Pertussis IgE and atopic disease

Background Pertussis toxin (PT) stimulates IgE production in animals, and pertussis vaccination and whooping cough may have similar effects in man. Methods We analyzed IgE responses to PT (FT-IgE) in sera from children primarily immunized with three doses of either an acellular 2- or 5-component vaccine, or a whole-cell (We) pertussis vaccine, and in children after whooping cough. The study comprised 50 children with both atopic disease and positive skin prick test, 99 nonatopic controls, and 40 children with verified pertussis.
Results Immunoglobulin E antibodies against PT were demonstrated in 19% and 24% of sera from vaccinated children at 7 and 12 months, respectively, and in 9% at 2.5 years. At 7 months, PT-IgE was more common after vaccination with acellular (24%) than with the We vaccine (3%, P = 0,02), PT-IgE was also more common (P = 0.00l) after vaccination in children classified as atopic (36%) than in the control group (10%). Thirty percent of the children with pertussis had PT-IgE, more often so in atopic than nonatopic children (P = 0.02), Conciusions Transient production of PT-lgE seems to be common after primary pertussis immunization with acellular vaccines, and after whooping cough, particularly in atopic subjects.     

Component-Resolved Diagnosis of Hazelnut Allergy in Children

Hazelnuts commonly elicit allergic reactions starting from childhood and adolescence, with a rare resolution over time. The definite diagnosis of a hazelnut allergy relies on an oral food challenge. The role of component resolved diagnostics in reducing the need for oral food challenges in the diagnosis of hazelnut allergies is still debated. Therefore, three electronic databases were systematically searched for studies on the diagnostic accuracy of specific-IgE (sIgE) on hazelnut proteins for identifying children with a hazelnut allergy. Studies regarding IgE testing on at least one hazelnut allergen component in children whose final diagnosis was determined by oral food challenges or a suggestive history of serious symptoms due to a hazelnut allergy were included. Study quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Eight studies enrolling 757 children, were identified. Overall, sensitivity, specificity, area under the curve and diagnostic odd ratio of Cor a 1 sIgE were lower than those of Cor a 9 and Cor a 14 sIge. When the test results were positive, the post-test probability of a hazelnut allergy was 34% for Cor a 1 sIgE, 60% for Cor a9 sIgE and 73% for Cor a 14 sIgE. When the test results were negative, the post-test probability of a hazelnut allergy was 55% for Cor a 1 sIgE, 16% for Cor a9 sIgE and 14% for Cor a 14 sIgE. Measurement of IgE levels to Cor a 9 and Cor a 14 might have the potential to improve specificity in detecting clinically tolerant children among hazelnut-sensitized ones, reducing the need to perform oral food challenges.     

Periprosthetic Tissue Reaction Independent of LTT Result and Implanted Materials in Total Knee Arthroplasty

BackgroundAn allergic reaction may rarely cause a painful or stiff total knee arthroplasty (TKA). However, no consensus diagnostic criteria for TKA immune failure exist. Lymphocyte transformation testing (LTT) measures immune sensitivity to various materials, but its role in diagnosing an allergic reaction to a TKA has not been established. This study compares TKA periprosthetic tissues in a) LTT-positive versus -negative patients and b) patients with conventional CoCrNi versus hypoallergenic implants.MethodsPeriprosthetic tissues from 26 revision cases of well-fixed, aseptic, but painful or stiff TKAs were analyzed. Twelve patients LTT positive for nickel (Ni) were matched as a cohort to 6 LTT-negative patients. In 4 patients LTT positive for Ni, tissue from first revision of CoCrNi implants was compared with tissue from subsequent revision of hypoallergenic implants. Histology was evaluated using the aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) score.ResultsNo correlation was found between LTT and any ALVAL score component. The mean total ALVAL score was 3.8 ± 1.5 for LTT-negative patients and 3.3 ± 1.2 for LTT-positive patients (P = .44). The mean total ALVAL score at revision of CoCrNi implants was 3.0 ± 1.8 compared with 5.8 ± 0.5 at rerevision of hypoallergenic implants (P = .053).ConclusionPeriprosthetic TKA tissue reactions were indistinguishable between LTT-positive and -negative patients. LTT does not predict the periprosthetic tissue response. ALVAL scores of hypoallergenic revision implant tissue trended higher than primary CoCrNi implant tissue. A positive LTT may not indicate that a periprosthetic immune reaction is the cause of pain and stiffness after TKA.Level of Evidence3, retrospective cohort study.     

食管内脏高敏感性动物模型的建立和评价

目的建立食管内脏高敏感性动物模型。方法采用腹腔注射鸡卵清蛋白（OVA）基础致敏联合食管酸灌注的方法处理SD大鼠，并采用免疫组织化学方法和显微图像分析技术评价内脏高敏感性一食管化学刺激大鼠模型的可靠性。结果OVA基础致敏联合食管酸灌注组大鼠被激活了一个复杂而广泛的大脑网络，其在额顶皮质、岛叶、扣带皮质、中央杏仁核、Kfilliker-Fuse核、疑核、臂旁核、下丘脑室旁核、丘脑室旁核、三叉旁核、孤束核、最后区、延髓网状核等Fos样免疫活性（FLI）神经元的数目均显著高于其余各组（P〈0．05）。模型组大鼠在中央杏仁核、臂旁核、室旁核、三叉旁核、孤束核的FLI阳性产物的平均光密度（OD）值亦较其余各组明显增高（P〈0．05）。结论预先腹腔注射鸡卵清蛋白基础致敏联合食管酸灌注可成功建立食管内脏高敏感性动物模型。     

Lymphokine-activated killer (LAK) cells modulate the effects of IL-2 on a T cell-mediated immune response.

The ability of LAK cells and/or IL-2 to affect the course of an established T cell response was examined in a delayed-type hypersensitivity (DTH) model. IL-2 greatly increased the magnitude of the response at 24 h, while LAK cells alone had no effect. The administration of LAK cells and IL-2 together also had no effect on the magnitude of the DTH response, demonstrating that LAK cells were able to remove the enhancement seen with IL-2 alone. The presence of LAK cells reduced the serum half-life of IL-2 significantly, but not to an extent able to account for the observed loss of IL-2 induced DTH enhancement. IL-2 administration influenced cell phenotypes in the spleen and draining lymph nodes (DLN), as well as increasing splenic weight; the additional presence of LAK cells markedly altered these effects of IL-2 in the spleen (but not the DLN). Taken together, these results suggest that LAK cells interact with activated T-cells within the immune system and modulate their function.     

YAG激光治疗牙本质过敏症的疗效分析

目的 :为探索治疗牙本质过敏症的新疗法 ,观察激光治疗后过敏齿的临床疗效 .方法 :应用 Nd:YAG激光点射治疗过敏齿 152 1颗 ,其中 °过敏 10 17颗 , °过敏 50 4颗 .结果 :即刻有效率为98.6 8% ;经 3～ 12个月的临床观察 , °过敏痊愈 814颗 (80 .0 4 % ) ,显效 183颗 (17.99% ) ,有效率为98.0 3% ; °过敏痊愈 119颗 (2 3.6 1% ) ,显效 339颗 (6 7.2 6 % ) .结论 :两组总有效率为 95.6 6 %。操作简便 ,无痛苦 ,是一种快速有效的方法