Anaphylactic shock during endodontic treatment due to allergy to formaldehyde in a root canal sealant.

A 41-yr-old patient experienced an anaphylactic shock reaction caused by formaldehyde in a root canal sealant during endodontic treatment. The clinical events, positive skin tests, and a high level of immunoglobin E to formalin RAST (class 4) suggest the involvement of immunoglobin E-dependent mechanisms toward formaldehyde. This very infrequent observation in endodontic therapy focuses attention on the different pathological manifestations related to formalin, their mechanisms, and the prevention possibilities in dentistry.

Comparison of genetically engineered hypoallergenic rBet v 1 derivatives with rBet v 1 wild-type by skin prick and intradermal testing: results obtained in a French population.

Background: Bet v 1, the major allergen in birch pollen, is recognized by more than 90% of patients allergic to birch in northern and central Europe. Immunotherapy is commonly performed with birch pollen extracts. Recently, hypoallergenic derivatives of Bet v 1 (rBet v 1 fragments, rBet v 1 dimer and trimer) were constructed and purified.

[Respiratory allergies and household allergenic environment].

Based on immunoassay techniques used to identify and quantify major indoor allergens, epidemiological studies have demonstrated that level of exposure depends on the geographical situation (climate, urbanization) and that there is a relationship between exposure and sensitization of predisposed patients. Most of the major mite allergens are proteases. For mammals and cockroaches, the major allergens belong to the retinal protein binding group.

[Elimination of airborne allergens from the household environment].

Exposure to allergens could be either a risk factor of sensitization and nonspecific hyperresponsiveness in genetically predisposed patients or a risk of onset of asthma attack in certain allergic asthma. During the past 20 years, in western countries the houses have become higher and the number of furred pets have increased and have been more kept inside the house which makes probable that exposure to indoor aeroallergen has increased. The development of new methods of allergen measurements allows a more precise identification of allergen source and reservoirs, an assessment of allergen exposure and a monitoring of allergen eviction methods.

[Exploration of respiratory allergies and prevention].

Respiratory allergies are found in more than 50% of the asthmatics. Allergen sources and their secondary reservoirs are better known. The different methods of exploration of allergic asthma consist of clinical history, skin tests, and in vitro tests particularly measurement of specific serum IgE.

[Domestic pollution (other than tobacco)].

Pollution of the air of the interior of premises are generally less understood than exterior town atmospheric pollution. Now the time spent at home is considerable, around 80%. Aerocontaminants are of chemical, biological or particulate nature.

Repeated inhalation of low doses of cat allergen that do not induce clinical symptoms increases bronchial hyperresponsiveness and eosinophil cationic protein levels.

The aim of this study was to investigate whether repeated exposure to subclinical doses of cat allergens, not inducing asthma symptoms, could affect eosinophil cationic protein (ECP) levels in bronchoalveolar lavage (BAL) or in peripheral blood, without the appearance of clinical symptoms. Twelve patients with mild asthma, all sensitized to cats and not exposed to cat allergen at home, underwent a series of inhalations of cat allergen or placebo for 8 days over 2 weeks. A methacholine challenge was performed before and after the allergen and saline exposures, and BAL and blood were sampled for ECP measurements and eosinophil counts.

[Experimental studies of the effects of atmospheric pollutants].

Experimental studies in man are an indispensable complement to epidemiological studies and experimental studies on animals. They aim at understanding the mechanisms of action of the main pollutants and at knowing their thresholds of triggering of the acute effects on the respiratory system. The studies made in man involve controlled exposure to different atmospheric pollutants, with measurement of the functional respiratory repercussions, studies of modification of the cells in broncho-alveolar lavage, as well as experimental protocols that combine inhalation of allergen and exposure to atmospheric pollutants by allergic subjects.

Up- and down-regulation by glucocorticoids of the constitutive expression of the mast cell growth factor stem cell factor by human lung fibroblasts in culture.

Stem cell factor (SCF) is a major mast cell growth factor that promotes differentiation and chemotaxis of mast cells and inhibits their apoptosis. SCF therefore may be involved in diseases associated with an increased number of tissue mast cells such as asthma, for which the major treatment is glucocorticoids. In this study, we evaluated the effect of the glucocorticoid budesonide on the constitutive expression of SCF by human lung fibroblasts in primary culture.

Serum eosinophil cationic protein measurements in the management of perennial and periodic asthma: a prospective study.

We performed a prospective study in order: 1) to determine whether a correlation could be found between serum eosinophil cationic protein (ECP) levels and clinical and functional status in perennial asthmatics during a 5 month prospective study; and 2) to evaluate the relationship between allergic exposure and ECP levels in periodic asthmatics. Two groups of asthmatic patients were selected: a group of acutely ill perennial asthmatics and a group of periodic asthmatics. The acutely ill perennial asthmatics (n=22, mean age=39.

Effects of various vacuum cleaners on the airborne content of major cat allergen (Fel d 1).

Background: It has been shown that a vacuum cleaner (VC) can increase airborne cat allergen levels. This study aimed to compare the degree of leakage of airborne Fel d 1 levels among five different VCs, both under laboratory conditions and in an apartment with cats.

Methods: Three of the VCs were marketed as antiallergic: a HEPA filter VC (VC A), a water impingement and HEPA filter VC (VC B), and a foam fabric filter VC (VC C).

[Asthma and household chemical pollutants (with the exception of tobacco)].

The relationship between allergens in a domestic environment and asthma has been extensively studied and it is only recently that studies have suggested the possibility of the role of chemical pollutants in the internal environment in the genesis of asthma. The pollutants studied are oxides of nitrogen (nitrogen dioxide NO2), volatile organic components (COV), formaldehyde, ozone (O3) and sulphur dioxide (SO2). The level of nitrogen dioxide in the interior of houses may be greater than those met outside.

Invasive pulmonary aspergillosis with cerebromeningeal involvement after short-term intravenous corticosteroid therapy in a patient with asthma.

The present case report describes a case of invasive pulmonary aspergillosis with cerebromeningeal invasion in an asthmatic non-immunocompromised patient. This fatal complication occurred despite early anti-fungal antibiotherapy after a 2-week course of intravenous corticosteroid therapy for treatment of an exacerbated asthma. Diagnostic and therapeutic procedures are discussed.

Post-traumatic pleural effusion: demonstration of local complement consumption.

The present case report describes a 27-year-old patient who presented with post-traumatic pleural effusion. Analysis of the pleural fluid showed hypereosinophilia (990 mm-3), a decreased level of total complement, and decreased levels of C3 and C4 fractions (less than 50% of normal serum levels), indicating a local consumption mechanism for complement. Complement serum levels (CH50, C3, C4) were normal.

Dust and airborne exposure to allergens derived from cockroach (Blattella germanica) in low-cost public housing in Strasbourg (France).

Background: Although a strong association between allergy to cockroach (CR) and asthma has been observed in the United States and Asia, there are little data about the extent of exposure to CR allergen in Europe.

Objective: To determine the levels of CR allergens in dust samples from apartments in Strasbourg and to determine the concentration and size of CR allergens in the air.

Methods: Nine apartments in a public housing complex were chosen on the basis of visual evidence of CR infestation.

[A cause of respiratory distress: eosinophilic pneumopathy due to minocycline].

We report a case of eosinophilic pneumonia secondary to taking Tetracycline whose severity required the use of mechanical ventilation and steroid therapy. On the basis of this case, we review the characteristics of drug-induced pneumonia as well as the differential diagnosis which are evoked.

[New aero-allergens].

As the number of proteins recognized as causing allergic respiratory diseases increases, new aero allergens have appeared in the animal and vegetable realms, both in home and professional environments. Lepidoglyphus destructor and Blomia tropicalis, two mites found in storage areas, are particularly important in agricultural areas and in homes. Over the last ten years, the frequency of reactions to cockroaches has also increased in several countries.

Systemic sarcoidosis initially presenting as an orbital tumour.

A 73 year old woman presented with redness, itching and painless proptosis of the left eye. Clinical examination and computed tomographic (CT) scan of the orbit revealed a postero-ocular mass, the biopsy of which showed a noncaseating, giant cellular, epithelioid granuloma compatible with sarcoidosis. The patient had no respiratory complaints, but the thoracic CT scan showed multiple bilateral hilar and mediastinal adenopathies.

[Importance of measuring exposure to the principal indoor allergens in allergic asthma].

Domestic allergens, such as mite and cat allergens, are a leading cause of allergic asthma. Allergen exposure is a risk factor for sensitization. Allergens also play a major role in the development of inflammation and non specific bronchial hyperreactivity as well as in the apparition and modulation of symptomatic asthma.

[Metrology of airborne particles carrying the principal air allergens].

The relationship between exposure to aeroallergens and the acquisition of allergy and asthma has been shown over the past ten years. Thanks to new developments for detecting major allergens amongst the principle aeroallergens, in future it will be possible to measure their airborne concentration and to determine the particle size of particles carrying them. We report the results obtained from three studies in which we have shown that airborne mites Group I and II and cockroaches Bla g 1 and Bla g 2 allergens have a broadly similar airborne behaviour.