elicited by this tTG-treated peptic fraction was 77% larger (P < .001) than that elicited by the untreated peptic fraction and 56% larger (P < .01) than that elicited by intact omega -5 gliadin. Conclusions: omega -5 Gliadin-derived peptides are cross-linked by tTG, which causes a marked increase in IgE binding both in vitro and in vivo. Activation of tTG during exercise in the intestinal mucosa of patients with WDEIA could lead to the formation of large allergen complexes capable of eliciting anaphylactic reactions.
- Atopy may be related to exercise-induced bronchospasm in asthma
Y. I. Koh, I. S. Choi and H. Lim.
Clinical and Experimental Allergy, Vol. 32, No. 4, Apr 2002, pp. 532-536.
Recent studies suggest that atopy may be associated with exercise-induced bronchospasm (EIB) in asthma. However, it is not clear whether atopy is related to EIB, regardless of airway hyper-responsiveness (AHR) to methacholine, because asthmatic subjects often show AHR to exercise and methacholine simultaneously. We investigated whether atopy is related to EIB in asthmatic subjects, independently of AHR to methacholine. Fifty-eight male asthmatic subjects were studied. Initial spirometry was performed. Skin prick test was carried out, using 53 common allergens including mites dust antigen. Atopy score was defined as a sum of mean weal diameters to all allergens tested. Methacholine bronchial provocation testing was performed. Twenty-four hours later, free running test was performed. Positive EIB was defined as a 15% reduction or more in FEV sub(1) from baseline after exercise. All subjects had AHR to methacholine. The degree of AHR to methacholine in asthmatics with EIB was similar to that in asthmatics without EIB. However, atopy score and skin reaction to Dermatophagoides pteronyssinus significantly increased in asthmatics with EIB compared with those without EIB (P < 0.05, respectively). Furthermore, the degree of EIB significantly correlated with atopy score in all subjects (r = 0.35, P < 0.01). This relationship was maintained even after the exclusion of EIB-negative asthmatic subjects. Atopy defined as skin test reactivity may contribute to the development of EIB in asthma, independently of AHR to methacholine.
- Copper allergy from dental copper amalgam?
L. Gerhardsson, B. Bjoerkner, M. Karlsteen and A. Schuetz.
Science of the Total Environment, Vol. 290, No. 1-3, 6 May 2002, pp. 41-46.
A 65-year-old female was investigated due to a gradually increasing greenish colour change of her plastic dental splint, which she used to prevent teeth grinding when sleeping. Furthermore, she had noted a greenish/bluish colour change on the back of her black gloves, which she used to wipe her tears away while walking outdoors. The investigation revealed that the patient had a contact allergy to copper, which is very rare. She had, however, had no occupational exposure to copper. The contact allergy may be caused by long-term exposure of the oral mucosa to copper from copper-rich amalgam fillings, which were frequently used in childhood dentistry up to the 1960s in Sweden. The deposition of a copper-containing coating on the dental splint may be caused by a raised copper intake from drinking water, increasing the copper excretion in saliva, in combination with release of copper due to electrochemical corrosion of dental amalgam. The greenish colour change of the surface of the splint is probably caused by deposition of a mixture of copper compounds, e.g. copper carbonates. Analysis by the X-ray diffraction technique indicates that the dominant component is copper oxide (Cu sub(2)O and CuO). The corresponding greenish/bluish discoloration observed on the back of the patient's gloves may be caused by increased copper excretion in tears.
- Effects of Intranasal Budesonide on Symptoms, Quality of Life, and Performance in Elite Athletes With Allergic Rhinoconjunctivitis
C. H. Katelaris, F. M. Carrozzi, T. V. Burke and K. Byth.
Clinical Journal of Sport Medicine, Vol. 12, No. 5, Sep 2002, pp. 296-300.
Objective: To assess change in symptoms, quality of life (QOL), and performance ability before, during, and after treatment with budesonide in a group of Olympic and Paralympic athletes with seasonal allergic rhinoconjunctivitis (SAR/C). Design: Because budesonide has already been proven to be an effective and well-tolerated treatment of SAR/C, super(1) an open-label treatment format was used. Setting: The study was community-based with participating athletes preparing for Olympic competition. Participants: Olympic and Paralympic athletes were screened for the presence of SAR/C using history and positive skin test results for pollen allergens. Interventions: All were offered treatment with intranasal budesonide, applied to each nostril, once daily for eight weeks. Outcome Measurements: Symptom and medication diaries were completed before treatment and after 4 and 8 weeks of treatment. Similarly, Quality of Life (QOL) was measured with the Rhinoconjunctivitis Quality of Life Questionnaire. As a secondary outcome measure, the ability to train and compete was assessed using a performance diary. Results: Of the 236 athletes eligible for the study, 145 (61%) agreed to participate. Forty-six percent of the athletes who were dispensed treatment did not return questionnaires. For those returning questionnaires, scores between baseline (week 0) and weeks 4 and 8 were calculated for total symptoms, QOL, and performance scores. There were statistically significant improvements in symptoms, QOL, and performance scores in athletes who used intranasal budesonide. Conclusion: SAR/C is a common condition and has demonstrable negative effects on athletes. Better education of coaches and athletes is necessary to ensure that the condition is correctly diagnosed and treated, with safe, effective, permitted medication.
- Exercise-Induced Changes in Pulmonary Function of Healthy, Elite Long-Distance Runners in Cold Air and Pollen Season Exercise Challenge Tests
I. Helenius, H. O. Tikkanen, M. Helenius, A. Lumme, V. Remes and T. Haahtela.
International Journal of Sports Medicine, Vol. 23, No. 4, May 2002, pp. 252-261.
Exercise-induced changes in postexercise pulmonary function have not been studied in healthy elite athletes in normal training conditions. Twelve healthy elite runners volunteered. They showed normal resting spirometry and bronchial responsiveness to histamine, and were non-atopic. They performed free running exercise challenge tests (ECT) at subzero temperature and immediately after highest birch pollen season. The mean maximal postexercise changes in FEV sub(1), PEF, FVC, and FEV sub(1)/FVC did not differ between the cold air and pollen season ECTs. Compared with pre-exercise values, FEV sub(1) increased significantly at 10 min (p = 0.028) and 20 min (p = 0.033) postexercise in the cold air ECT, as well as at 10 min (p = 0.024) and 20 min (p = 0.010) postexercise in the pollen season ECT. The mean (SEM) maximal postexercise change in FEV sub(1) was mostly small + 2.6 (0.6)% in the winter and + 2.7 (0.9)% in the pollen season. In contrast, significant decreases in PEF, compared with baseline, were found at 10 min (p = 0.071) and 20 min (p = 0.0029) postexercise in the cold air ECT, as well as at 10 min (p = 0.060) and 20 min (p = 0.010) postexercise in the pollen season ECT (p = 0.0076). The mean (SEM) maximal postexercise fall in PEF was 5.9 (1.0)% in the winter and 6.0 (1.8)% in the pollen season. Heavy exercise challenge tests in extreme conditions increased FEV sub(1) post-exercise, while PEF decreased as compared with pre-exercise values. Thus, even small postexercise falls in FEV sub(1) may be considered as deviate exercise responses in elite athletes.
- Exploring lymphocyte differentiation pathways
Max D. Cooper.
Immunological reviews, Vol. 185, Jul 2002, pp. 175-185.
Highlights in a 4-decade exploration of lymphocyte differentiation begin with comparative studies in birds and mammals leading to recognition of the separate T- and B-cell differentiation pathways and their cooperative interaction. The global effects of aborting IgM B-cell development with anti-mu antibodies indicated that B cells can undergo immunoglobulin isotype switching. A search for the mammalian bursa equivalent that began with an extended excursion through the gut-associated lymphoepithelial tissues ultimately led to the hematopoietic tissue origin of mammalian B cells. The identification of the precursors of B cells in hematopoietic tissues provided an expanded view of the life history of B cells. A recurring theme in this essay is the interplay between understanding normal lymphocyte differentiation and the defects that underlie immunodeficiency diseases and lymphoid malignancies.
- The influence of maternal exposure to volatile organic compounds on the cytokine secretion profile of neonatal T cells
I. Lehmann, A. Thoelke and M. Rehwagen, et al.
Environmental toxicology, Vol. 17, No. 3, 2002, pp. 203-210.
Indoor VOC (volatile organic compound) exposure has been shown to be correlated with airway symptoms and allergic manifestations in children. An investigation was conducted within an ongoing birth cohort study (LISA: Lifestyle-Immune System-Allergy) of the association between maternal exposure to VOCs and immune status at birth, in particular the cytokine secretion profile of cord-blood T cells. In a randomly selected group of 85 neonates, cytokine-producing cord-blood T cells were analyzed using intracellular cytokine detection. VOC exposure was measured in children's dwellings by passive sampling, while parents were asked to complete questionnaires about possible sources of VOC exposure. Adjusted odds ratios (ORs) were calculated by logistic regression based on categorized quartiles. A positive association was found between elevated percentages of interleukin-4-producing (IL-4) type 2 T cells and exposure to naphthalene (OR = 2.9) and methylcyclopentane (OR = 3.3). Exposure to tetrachloroethylene was associated with reduced percentages of interferon- gamma -producing (IFN- gamma ) type 1 T cells (OR = 2.9). In addition, smoking during pregnancy was correlated with a higher indoor air concentration of naphthalene (OR = 3.8), new carpets in infants' bedrooms with elevated methylcyclopentane concentrations (OR = 4.1), and home renovation with a higher trichloroethylene burden (OR = 4.9). Our data suggest that maternal exposure to VOC may have an influence on the immune status of the newborn child.
- Primary immunodeficiency diseases: dissectors of the immune system
Rebecca H. Buckley.
Immunological reviews, Vol. 185, Jul 2002, pp. 206-219.
The past 50 years have seen enormous progress in this field. An unknown concept until 1952, there are now more than 100 different primary immunodeficiency syndromes in the world's literature. Each novel syndrome has shed new insight into the workings of the immune system, dissecting its multiple parts into unique functioning components. This has been especially true over the past decade, as the molecular bases of approximately 40 of these diseases have been identified in rapid succession. Advances in the treatment of these diseases have also been impressive. Antibody replacement has been improved greatly by the development of human immunoglobulin preparations that can be safely administered by the intravenous route, and cytokine and humanized anticytokine therapies are now possible through recombinant technologies. The ability to achieve life-saving immune reconstitution of patients with lethal severe combined immunodeficiency by administering rigorously T-cell-depleted allogeneic related haploidentical bone marrow stem cells has extended this option to virtually all such infants, if diagnosed before untreatable infections develop. Finally, the past 3 years have witnessed the first truly successful gene therapy. The impressive results in X-linked severe combined immunodeficiency offer hope that this approach can be extended to many more diseases in the future.
- Reprogramming the immune system
Immunological reviews, Vol. 185, Jul 2002, pp. 227-235.
The immune system is organized so as to react to pathogens without risking damage to self. Harnessing those processes that prevent self-reactivity will have enormous potential in clinical medicine. This review outlines the efforts of this laboratory over the last 25 years to exploit tolerance so as to reprogram the immune system for therapeutic purposes.
- Chemical intermediates scavengers in the therapy of allergic diseases
J. M. Mates, J. M. Segura, C. Perez-Gomez, M. Asenjo and M. Blanca.
Res Chem Intermed, Vol. 27, No. 3, 2001, pp. 297-304.
Although oxidative status has been related to several pathophysiologic processes, there is not a well established connection between antioxidant defense and allergy. An imbalance of reactive oxygen species is related to inflammation in allergic diseases. Antioxidant enzymes are involved in cell detoxification. This primary antioxidant defence system might work against allergic's symptoms. In this work, arguments in favour of the potential of free radical scavengers in antioxidant therapy for allergic patients are discussed.
- Emergency Management of Allergic Reactions
E. Swann and R. R. Castle.
Athletic Therapy Today, Vol. 6, No. 5, Sep 2001, pp. 11-15.
In any type of physical activity or sport, athletes are susceptible to allergic reactions. Allergic reactions are immunological responses to stimuli including insect bites or stings, dust, pollen, plants, foods, medications, and exercise. The body's outward immunological response can range from mild urticaria, or hives, to life-threatening situations such as respiratory distress.
- Frequency of food-dependent, exercise-induced anaphylaxis in Japanese junior-high-school students
Y. Aihara, Y. Takahashi and T. Kotoyori, et al.
Journal of Allergy and Clinical Immunology, Vol. 108, No. 6, Dec 2001, pp. 1035-1039.
Food-dependent, exercise-induced anaphylaxis (FEIAn) is classified among the physical allergies. The pathophysiology of FEIAn remains unknown, as does the frequency of FEIAn in the general population. We sought to study the epidemiology of FEIAn, especially its frequency in junior-high-school students in Yokohama, Japan. A questionnaire asking about the occurrence of FEIAn in school students was sent to all 145 public junior-high-school nurses in Yokohama. One hundred thirty-two junior-high-school nurses responded to the questionnaire, and 13 (11 boys and 2 girls) cases of FEIAn among 76,229 junior-high-school students were reported. In addition, 24 (12 boys and 12 girls) subjects with exercise-induced anaphylaxis (EIAn) were detected. From this survey, the frequency of FEIAn was 0.017% in this population, and its frequency was significantly higher in boys than in girls (P < .05). The frequency of EIAn was 0.031%, and there was no difference according to sex. Only one third of junior-high-school nurses had any knowledge of FEIAn. We also performed provocation tests in 5 of the 13 cases with FEIAn after obtaining informed consent from the students and their parents and were able to confirm the diagnosis. This study showed that FEIAn and EIAn are relatively rare diseases among junior-high-school students in Yokohama. To avoid serious outcomes, we believe it is important that not only physicians but also school nurses and teachers of physical education be aware of these diseases.
- Immunologists getting nervous: neuropeptides, dendritic cells and T cell activation
B. N. Lambrecht.
Respiratory research, Vol. 2, No. 3, 2001, pp. 133-8. Epub: 2001 Apr 19.
It is increasingly recognised that the immune and nervous systems are closely integrated to optimise defence systems within the lung. In this commentary, the contribution of various neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide and somatostatin to the regulation of T cell activation is discussed. These neuropeptides are released not only from nerve endings but also from inflammatory immune cells such as monocytes, dendritic cells, eosinophils and mast cells. On release they can exert both direct stimulatory and inhibitory effects on T cell activation and also indirect effects through their influence on the recruitment and activation of professional antigen-presenting dendritic cells. Neuropeptides should therefore be included in the conceptual framework of the immune regulation of T cell function by dendritic cells.
- Respiratory arrest in a male athlete after running through a wheat field
I. L. Swaine and W. D. Riding.
International Journal of Sports Medicine, Vol. 22, No. 4, 2001, pp. 268-269.
A male athlete suffered complete respiratory arrest after collapsing at the entrance to an Accident and Emergency Department of a hospital. He was resuscitated and recovered fully after several hours. He had multiple wheals on both legs and had complained of severe breathlessness before collapsing. The athlete had run through a wheat field, upon finding his usual pathway overgrown, which had caused wheat pollen to be released. He had been a mild asthmatic for 30 years and had recalled some mild urticaria after exercise but had never experienced exercise-induced asthma, or hay fever. Subsequent allergy tests showed negative for wheat but positive for house dust mite and grass mix. It is possible that the symptoms were triggered either by the running itself, inhalation of allergens other than wheat pollen, skin abrasions caused by contact with wheat stalks, or a combination of these factors.
- Respiratory effects of a single dive to 50 meters in sport divers with asymptomatic respiratory atopy
K. Tetzlaff, C. M. Staschen, N. Struck and T. S. Mutzbauer.
International Journal of Sports Medicine, Vol. 22, No. 2, 2001, pp. 85-89.
Increasing popularity of sports diving makes it likely that subjects with allergic respiratory diseases will be involved in diving with self contained underwater breathing apparatus (scuba). The present study evaluated the effects of a single scuba-dive on pulmonary function in subjects with respiratory atopy. Specific airways conductance (sGaw), residual volume (RV), forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), mid expiratory flow at 50% of FVC (MEF50), and transfer factor for carbon monoxide (TLCO) were measured in 9 sport divers with a history of hay fever and 9 matched healthy sport divers (control) before, 3 hours and 24 hours after a wet hyperbaric chamber dive to a depth of 50 m. Airway hyperresponsiveness (AHR) was assessed by methacholine challenge 4 weeks after the dive. Atopic subjects and controls did not differ with respect to anthropometric data, diving experience, and predive lung function. A 3% reduction in FVC was found 24h after the dive (p < 0.05) in both groups, whereas sGaw decreased by 15% 24 h after the dive (p < 0.05) in the subjects with respiratory atopy only. Postdive changes in RV, FEV1, MEF50, and TLCO did not reach level of statistical significance. AHR was obtained in 8/9 subjects with respiratory atopy. We conclude that subjects with atopic sensitization and asymptomatic AHR may be more susceptible to effects of diving on pulmonary function.
- [Immunology in the 20th century--progress made in research on infectious and immunological diseases]
Kekkaku : [Tuberculosis]., Vol. 75, No. 10, Oct 2000, pp. 595-598.
The new era of the modern medicine was opened 100 years ago by Robert Koch and Louis Pasteur who demonstrated that various infectious diseases were caused by their respective microbes. Koch discovered Mycobacterium tuberculosis, the causative agent of tuberculosis. The first breakthrough in the modern medicine to combat against infectious diseases was the discovery of anti-diphtheria toxin antibody by E.A. von Behring and S. Kitasato. The concept of immunity--immune from disease--has thus been established. The immune response between antigen and antibody sometimes provides the host with a harmful effect. The concept of allergy was introduced by Richet and later by Prausnitz and Küstner. Why the same immune response leads to the different outcome, immunity or allergy had not been made clear until the discovery of IgE by Drs. Kimishige and Teruko Ishizaka in 1968: The IgG antibody plays a role in immunity whereas IgE antibody is involved in allergy. Tuberculin skin reaction which is well known as the diagnostic tool for mycobacterial infection was studied by M. Chase in 1945 demonstrating that it was able to be transferred to the healthy individual by immune cells but not by antibody. The immune response is now categorized into two; soluble immunity--immediate type allergy and cell-mediated immunity--delayed type allergy. The rapid progress in the molecular biology in the past decades has also accelerated the progress in immunology, several of which include discovery of two types of lymphocytes; T and B cells; concept of two T cells; Th1 and Th2 cells; and the discovery of cytokines which regulate immune cell responses. The mechanism of the immune response is now understood at the gene level. Several immunological diseases can now be successfully treated by controlling the levels of cytokines involved. For example, refractory rheumatoid arthritis is now under control by the administration of recombinant soluble TNF receptor molecules to the patients. The complete human genome sequence is currently under investigation. We can now envisage the advent of the days when every disease can be diagnosed and intervened at the gene level.
- Gene therapy of chronic inflammatory disease
Mary Lynne Hedley.
Advanced Drug Delivery Reviews, Vol. 44, No. 2-3, Nov 2000, pp. 195-207.
Immune mediated inflammation that culminates in severe tissue necrosis is the hallmark of diseases that result from an inappropriate response to antigen. The inflammatory response becomes chronic when antigen is non-limiting and persists until the reactive tissue is destroyed, or the environment is changed and exposure to antigen is eliminated. The purpose of this review is to: (1) briefly outline common features of immune related inflammatory diseases such as rheumatoid arthritis (RA), multiple sclerosis (MS), inflammatory bowel disease (IBD), and allergic asthma; (2) provide a rationale for the development of gene based drugs for these indications; and (3) describe current experimental results that support the usefulness of this approach for creating novel DNA based therapeutics.
- Longitudinal case analysis in atopic dermatitis
P. Helmbold, G. Gaisbauer, J. Kupfer and U. F. Haustein.
Acta Dermato-Venereologica, Vol. 80, No. 5, 2000, pp. 348-352.
The current knowledge on atopic dermatitis comes mainly from cross-sectional studies, which are not suited to establish time-courses or causal links in complex diseases. As an alternative approach, the method of longitudinal case analysis by the autoregressive integrated moving average (ARIMA) method has been introduced to investigate the pathogenesis of atopic dermatitis. The method was applied to the investigation of 2 patients suffering from severe and moderate atopic dermatitis. Disease activity, peripheral blood parameters (differential blood count, lymphocyte subpopulations, immunoglobulin E, eosinophilic cationic protein, soluble interleukin-2 receptor), mental stress and environmental factors were determined daily for 50 days. Both patients showed a positive correlation between CD4+ and CD25+ T-cells, a negative correlation between CD16/56+ natural killer cells and CD4+ T-cells, a negative correlation between eosinophils and polymorphonuclear leukocytes, and a time-shifted positive correlation of up to 2 days between scores quantifying mental stress and disease activity. A positive correlation between T-cells and polymorphonuclear leukocytes, CD4+ T-cells and the CD45RA+ subtype, as well as a negative correlation between stress and eosinophils, sports and eosinophils, and sports and disease activity were found only in one patient with more severe atopic dermatitis. In conclusion, longitudinal time-series analysis might represent an interesting and adequate method to generate and test new hypotheses on biomedical problems which cannot be addressed by cross-sectional studies.
- Asthma care specialists improve outcomes
Healthcare benchmarks, Vol. 6, No. 7, Jul 1999, pp. 76-78.
The incidence of asthma in the United States is widespread and growing, consuming a great deal of health care resources. A number of studies have concluded that treatment of asthma patients by specialists achieves superior outcomes and saves costs. Better use of aggressive techniques by allergists is central to their success in treating asthma patients.
- Treatment of chronic rhinitis by an allergy specialist improves quality of life outcomes
S. E. Bagenstose and J. A. Bernstein.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, Vol. 83, No. 6 Pt 1, Dec 1999, pp. 524-528.
BACKGROUND: Allergic rhinitis is associated with significant impairment in quality of life and therefore has a significant impact on the indirect health care costs associated with treatment of chronic rhinitis in the United States. It has been stated that early intervention in the treatment of chronic rhinitis by an allergy specialist improves health outcomes but few unbiased studies have been conducted to substantiate this claim. OBJECTIVE: This study measured quality of life outcomes in the treatment of chronic rhinitis by an allergy specialist. METHODS: Quality of life changes were assessed using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the "Short-Form" 36-item questionnaire (SF-36) in patients before and after treatment of chronic rhinitis symptoms by a board-certified allergist. Patients with chronic rhinitis were asked by a 3rd year medical student to complete these questionnaires prior to any contact with the allergist. Treatment by the allergist included counseling on avoidance measures when appropriate and a new medication regimen. Patients were contacted by the 3rd year medical student 3 to 5 months later to complete follow-up RQLQ and SF-36 surveys. All data analysis was conducted independently by the 3rd year medical student. RESULTS: Complete sets of pre-treatment and post-treatment surveys were obtained from 19 patients. Perennial allergic rhinitis was diagnosed for 13 patients, perennial allergic rhinitis with a seasonal component was diagnosed for three patients, vasomotor rhinitis was diagnosed for two patients and mixed allergic and non-allergic rhinitis was diagnosed for one patient. Statistically significant improvement was observed in four of the nine health concepts measured by the SF-36 questionnaire. Significant changes above the minimal important difference (MID) were observed post-treatment in six of eight RQLQ dimensions. CONCLUSIONS: This study indicates that intervention by a board-certified allergist significantly improves many areas of health-related quality of life. Further studies comparing health care outcomes and costs of treating chronic rhinitis by primary care physicians to early intervention by allergy specialists are warranted.
- Assessment of asthma severity in adults with asthma treated by family practitioners, allergists, and pulmonologists
M. D. Eisner, P. P. Katz, E. H. Yelin, J. Henke, S. Smith and P. D. Blanc.
Medical care., Vol. 36, No. 11, Nov 1998, pp. 1567-1577.
OBJECTIVES: Accurate measurement of asthma severity is critical for research evaluating asthma health outcomes. There are, however, no widely accepted asthma severity measures. A severity-of-asthma score, which is based on self-reported information, was previously developed and validated in subjects recruited from pulmonary and allergy subspecialty practices. The purpose of this study was to validate the severity-of-asthma score in subjects treated by family practice physicians and to compare asthma severity in subjects treated by family practitioners (n = 150) with those seen by allergists (n = 217) and pulmonologists (n = 384). METHODS: The study was an ongoing panel study of adults with asthma. Subjects were a random sample of board-certified family practice, allergy, and pulmonary physicians. Each physician registered patients with asthma aged 18 to 50 years. Of 869 subjects registered, 751 (86%) completed structured telephone interviews. The family practice panel was recruited approximately 3 years after the subspecialty panel. RESULTS: In the family practice subjects, the severity-of-asthma score demonstrated internal consistency (Cronbach's alpha 0.76) and concurrent validity, correlating strongly with asthma-specific quality of life, SF-36 General Health and Physical Functioning scales, and subject-perceived asthma severity. After controlling for demographic characteristics, a 5-point score increment was associated with increased emergency department visits, urgent physician visits, and restricted activity days. The mean severity score was highest in the pulmonary group (11.8 +/- 6.3), followed by the allergy (10.3 +/- 5.3) and family practice (9.3 +/- 5.5) groups. CONCLUSIONS: The severity-of-asthma score was a valid measure in generalist-treated subjects. Asthma severity varied significantly by physician specialty.
- Health conditions in a population living near an industrial waste recycling plant in Mexico
H. T. Ahumada.
Revista Panamericana de Salud Publica/Pan American Journal
of Public Health, Vol. 3, No. 3, 1998, pp. .
The present study was conducted in a population living near a recycling plant for zinc and other metallic dusts to determine whether exposures to these substances were occurring and producing adverse health effects. The plant is situated in a suburb of Monterrey, which is the third most populous city in Mexico and the second most industrialized. A cross-sectional study design was used for the investigation, which was carried out from September to November 1994. Using cluster sampling procedures, homes in two areas were selected-one exposed through proximity to the plant, and the other unexposed to serve as a control-until the desired sample size was achieved (621 individuals, with an average of five per dwelling). A specially trained psychology student administered a questionnaire to an adult member of each family, soliciting data on the presence of acute and chronic infections, complications of pregnancy, and congenital diseases among the family members. One hundred twenty-seven questionnaires were administered in the exposed population, yielding information on 596 individuals. In the unexposed population, 147 questionnaires were administered furnishing data on 743 individuals. The sex and age distributions of the two populations were similar. The unexposed population had a slightly longer average duration of residence. The most common health problems in the exposed population were irritation of the eyes and upper respiratory tract, allergies, sleep disturbances, bronchitis, excessive fatigue, skin problems, otitis, and anemia. The exposed population had significantly higher risks for skin eruptions and diseases, excessive fatigue, sleep disturbances, upper respiratory infections, otitis, bronchitis, and allergies. Exposed and unexposed women had comparable prevalences of obstetrical problems, spontaneous abortions, congenitally malformed offspring, and low birthweight. The questionnaire used to detect health problems has low sensitivity and may have generated understimates of some conditions. Nevertheless, the analysis controlled for several different biases, and thus it can be concluded that a positive association exists between environmental exposure to these wastes and increased risk of disease.
- The occurrence of late asthmatic response to exercise after allergen challenge
Y. Koh, J. Jeong, S. Jin, C. Kim and K. Min.
Annals of Allergy, Asthma & Immunology, Vol. 81, No. 3, Sep 1998, pp. 366-372.
The determinants of late asthmatic responses to exercise remain unknown. It has been reported that they may develop in some adult subjects with asthma following a late asthmatic response to allergen. We intended to corroborate this finding in children with asthma and to investigate which aspect of airway responses to allergen is associated with late asthmatic responses to exercise. We studied 17 children with allergic asthma, who showed late asthmatic responses to inhaled allergen (Dermatophagoides pteronyssinus). Each underwent an exercise challenge test two days before (pre-allergen) and two days after (postallergen) an allergen inhalation challenge. FEV sub(1) was measured at regular intervals up to ten hours after each challenge. Methacholine PC sub(20) was measured before the allergen challenge and before the postallergen exercise challenge. After the pre-allergen exercise test, all the subjects showed isolated early asthmatic responses. After the postallergen exercise test, seven showed dual responses (early and late asthmatic responses) (group I) and the remaining ten showed isolated early asthmatic responses (group II). Bronchial responses to pre-allergen exercise or inhaled allergen and the severity of early asthmatic responses to postallergen exercise were similar in groups I and II. Neither before allergen inhalation nor before the postallergen exercise was methacholine PC sub(20) different between the two groups. Methacholine dose shift caused by allergen challenge, however, was significantly greater in group I than in group II (-2.00 plus or minus 0.39 versus - 1.36 plus or minus 0.53 doubling doses; P < .05). There was significant correlation between the dose shift and the magnitude of late response to the postallergen exercise in the whole group (r = 0.51, P < .05). Late asthmatic responses to exercise may develop in some children with asthma following a late asthmatic response to allergen. This phenomenon was related neither to the baseline nor to postallergen methacholine PC sub(20) but to the extent of increased sensitivity to methacholine caused by allergen challenge.
- Allergenic proteins in soybean: Processing and reduction of P34 allergenicity
S. Wilson, K. Blaschek and E. Gonzalez de Mejia.
Nutrition reviews, Vol. 63, No. 2, Feb 2005, pp. 47-58.
Soybean ranks among the "big 8" of the most allergenic foods, and with increasing consumption of soybean products, the incidence of soy-caused allergies is expected to escalate. Soybean and its derivatives have become ubiquitous in vegetarian and many meat-based food products, and as a result, dietary avoidance has become difficult. However, soybeans can be manipulated in a variety of ways to alter their allergenicity. Several studies have focused on reducing the allergenicity of soybeans by changing the structure of the immunodominant allergen P34 using food processing, agronomic, or genetic manipulation techniques. A review of the literature pertaining to these studies is presented here.
- Allergenicity of Maillard reaction products from peanut proteins
S. Y. Chung and E. T. Champagne.
Journal of Agricultural and Food Chemistry, Vol. 47, No. 12, Dec 1999, pp. 5227-5231.
It is known that peanut allergy is caused by peanut proteins. However, little is known about the impact of roasting on the allergenicity of peanuts. During roasting, proteins react with sugars to form Maillard reaction products, which could affect allergenicity. To determine if the Maillard reaction could convert a nonallergenic peanut protein into a potentially allergenic product, nonallergenic lectin was reacted with glucose or fructose at 50 degrees C for 28 days. Browning products from heat-treated peanuts were also examined. The products were analyzed in immunoblot and competitive assays, using a pooled serum (i.e., IgE antibodies) from patients with peanut anaphylaxis. Results showed that the products were recognized by IgE and had an inhibitory effect on IgE binding to a peanut allergen. Thus, the findings suggest that these Maillard reaction products are potentially allergenic and indicate the need to verify whether the Maillard reaction products formed in peanuts during roasting increase their allergenicity.
- Changes in the antigenic and immunoglobulin E-binding properties of hen's egg albumin with the combination of heat and gamma irradiation treatment
M. J. Kim, J. W. Lee, H. S. Yook, S. Y. Lee, M. C. Kim and M. W. Byun.
Journal of food protection, Vol. 65, No. 7, July 2002, pp. 1192-1195.
This study was carried out to evaluate the changes in the allergenic and antigenic properties of hen's egg albumin (ovalbumin [OVA]) with the combination of heat and gamma irradiation treatment. OVA solution samples were treated by (i) heating (sample 1), (ii) irradiation after heating (sample 2), and (iii) heating after irradiation (sample 3). Samples were isothermally heated and irradiated at the absorption dose of 10 kGy. Competitive indirect enzyme-linked immunosorbent assays (ELISAs) were performed with blood serum to test the ability of treated OVA to bind to immunoglobulin E (IgE) and mouse murine monoclonal antibody (IgG). OVA's ability to bind to mouse IgG changed upon heating at 75 degrees C, and its ability to bind to egg-allergic IgE changed upon heating at 80 degrees C. The ELISAs showed that egg-allergic IgE did not recognize OVA very well when heated at > or = 80 degrees C, while mouse IgG retained better activity under these conditions. Egg-allergic IgE binding was low both for OVA samples treated by heating and for samples treated by irradiation followed by heating. These results show that allergies induced by OVA could be effectively reduced by the combination of heat and gamma irradiation treatment.
- Decrease in antigenic and allergenic potentials of ovomucoid by heating in the presence of wheat flour: dependence on wheat variety and intermolecular disulfide bridges
Y. Kato, E. Oozawa and T. Matsuda.
Journal of Agricultural and Food Chemistry, Vol. 49, No. 8, Aug 2001, pp. 3661-3665.
The antigenic and allergenic activities of ovomucoid (OM) remaining in soluble fractions of pasta-like model samples of wheat flour mixed with egg white were investigated by ELISA competitive inhibition and immunoblotting analyses using a rabbit anti-OM IgG and the serum IgE specific for OM in patients allergic to egg white. The mixture of egg white and wheat flour of soft, hard, and durum varieties was kneaded for 10-50 min and benched for 1 h at RT, and then small pieces of the dough were heated in boiling 1% NaCl solution for 15 min. Even before heating, only after the kneading for 30 min or more, but not after kneading for only 20 min, followed by the benching, the antigenic activity of OM which remained in the phosphate-buffered saline extract from the dough markedly decreased. Almost no antigenic activity of OM was detected in the extracts of heated samples. Furthermore, in the extracts of heated durum samples, only a trace of or almost no IgE-reactive OM was detected against the five patients' sera. These reductive effects of wheat on the OM antigenicity and allergenicity were more remarkable in the durum variety than in the others. No detectable proteins were extracted with 1% SDS from the heated samples, whereas OM was extracted with 1% SDS containing 10% 2-mercaptoethanol, suggesting heat-induced polymerization through intermolecular disulfide bonds among OM and wheat.
- Effect of technological processing on the allergenicity of mangoes (Mangifera indica L.)
M. Dube, K. Zunker, S. Neidhart, R. Carle, H. Steinhart and A. Paschke.
Journal of Agricultural and Food Chemistry, Vol. 52, No. 12, 16 June 2004, pp. 3938-3945.
In parallel with the rising popularity of exotic fruits in Europe, allergy against mango is of increasing importance. Because mangoes are also consumed as processed products such as chutneys or beverages, the influences of different process conditions on their allergenicity were investigated. Mango purees and nectars were manufactured at small pilot-plant scale, and the allergenic potencies of the resulting intermediate and final products were determined by means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting and inhibitive enzyme allergosorbent tests (EAST-inhibition), using a pool serum of 9 individuals with manifest mango allergy. The mango allergens were shown to be very stable during technological processing. Irrespective of enzymatic matrix decomposition, mechanical tissue disintegration and heating during peeling, mash treatment, and pasteurization, significant loss of allergenicity could not be observed in the extracts of mango purees and nectars derived thereof. These results were confirmed by analogous investigation of commercial mango drinks and nectars. Hence, conventional mango processing into pulp-containing products typical for this species obviously does not allow complete elimination of the allergenic potency.
- Effects of extrusion, boiling, autoclaving, and microwave heating on lupine allergenicity
J. Alvarez-Alvarez, E. Guillamon and J. F. Crespo, et al.
Journal of Agricultural and Food Chemistry, Vol. 53, No. 4, 23 Feb 2005, pp. 1294-1298.
Lupine flour has been reported as a causative agent of allergic reactions. However, the allergenicity of lupine after thermal processing is not well-known. For this purpose, the allergenic characteristics of lupine seeds after boiling (up to 60 min), autoclaving (121 degrees C, 1.18 atm, up to 20 min and 138 degrees C, 2.56 atm, up to 30 min), microwave heating (30 min), and extrusion cooking were studied. The IgE-binding capacity was analyzed by IgE-immunoblotting and CAP inhibition using a serum pool from 23 patients with lupine-specific IgE. Skin testing was carried out in four patients. An important reduction in allergenicity after autoclaving at 138 degrees C for 20 min was observed. IgE antibodies from two individual sera recognized bands at 23 and 29 kDa in autoclaved samples at 138 degrees C for 20 min. Autoclaving for 30 min abolished the IgE binding to these two components. A previously undetected band at 70 kDa was recognized by an individual serum. Therefore, prolonged autoclaving might have an important effect on the allergenicity of lupine with the majority of patients lacking IgE reactivity to these processed samples.
- Effects of roasting, blanching, autoclaving, and microwave heating on antigenicity of almond (Prunus dulcis L.) proteins
M. Venkatachalam, S. S. Teuber, K. H. Roux and S. K. Sathe.
Journal of Agricultural and Food Chemistry, Vol. 50, No. 12, 5 June 2002, pp. 3544-3548.
Whole, unprocessed Nonpareil almonds were subjected to a variety of heat processing methods that included roasting (280, 300, and 320 degrees for 20 and 30 min each; and 335 and 350 degrees for 8, 10, and 12 min each), autoclaving (121 degrees C, 15 psi, for 5, 10, 15, 20, 25, and 30 min), blanching (100 degrees C for 1, 2, 3, 4, 5, and 10 min), and microwave heating (1, 2, and 3 min). Proteins were extracted from defatted almond flour in borate saline buffer, and immunoreactivity of the soluble proteins (normalized to 1 mg protein/mL for all samples) was determined using enzyme linked immunosorbent assay (ELISA). Antigenic stability of the almond major protein (amandin) in the heat-processed samples was determined by competitive inhibition ELISA using rabbit polyclonal antibodies raised against amandin. Processed samples were also assessed for heat stability of total antigenic proteins by sandwich ELISA using goat and rabbit polyclonal antibodies raised against unprocessed Nonpareil almond total protein extract. ELISA assays and Western blotting experiments that used both rabbit polyclonal antibodies and human IgE from pooled sera indicated antigenic stability of almond proteins when compared with that of the unprocessed counterpart.
- Efficiency and limitations of immunochemical assays for the testing of gluten-free foods
S. Denery-Papini, Y. Nicolas and Y. Popineau.
Journal of cereal science, Vol. 30, No. 2, Sept 1999, pp. 121-131.
This review considers the various immunochemical assays developed for gluten quantification and their feasibility for testing gluten-free food consumed by patients with coeliac disease. The first part concerns the major requirements of these assays: (a) detection of prolamins from the different cereals involved in gluten intolerance (wheat, rye, barley and oats) and avoidance of cross-reactions with prolamins from maize, rice, etc.; and (b) sensitive detection of native proteins as well as those denatured by cooking or other treatments. The second part evaluates several immunochemical assays in terms of their specificity, sensitivity and dependence on heat treatments.
- Food allergy to wheat products: the effect of bread baking and in vitro digestion on wheat allergenic proteins. A study with bread dough, crumb, and crust
B. Simonato, G. Pasini, M. Giannattasio, A. D. B. Peruffo, F. De Lazzari and A. Curioni.
Journal of Agricultural and Food Chemistry, Vol. 49, No. 11, Nov 2001, pp. 5668-5673.
The effect of baking and digestion on the allergenicity of wheat flour proteins has been studied. Pooled sera of patients suffering from food allergy to wheat products were tested for IgE binding to the proteins of the wheat dough and of the bread crumb and crust, before and after being in vitro digested. During in vitro digestion, the IgE binding protein components of the unheated dough tended to disappear, whereas a permanence of IgE recognition was evident for both the bread crumb and crust. This indicates that the baking process increases the resistance of the potential allergens of the wheat flour to proteolytic digestion, allowing them to reach the gastrointestinal tract, where they can elicit the immunological response. Therefore, the effects of baking must be carefully considered in studying food allergies to wheat products.
- Modification of lgE binding during heat processing of the cow's milk allergen β-lactoglobulin
B. M. Ehn, B. Ekstrand, U. Bengtsson and S. Ahlstedt.
Journal of Agricultural and Food Chemistry, Vol. 52, No. 5, 10 Mar 2004, pp. 1398-1403.
The effect of heat treatment on the IgE binding ability of β-lactoglobulin, as pure protein or in whole milk, was studied by inhibition of IgE antibody binding using FEIA-CAP inhibition. A slight but significant decreased IgE binding was seen between unheated and heat-treated β-lactoglobulin solution at 74 °C (IC50 = 2.03 and 3.59 microgram/mL, respectively, p = 0.032). A more pronounced decrease was found at 90 °C with an IC50 of 8.45 microgram/mL (p = 0.014). The inhibition of IgE binding of milk after heat treatment at 90 °C was also significantly decreased (p = 0.007). However, at all heat treatments, a similar total amount of IgE antibodies could be inhibited at a sufficiently high concentration of β-lactoglobulin. The inhibiting ability of β-lactoglobulin was significantly impaired in some fermented acidified milk products such as yogurt as compared to that in nonfermented milk (p < 0.001). There was only a small difference of IgE binding between the native forms of genetic variants A and B.
- Prophylactic and therapeutic uses of probiotics: a review
Journal of the American Dietetic Association, Vol. 101, No. 2, 241, Feb 2001, pp. 229-238.
Probiotics, live microbial food supplements that beneficially affect the host by improving its intestinal microbial balance, are quickly gaining interest as functional foods in the current era of self-care and complementary medicine. Microbes have been used for years in food and alcoholic fermentations and relatively recently have undergone scientific scrutiny to examine their purported health benefits. Some of the claims for which research supports a beneficial effect of probiotic consumption include: improving intestinal tract health, enhancing the immune system, synthesizing and enhancing the bioavailability of nutrients, reducing symptoms of lactose intolerance, decreasing the prevalence of allergy in susceptible individuals, and reducing risk of certain cancers. The mechanisms by which probiotics exert their effects are largely unknown, but may involve modifying gut pH, antagonizing pathogens through production of antimicrobial and antibacterial compounds, competing for pathogen binding and receptor sites as well as for available nutrients and growth factors, stimulating immunomodulatory cells, and producing lactase. Selection criteria, efficacy, food and supplement sources and safety issues around probiotics are reviewed. Nutrition professionals can provide a tremendous service by helping clients overcome negative perceptions of all bacteria and, when appropriate, by developing individualized dietary plans to take advantage of the benefits probiotics may confer.
- Reduction of immunoreactivity of bovine beta-lactoglobulin upon combined physical and proteolytic treatment
F. Bonomi, A. Fiocchi and H. Frokiaer, et al.
Journal of dairy research, Vol. 70, No. 1, Feb 2003, pp. 51-59.
Bovine beta-lactoglobulin was hydrolyzed with trypsin or chymotrypsin before, during and after treatment at 600 MPa and pH 6·8 for 10 min at 30, 37 and 44 degrees C. The extent of beta-lactoglobulin hydrolysis under pressure was noticeably higher than at atmospheric pressure, particularly when chymotrypsin was used. Addition of proteases at ambient pressure to previously pressure-treated beta-lactoglobulin gave only a modest increase in proteolysis with respect to the untreated protein. Products of enzyme hydrolysis under pressure were separated by reverse-phase HPLC, and were found to be different from those obtained at atmospheric pressure when chymotrypsin was used. The residual immunochemical reactivity of the products of combined pressure-enzyme treatment was assessed on the unresolved hydrolysates by ELISA tests using polyclonal and monoclonal antibodies, and on individual hydrolytic fractions by Western Blotting using sera of paediatric patients allergic to whey proteins in cow milk. The immunoreactivity of the whole hydrolysates was related to their content of residual intact beta-lactoglobulin, and no immunochemical reactivity was found for all the products of chymotrypsin hydrolysis under pressure. The results indicate that chymotrypsin effectively hydrolysed hydrophobic regions of -lactoglobulin that were transiently exposed during the pressure treatments and that were not accessible in the native protein or in the protein that had been previously pressure treated.