人眼睑蠕形螨的感染

作者对114例在临床上反复发作的毛囊虫皮炎和酒渣鼻等病人眼睑和鼻进行螨检。结果表明:病人对螨的感染率为94.7％,其中眼睑中查见有螨寄生的阳性感染率达44.7％有黑色颗粒(蠕形螨的新陈代谢产物所致的异物反应)者为32.5％;而健康对照组的螨感染率为35％,其中眼险中有螨寄生或有黑色颗粒的达16.3％。病人眼睑蠕形螨的感染率高,可造成病人鼻,颜面等部位对螨的重复感染,是导致酒渣鼻等疾病复发的病因之一。     

过敏性哮喘患者痰中粉尘螨特异性IgE和总IgE检测

本文用BA-ELISA测定100例过敏性哮喘患者的痰和血清中粉尘螨特异性IgE和总IgE,结果表明,68例粉尘螨过敏性哮喘患者的痰和血清中特异性IgE、总IgE水平高于32例非粉尘螨过敏性哮喘患者,两者有非常显著性差异(P<0.001)。在粉尘螨过敏性哮喘患者痰中特异性IgE、总IgE亦明显高于血清。选择22例哮喘患者经减敏治疗半年后,多数病例痰和血清中特异性IgE、总IgE均有下降,治疗前后差异显著(P<0.001)。     

Mite Fauna and Fungal Flora in House Dust from Homes of Asthmatic Children

Mite fauna and fungal flora in the house dust from homes of asthmatic children with positive and negative skin test to house dust allergen and non-asthmatic controls were examined. There was no conspicuous difference in mile species distribution among the three groups. Pyroglyphid mites dominate the mite fauna in house dust more than half of which being Dermatophagoides: D. pteronvssinus and D. farinae. There was no statisucally significant difference in numbers between the two species and either species could dominate depending on the conditions of the individual houses. The average number of acarina in 0.5 g of fine dust did not differ statistically among the three groups; however, mite number per square meter floor differed between patients with positive skin test and negative skin test. The results suggest that house-cleaning might influence the possible sensitization of children. The genetic distribution of mould fungi in house dust was largely similar to that of airborne fungi. The average number of fungal colonies detected in 0.5 g of dust did not differ statistically among the three groups. Wallemia with its minute spores may cause sensitization but has so far been investigated investigated.     

Inhibition Experiments with Solid Phase Mite or Epithelia in House Dust Hypersensitivity

The present study was undertaken to verify that mites are not the only allergens in house dust extracts and that other allergens such as cat epithelia can also be responsible for house dust hypersensitivities detected both by house dust skin tests and house dust RAST studies. In order to determine whether mite or epithelia fixed on a solid phase could remove not only the IgE antibodies reactive with the homologous allergens, but also the IgE antibodies reactive with house dust allergens, the authors have absorbed 10 sera of house dust allergic patients with solid phase mite or epithelia. The absorption procedure removed a large part of the IgE antibodies reactive with specific immunosorbent (Dermatophagoides pteronyssinus or cat epithelia) and in the same way the IgE antibodies reactive with house dust immunosorbent. The percentage of RAST inhibition varied from 65% to 92% for Dermatophagoides pteronyssinus and from 65% to 94% for house dust in patients allergic to house dust and mite; the percentage of RAST inhibition varied from 67% to 92% for cat epithelia and from 73% to 90% for house dust in patients allergic to house dust and cat epithelia. This is in accordance with the hypothesis that house dust is not an allergen per se, but rather a complex mosaic of several allergens including mite, animal epithelia, etc.     

Dust anchoring characteristics of electret fibres with respect to Der p 1 allergen carrying particles

The avoidance of house dust mite allergens is a major area of interest and essentially requires a significant removal of these allergens from the immediately respirable air. Electrostatic attraction and anchoring of particulate matter using electret polymers is commonly used for air filtration purposes. This effect is investigated for its possible use in domestic allergen avoidance. Polypropylene electret, heat-treated electret and non-electret, and wool and nylon fibre samples were soiled with house dust known to contain Der p 1 allergen. These samples were vacuumed at three air face velocities. The proportions of released and anchored dust were calculated. Released dust was collected and analysed for Der p 1 concentration and compared to stock dust values. Results showed that compared to uncharged fibres at least 95% more dust remained anchored in the electret fibres. Also, overall Der p 1 release was reduced by more than 49%. Der p 1 allergen concentrations in the collected dust were relatively constant for all the fibres tested, indicating no selective attraction or repulsion of Der p 1 allergen carrying particles in the experimental dust. The consistently high dust anchoring ability of the electret fibres could be used in many domestic products that are known to harbour particulate allergens, to reduce their release and inhalation.     

Usefulness of specific immunotherapy in patients with severe perennial allergic rhinitis induced by house dust mite: a double-blind, randomized, placebo-controlled trial

OBJECTIVES: To evaluate the effectiveness of specific immunotherapy (SIT) in patients with severe house dust mite (HDM)-induced perennial allergic rhinitis using diary cards and objective endpoints. PATIENTS AND METHODS: Thirty-six adult patients were selected with moderate to severe allergic rhinitis due to HDM allergy uncontrolled by regular anti-allergic drugs. Twenty-eight patients completed the study, 22 of these patients also had mild asthma. Subjects were stratified for HDM sensitivity on the basis of their 4-week diary card score and the size of their immediate and late-phase skin reaction to HDM. The groups were well matched for all relevant parameters. Patients were randomized to receive active preparation (Alutard(R)-SQ, ALK, Dermatophagoides pteronyssinus extract) or an identical placebo preparation. Increasing doses were administered until the maintenance dose was reached. This dose was then given once a month for 12 months. RESULTS: Clinical efficacy was evaluated by symptom medication diary cards recorded for 4 weeks after 12 months of continuous treatment and compared with pre-treatment scores. Skin test reactivity was re-measured after 12 months of treatment to HDM, cat dander and codeine phosphate. After 1 year of treatment, the actively treated group showed a 58% reduction in diary card symptom scores (P<0.002) and a 20% reduction in the use of rescue medication. The placebo group had a 32% reduction in symptom scores (P=NS), but no reduction in rescue medication requirements. The active group showed 36% reduction in skin prick test sensitivity to D. pteronyssinus (P=0.006), while the placebo group values were unchanged. Skin reactivity to codeine was unchanged in both groups. No significant adverse reactions to SIT were encountered. CONCLUSIONS: One year of SIT for D. pteronyssinus in patients with poorly controlled rhinitis (+/-mild asthma) produced clinically useful improvement as shown by symptom-medication diary cards and reductions in immediate skin reactions compared with placebo treatment.     

Comparison of olfactory function in patients with seasonal and perennial allergic rhinitis

Hyposmia is a common symptom in allergic rhinitis. However, little is known about differences in the olfactory function of patients with seasonal or perennial allergy. A prospective controlled study was performed on 28 patients with allergic rhinitis to grass pollen and on 47 patients with allergic rhinitis to mites. Sixty-six healthy volunteers served as a control. Olfactory function was evaluated by a modified Connecticut Chemosensory Clinical Research Center testing procedure for threshold, identification, and discrimination. The grass pollen-allergic patients were tested prcseasonally and after 3 weeks of intraseasonal grass pollen exposure: the mite-allergic patients and the volunteers were tested once. In the mite allergies, olfactory threshold, identification, and discrimination tests were significantly worse than in the volunteers (all P<0.0001). In the grass pollen allergies, the results in olfactory identification and discrimination tests were not different from the controls if tested out of the season (both F>0.05). However, in threshold testing (P=0.0139), the results were worse. Intraseasonally, the grass pollen allergies showed a significant decrease in threshold, identification (both P<0.001), and discrimination testing (P=0.0()29). If the intraseasonal pollen allergies were compared to the mite allergies, they showed better results in identification (F=0.(X)87) and threshold (F<0.001) tests, but worse results m discrimination testing (P=0.(XM)2). Therefore, the different kind of allergen exposure seems to result in a different pattern of allergic olfactory dysfunction.     

House-dust mite allergen Der p 1: amount or concentration?

There is a lack of consensus as to the best way to quantify settled house-dust mite Der p 1 allergen from planar and nonplanar surfaces. To investigate the most appropriate measure of settled house-dust mite Der p 1 allergen, we determined the relationship between Der p 1 allergen content and collected dust weight from planar-surface (mattress) and nonplanar-surface (living-room) samples in 58 homes. There was a direct relationship between Der p 1 content and dust weight for both planar-surface (mattress, n =217) samples ( r =0.50, P <0.0001) and nonplanar-surface (living-room, n =48) samples ( r =0.61, P <0.0001). Correction for the surface area of the planar surface (mattress) vacuum-cleaned resulted in no additional benefit. We conclude that expression of Der p 1 level per weight of collected dust appears to be the best method for both planar and nonplanar surfaces.     

Genetic variation of Der p 2 allergens: effects on T cell responses and immunoglobulin E binding

BACKGROUND: Der p 2 is a highly polymorphic allergen that shows a distinct pattern of sequence divergence. The effect of the variations on T cell and antibody responses has not been compared. OBJECTIVES: To compare IgE antibody binding and T cell proliferation and cytokine release induced by variants of Der p 2. METHODS: Peripheral blood mononuclear cells (PBMC) from 19 allergic and 15 non-allergic people were stimulated with recombinant variants of Der p 2. IL-5, IL-10, IL-13 and IFN-gamma were measured by a time resolved fluorescence (TRF) assay. Serum IgE antibody was measured using a solid-phase TRF assay. RESULTS: Overall the most prevalent variant of Der p 2 (Der p 2. 0101) was the highest or approximately equal highest inducer of T cell proliferation and IL-5, IL-10, IL-13 and IFN-gamma release. The most divergent variant 0104 induced the next highest responses. The variants 0107 and 0108 showed interesting changes especially when the allergic status was considered. Responses to 0107 showed poor Th1/Th2 polarization and, except for IL-10 release, cytokine responses to 0108 were low for non-allergic subjects. The variant 0101 showed similar monoclonal antibody binding but moderately less IgE binding than the other variants. CONCLUSIONS: The most prevalent variant, Der p 2. 0101, was the most active for T cell stimulation and although its IgE binding was slightly less than other variants that was highly correlated. The variant Der p 2. 0104 which contains the known common polymorphic changes had a response which was similar to Der p 2. 0101 and thus these two variants were the most stimulatory representations of Der p 2. The T cell responses to the less common variants 0107 and 0108 however, showed consistent differences demonstrating that changes in the sequence could change the cytokine response.     

Epicutaneous immunotherapy on intact skin using a new delivery system in a murine model of allergy

Background Allergen‐specific immunotherapy, subcutaneous immunotherapy (SCIT) or oral, has been used for almost a century to redirect inappropriate immune responses in atopic patients. A new mode of administration through the intact skin [epicutaneous immunotherapy (EPIT)], using an original epicutaneous delivery system, may represent an alternative to these classical methods. Objective Proof of concept of efficacy of EPIT on intact skin in mice sensitized to aeroallergens or food allergens. Methods Mice were sensitized to pollen (n=18), house dust mite (HDM, n=24), ovalbumin (OVA, n=18) or peanut (n=18), and allocated to four groups: EPIT, SCIT, not treated (NT) and control. Specific Ig (sIg)E, sIgG1 and sIgG2a were monitored. After 8 weeks of treatment, plethysmography was performed after aerosol provocation with appropriate allergens. Results At the highest doses of methacholine, pause enhancement (Penh) values were significantly decreased in the EPIT group vs. the sensitized NT groups (7.5 vs. 12.3 – pollen, 7.6 vs. 8.9 – HDM, 11.5 vs. 14.5 – OVA, 7.6 vs. 12.8 – peanut, respectively) (P<0.05). With all the allergens tested, Penh values were similar in SCIT, EPIT and control. IgG2a for pollen, HDM, OVA and peanuts were significantly increased in the EPIT group vs. NT: 0.97 vs. 0.42 μg/mL, 2.5 vs. 0.46 μg/mL, 0.39 vs. 0.05 μg/mL and 15.0 vs. 5.5 μg/mL, respectively (P<0.05). There were no significant differences between EPIT and SCIT groups. The IgE/IgG2a ratio decreased significantly in the EPIT group for the four allergens from 70 to 58 (pollen), 175 to 26 (HDM), 5433 to 120 (OVA) and 49 to 6 (peanut), respectively (P<0.05). Conclusion In mice sensitized to the four allergens tested, EPIT was as efficacious as SCIT, considered as the reference immunotherapy. These first results have to be confirmed by clinical studies. Cite this as: L. Mondoulet, V. Dioszeghy, M. Ligouis, V. Dhelft, C. Dupont and P.‐H. Benhamou, Clinical & Experimental Allergy, 2010 (40) 659–667.