Asthma and allergy in Albania.

Background: The risk of allergic disease may be influenced by the degree of "westernization". A survey was conducted to ascertain whether the prevalence of allergy was lower in Albania than elsewhere in Europe, as it has been the most isolated European country.

Methods: The subjects were residents of Tirana aged 20-44 years.

Diagnostic allergy laboratory external proficiency testing in Europe.

As with all diagnostic laboratory testing, some form of external proficiency testing is required both for the laboratory undertaking the testing and for the safety of the requesting clinician and his patient. Allergen Specific immunoglobulin E antibody testing in serum can produce different results depending on the method. Originally External Quality Assessment schemes in Europe were run on a National basis but 5 years ago a cooperation scheme was adopted whereby each National scheme adopted common serum pools for distribution, common distribution dates, and a common report format.

Tryptase and IgE concentrations in the respiratory tract of infants with acute bronchiolitis.

It has been proposed that a specific IgE response contributes to the immunopathology of acute respiratory syncytial virus (RSV) bronchiolitis but previous work has been difficult to replicate. Indirect evidence that might support this contention was sought by measuring total IgE concentrations in bronchoalveolar lavage (BAL) samples obtained from intubated infants and by attempting to detect mRNA for IgE in cells obtained from both the upper and lower respiratory tract. Evidence of significant mast cell activation was sought by measuring tryptase concentrations in BAL fluid and serum.

Inter-laboratory external quality assessment schemes for specific IgE antibodies. The results of a European scheme for 1992.

External quality assessment programmes for specific IgE have been organised for some years in the United Kingdom, Belgium and the Netherlands but independently. This paper describes a co-operation scheme whereby the same samples were circulated simultaneously from each of the three countries and subsequent results combined to produce a single "EURO EQAS" report. Serum pools were prepared each containing antibodies, at differing concentrations, to 4 different allergens.

Temperature and risk factors for ischaemic heart disease in the Caerphilly prospective study.

Objective: To examine the associations between air temperature and risk factors for ischaemic heart disease.

Method: Data on risk factors are available from up to 2036 men in the Caerphilly Prospective Heart Disease Study. Daily temperatures were obtained from the Meteorological Office.

Salivary IgA antigliadin antibody as a marker for coeliac disease.

In recent years, serum antibodies to gliadin (AGA) have been reported to be useful markers of coeliac disease. IgA AGA have also been found in intestinal secretions and saliva in coeliac disease and may offer a convenient, non-invasive screening test. In order to test this hypothesis, salivary and serum AGA were measured in children with coeliac disease proved by biopsy and compared with several control groups.

Sequential serological responses to Aspergillus fumigatus in patients with cystic fibrosis. Use of antigen 'stretching' to delineate IgG and IgE activity.

Immunogens from Aspergillus fumigatus were fractionated on the basis of molecular weight. Nine fractions ranging from 900 to 10 kDa were used in ELISA and in a radioallergosorbent test (RAST) with sera from cases of allergic bronchopulmonary aspergillosis (ABPA) and from cystic fibrosis (CF) patients with ABPA or other Aspergillus involvement and compared with control subjects. The profile of IgG reactivity to the nine fractions did not vary substantially for all Aspergillus-involved groups producing peaks at greater than 900 kD and 170 kD whereas the profile for control subjects had a peak at greater than 900 kD only.

An immunochemical evaluation for the identification and typing of monoclonal proteins.

Using automated measurements of kappa (kappa) and lambda (lambda) light chain and IgG, IgA and IgM concentrations we assessed the ability of the kappa/lambda ratio and the heavy/light chain ratio to identify and type monoclonal components which had been previously identified by serum protein electrophoresis and immunoelectrophoresis. We examined 1151 samples, of which 277 contained monoclonal components; 90% of the monoclonal proteins could be identified by this approach, of which 95% were correctly typed. In addition 19 of 874 samples without monoclonal components showed an abnormal kappa/lambda ratio.

Ispaghula sensitization in workers manufacturing a bulk laxative.

Exposure to ispaghula dust in a pharmaceutical factory resulted in chest tightness/wheeze, nasal, and ocular or skin symptoms in 48 of 92 exposed workers. Whilst symptoms were not incapacitating in the majority (44) of these, one worker required antihistamines and three others experienced severe respiratory symptoms when exposed to the dust. These three were atopic, had a positive RAST and skin test to ispaghula; a combination unique to them.

Seasonal variation in suppressor T cell subsets and non-specific suppressor cell function in hay fever sufferers.

The helper/suppressor T cell ratio, as defined by monoclonal antibodies, was significantly higher in hay fever sufferers compared with controls (P less than 0.05), but only during or shortly after the pollen season. This was due to a reduction in the suppressor subset, which returned to control values in the winter.

Platelet number and size in relation to serum orosomucoid concentration in Crohn's disease.

The relationship between platelet size and platelet count was investigated in 41 patients with Crohn's disease. A high platelet count was associated with a decrease in platelet size, but an overall increase in the platelet crit. There was also a significant correlation between the patient's platelet count and serum orosomucoids, which have traditionally been used to assess disease activity.

Can the risk of peritonitis be predicted for new continuous ambulatory peritoneal dialysis (CAPD) patients?

Serum and overnight dialysate samples were obtained from 36 adult uraemic patients at the end of their continuous ambulatory peritoneal dialysis (CAPD) training. The samples were analysed for albumin, IgG, C3, and antistaphylococcal peptidoglycan antibody. None of the dialysate measurements correlated with the risk of peritonitis during up to one year's CAPD treatment.

Immunological changes associated with a successful outcome of pollen immunotherapy.

Changes in immunological measurements thought to be important in the mechanism of immunotherapy for hay fever were related to objective measurements of treatment outcome. Antigen-specific IgE and IgG, and T suppressor cell status, using monoclonal antibodies and a specific functional assay, were measured before and after immunotherapy. Treatment outcome was assessed using nasal and conjunctival challenge tests.

Use of immunoglobulin heavy- and light-chain measurements compared with existing techniques as a means of typing monoclonal immunoglobulins.

Using automated measurements of kappa and lambda light chains and IgG, IgA, and IgM, we assessed the utility of the kappa/lambda ratio and the heavy chain/light chain ratio in characterizing monoclonal immunoglobulins previously identified by sensitive electrophoresis on agarose gel and typed by immunofixation or immunoelectrophoresis. We examined 348 selected samples, of which 165 contained monoclonal components, finding that 93.4% were detected and 89% correctly typed by this approach.

Overestimation of immunoglobulins in the presence of rheumatoid factor by kinetic immunonephelometry and rapid immunoturbidimetry.

The United Kingdom External Quality Assessment Scheme for Specific Proteins has demonstrated that one method group, comprised of kinetic immunonephelometric assays, gives significantly higher results for immunoglobulins in certain pathological sera containing rheumatoid factor. Using IgM as a model, we have compared kinetic immunonephelometry and a rapid (5 min incubation) immunoturbidimetric assay with radial immunodiffusion (RID) on seven sera. Compared with RID significantly higher results were obtained by kinetic nephelometry on all five sera positive for rheumatoid factor, and by turbidimetry on three of the four of these studied.

Challenge tests and specific IgE in hay fever sufferers.

The relationship between challenge tests, specific IgE and seasonal effects in hay fever sufferers was studied. There were significant relationships between nasal challenge, conjunctival challenge and skin-prick test threshold doses, although the skin and conjunctiva tended to be less sensitive than the nose. A seasonal effect was apparent on nasal challenge, but not conjunctival challenge or skin-prick testing, with lower threshold doses recorded after the pollen season than in midwinter.

Total IgE and allergen-specific IgE assays: guidelines for the provision of a laboratory service.

The Analytical Methods Working Party of the Association of Clinical Biochemists (ACB) established this Task Force to consider the measurement of total serum IgE and specific IgE. The aims were to give general guidance on available methods of assay; to survey commercial kits and 'in-house' methods; to investigate performance based on external Quality Assessment and independent evaluation, and to advise on criteria laboratories should consider before setting up IgE and specific IgE assays.

Cerebrospinal fluid C9 in demyelinating disease.

We measured CSF and plasma concentrations of C9, IgG, and albumin in 91 patients with demyelination and 73 controls with other neurologic diseases. The C9 index was reduced and IgG index increased in patients with multiple sclerosis and those with isolated demyelinating lesions, irrespective of disease activity; abnormalities were less marked in patients with isolated lesions than in those with MS. Humoral mechanisms may not be responsible for initiating demyelination, but activation of the complement system could amplify tissue damage and account for some symptomatic recovery.

The plasma protein binding of metoclopramide in health and renal disease.

The plasma protein binding of metoclopramide was measured after addition of the drug (60 ng ml-1) to plasma from 18 patients with renal disease and 18 age and sex matched healthy individuals. The mean free fraction in renal disease (0.59 range 0.

The ex vivo plasma protein binding of theophylline in renal disease.

The plasma protein binding of theophylline was measured in 21 patients with renal disease and 21 healthy age and sex matched controls. The percentage of theophylline unbound to plasma was greater in patients with nephrotic syndrome and in chronic renal failure than in controls. In nephrotic syndrome the impairment of drug binding mirrored the marked degree of hypoalbuminaemia seen in this condition but in chronic renal failure the impairment of protein binding was greater than would be expected from the plasma albumin concentration changes.