Food-induced contact urticaria syndrome (CUS) in atopic dermatitis: reproducibility of repeated and duplicate testing with a skin provocation test, the skin application food test (SAFT)

IgE-mediated contact urticaria syndrome (CUS) is one of the manifestations of allergy in childhood atopic dermatitis (AD). Allergens such as foods and animal products penetrate the skin easily. They can then cause urticarial reactions in sensitized individuals. A provocation test system for foods, called the skin application food test (SAFT), has been developed. Over more than 5 years, a group of 175 patients with AD was built-up and investigated in a prospective follow-up study with SAFT. SAFT was more frequently positive in AD children aged 6–2 years than in older children. In several children of this population (Group 1), we repeated SAFT within a period of 1 year. In another unrelated group of children (Group 2–1), we compared the results of 'original' SAFT and SAFT using square chambers (Van der Bend) or Silver patches. In the 3rd group (Group 2–2) we compared'original' SAFT with SAFT using big Finn Chambers. The agreement between the tests was high: in Group 1, we observed 88 to 93% concordant scores, and in Group 2, the scores were 96% to 100%. Statistically, the K coefficient ranged from 0.71–0.87 in Group 1, and from 0.83–1.00 in Group 2. SAFT is therefore highly reproducible. Agreement was at least 88% between the scores (the lowest K value observed was at least 0.71).     

A noncomparative study of cefprozil at two dose levels in the treatment of acute uncomplicated bacterial sinusitis.

The efficacy and safety of cefprozil at two dose levels were evaluated in 110 patients with acute uncomplicated bacterial sinusitis in an uncontrolled, noncomparative, Phase II trial. Ninety patients received 250 mg of cefprozil (low-dose group) and 20 patients received 500 mg of cefprozil (high-dose group) every 12 hours for ten days. Evaluable patients had symptoms consistent with acute sinusitis, pathogens isolated at pretreatment susceptible to cefprozil, and a radiograph positive for sinusitis within 48 hours before treatment. A satisfactory clinical response was achieved in 34 of 39 evaluable patients (87%) in the low-dose group and in all 16 evaluable patients (100%) in the high-dose group. Pathogens were eradicated in 35 of 39 patients (90%) in the low-dose group and in 15 of 16 patients (94%) in the high-dose group. A total of 140 of 155 pathogens (90%) isolated pretreatment were susceptible to cefprozil. Six patients (7%) in the low-dose group and one patient (5%) in the high-dose group reported at least one adverse clinical event.     

Quadricentenary: death of the humanist Christophe Plantin (1520-1589), editor of medical works

During the XVIth century, which was one of the most actively intellectual centuries of our era, philosophers and artisans worked hand in hand to spread and advance the cause of the sciences, and particularly those which pave the way for the adequate practice of medicine. This is magnificently illustrated by the life and work of a Frenchman who set up a publishing house abroad which was, and still is, a real beehive of energy, where each worker had his specialisation, a cultural centre and a refuge of humanism.     

Impact of pasteurization on the antibacterial properties of human milk

Growing evidence favours the use of human milk for the feeding of preterm newborns based on its many beneficial effects. Despite the many benefits, human milk has been associated as a possible vehicle of transmission for a number of infections. Although pasteurization of human milk can diminish the risk of neonatal infection, it also significantly reduces the concentrations of immunological components in human milk due to thermal damage. In order to evaluate the impact of pasteurization on the antibacterial properties of human milk, we aimed to compare the capacity of raw and pasteurized human milk to inhibit bacterial proliferation. Therefore, a single milk sample was collected from ten healthy lactating mothers. Each sample was divided into two aliquots; one aliquot was pasteurized, while the other was kept raw. Both aliquots were inoculated either with Escherichia coli or Staphylococcus aureus and incubated at 37 °C during 8 h. Viable colony counts from the inoculated samples were performed at regular time points to compare the bacterial growth in both forms of breast milk. Relative to the tryptic soy broth control sample, both raw and pasteurized milk samples exhibited an inhibitory effect on the growth of E. coli and S. aureus. Compared with the raw portion, growth inhibition was significantly lower in the pasteurized milk at every time point beyond T0 (after 2, 4 and 8 h of incubation) (p?=?0.0003 for E. coli and p?相似文献   

Kinetic proofreading of lipochitooligosaccharides determines signal activation of symbiotic plant receptors

Plants and animals use cell surface receptors to sense and interpret environmental signals. In legume symbiosis with nitrogen-fixing bacteria, the specific recognition of bacterial lipochitooligosaccharide (LCO) signals by single-pass transmembrane receptor kinases determines compatibility. Here, we determine the structural basis for LCO perception from the crystal structures of two lysin motif receptor ectodomains and identify a hydrophobic patch in the binding site essential for LCO recognition and symbiotic function. We show that the receptor monitors the composition of the amphiphilic LCO molecules and uses kinetic proofreading to control receptor activation and signaling specificity. We demonstrate engineering of the LCO binding site to fine-tune ligand selectivity and correct binding kinetics required for activation of symbiotic signaling in plants. Finally, the hydrophobic patch is found to be a conserved structural signature in this class of LCO receptors across legumes that can be used for in silico predictions. Our results provide insights into the mechanism of cell-surface receptor activation by kinetic proofreading of ligands and highlight the potential in receptor engineering to capture benefits in plant–microbe interactions.

Bacteria and fungi surrounding plants synthesize amphiphilic lipochitooligosaccharide (LCO)-signaling molecules consisting of a chitin backbone decorated with a large variety of substitutions at the terminal moieties including hydrophobic acyls at the nonreducing end (1–3). The selectivity and activation mechanisms of single-pass transmembrane receptors involved in deciphering between this myriad of extracellular signals is still unknown. The symbiotic relationship between rhizobia and legumes is an example of selective recognition guided by LCO structural variation, and this plant–bacterial interaction offers a rare opportunity for understanding receptor selectivity and signaling function. Specific legume species recognize and engage in root nodule symbiosis only with a distinct subset of rhizobial strains and vice versa. Among the ∼18,000 legume species, this host/nonhost relationship represents a continuum. At one end of the spectrum, the broad–host-range strain Sinorhizobium fredii NGR234 is capable of infecting and eliciting nodule formation on more than 200 distantly related legume species (4), and at the other end of the spectrum, narrow–host-range rhizobia like Sinorhizobium meliloti primarily nodulate Medicago truncatula (Medicago) and closely related medics such as alfalfa (Medicago sativa). Legume–rhizobia compatibility is dependent on plant recognition of specific bacterial symbiotic LCO-signaling molecules (5), known as Nod factors, with additional contributions by exopolysaccharides, lipopolysaccharides, cyclic β-glucans, and proteinaceous effectors. Nod factor receptors and exopolysaccharide receptors have been identified in many legumes, including the model species Medicago (6–8) and Lotus japonicus (Lotus) (9–15). Purified rhizobial LCOs are directly perceived by two different classes of single-pass transmembrane lysin motif (LysM) receptors (14, 16). One class has an active intracellular kinase (Medicago LYK3/Lotus NFR1), and the other has a pseudokinase domain (Medicago NFP/Lotus NFR5). All plant responses to LCOs are abolished in Medicago nfp and Lotus nfr5 mutants and in the corresponding pea (sym10) (9, 17) and soybean (nfr5α) mutants (18). Genetic and physiological studies examining LCO interactions across four legume species demonstrate that the NFP/NFR5 class of receptors are crucial for initial LCO perception and essential for LCO-mediated root nodule symbiosis (6, 8–10). Consistent with this fundamental role, recent studies show that the emergence of the NFP/NFR5 class of receptors was one of the key innovations in the evolution of nitrogen-fixing symbiosis (19, 20).     

Mastocytosis in children: a protocol for management

Abstract:  Mastocytosis is characterized by an increased number of mast cells with an abnormal growth and accumulation in one or more organs. In most children mastocytosis is limited to the skin (cutaneous mastocytosis) and often transient as compared with that in adults in whom mastocytosis is usually progressive and systemic. Generally, we recognize three more common forms of cutaneous mastocytosis: maculopapulous mastocytosis (formerly urticaria pigmentosa), mastocytoma of skin, and diffuse cutaneous mastocytosis. Childhood mastocytosis can further be divided into cutaneous mastocytosis (nonpersisting and persisting) and systemic mastocytosis (extremely rare). An approach to management using a set protocol is described in table form. In most cases of mastocytosis, only yearly checkups are necessary and no treatment is required; preventive recommendations are warranted in those individuals with systemic disease and constitutional symptoms. Symptomatic therapy is advised in only a minority of cases. This article is meant as a guideline for physicians involved in the care of children with mastocytosis and their parents.