Measuring allergen-specific IgE: where have we been and where are we going?

About 40 yr ago, two groups of investigators identified a new class of immunoglobulins, IgE. By exchanging their results and reagents, they proved that the immunoglobulin responsible for immediate hypersensitivity was IgE. From that day forward the science of allergy was greatly advanced.

Complement split products C3a and C4a are early markers of acute lyme disease in tick bite patients in the United States.

Background: Current laboratory markers do not readily detect acute Lyme disease. We assessed the utility of complement and its split products as markers of Lyme disease in patients shortly after a tick bite.

Methods: Thirty-one consecutive acute Lyme disease patients, 14 with and 17 without erythema migrans (EM) skin rash, seen by a physician within 96 h of a tick bite were matched with 24 consecutive tick bite patients without Lyme disease symptoms and 46 healthy control subjects.

Links between pollen, atopy and the asthma epidemic.

Pollen allergy has been found in 80-90% of childhood asthmatics and 40-50% of adult-onset asthmatics. Despite the high prevalence of atopy in asthmatics, a causal relationship between the allergic response and asthma has not been clearly established. Pollen grains are too large to penetrate the small airways where asthma occurs.

Identification and possible disease mechanisms of an under-recognized fungus, Aureobasidium pullulans.

Background: Investigations into the occurrence and health effects of yeast-like fungi in the outdoor air in the US have been limited. We sought to identify a respirable-sized fungus common in the Pasadena air, locate a major source for the emissions and investigate its relevance to allergic disease.

Methods: Yeast-like fungi sampled from the environment were isolated, microscopically examined and sequenced.

Complement determinations in human disease.

Objective: To define techniques used for complement measurements and examine the clinical relevance of alterations of complement determinations in disease.

Data Sources: Data have been assembled from the authors' research, original articles, and reviews, as well as chapters and complete books on complement.

Study Selection: Studies were chosen for inclusion by the opinions of the authors, relevant complement reviews, publications, and books.

Birch pollen rupture and the release of aerosols of respirable allergens.

Background: Birch pollen allergens have been implicated as asthma triggers; however, pollen grains are too large to reach the lower airways where asthmatic reactions occur. Respirable-sized particles containing birch pollen allergens have been detected in air filters, especially after rainfall but the source of these particles has remained speculative.

Objective: To determine the processes by which birch pollen allergens become airborne particles of respirable size with the potential to contribute to airways inflammation.

Release of allergens as respirable aerosols: A link between grass pollen and asthma.

Background: Asthma incidence has long been linked to pollen, even though pollen grains are too large to penetrate into the airways where asthmatic responses originate. Pollen allergens found in small, respirable particles have been implicated in a number of asthma epidemics, particularly ones following rainfall or thunderstorms.

Objective: The aim of this study was to determine how pollen allergens form the respirable aerosols necessary for triggering asthma.

Complement-dependent immune complex-induced bronchial inflammation and hyperreactivity.

Bronchoconstriction responses in the airway are caused by multiple insults and are the hallmark symptom in asthma. In an acute lung injury model in mice, IgG immune complex deposition elicited severe airway hyperreactivity that peaked by 1 h, was maintained at 4 h, and was resolved by 24 h. The depletion of complement with cobra venom factor (CVF) markedly reduced the hyperreactive airway responses, suggesting that complement played an important role in the response.

A multicenter, randomized, double-blind, placebo-controlled trial of high-dose intravenous immunoglobulin for oral corticosteroid-dependent asthma.

To determine the efficacy of high doses of intravenous gammaglobulin (IVIG) for the treatment of severe, steroid-dependent asthma in patients between 6 and 68 years of age, a randomized, double-blind, placebo-controlled multicenter clinical trial was conducted in private and university hospitals in the United States. Patients were randomized to one of three treatment arms: 2 g IVIG/kg/month (16 patients); 1 g IVIG/kg/month (9 patients); or 2 g iv albumin (placebo)/kg/month (15 patients). The treatment consisted of seven monthly infusions followed by a posttreatment observation period.

Upper airways involvement in bronchial asthma.

The upper airways--the nose, pharynx, and mouth--lead through the larynx and into the tracheobronchial tree of the lung (the lower airways). This cavernous void in the upper airways transports external air to the alveolar sacs, in the distal segments of the tracheobronchial tree. Oxygen is absorbed from the alveolar sacs and carbon dioxide is released.

Particulate air pollution: possible relevance in asthma.

The relative importance of air pollution in the pathogenesis of bronchial asthma has been of interest for several decades. Numerous studies on the role of gaseous air pollution containing ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide have been published. Very little attention has been focused on the role of respirable particles in the causation of asthma.

Latex allergens in tire dust and airborne particles.

The prevalence and severity of latex allergy has increased dramatically in the last 15 years due to exposure to natural rubber products. Although historically this health risk has been elevated in hospital personnel and patients, a recent survey has indicated a significant potential risk for the general population. To obtain a wide-spread source for latex exposure, we have considered tire debris.

Comparative effect of C3a and C5a on adhesion molecule expression on neutrophils and endothelial cells.

Complement activation is known to enhance neutrophil binding to human umbilical vein endothelial cells (HUVECs). Recently, we have shown that recombinant human C5a upregulates P-selectin in HUVECs. Unstimulated human neutrophil binding is also increased on C5a stimulated HUVECs.

Cetirizine in patients with seasonal rhinitis and concomitant asthma: prospective, randomized, placebo-controlled trial.

Objective: This study explored the safety and efficacy of cetirizine for treatment of allergic rhinitis and asthma.

Methods: Daily treatment for 6 weeks with cetirizine 10 mg (93 patients) was compared with placebo treatment (93 patients) in a randomized, double-blind parallel study of patients with allergic rhinitis and asthma. This multicenter study was started just before onset of the fall pollen season.

C5a-induced expression of P-selectin in endothelial cells.

Human umbilical vein endothelial cells have recently been shown to respond to C5a with increases in intracellular Ca2+, production of D-myo-inositol 1,4,5-triphosphate and superoxide anion generation. In the current studies, C5a had been found to cause in a time- and dose-dependent manner rapid expression of endothelial P-selectin, secretion of von Willebrand factor, and adhesiveness for human neutrophils. The effects of C5a in P-selectin expression and adhesiveness of neutrophils were similar to the effects of histamine and thrombin on endothelial cells.

Hypoxic and Complement-Induced Lung Injury in the Isolated Perfused Rat Lung as Determined by Phosphorous-31 Nuclear Magnetic Resonance.

Magnetic resonance spectroscopy (MRS) is a non-invasive method of obtaining biochemical information. Patients or experimental animals are placed within a magnetic imaging device and specific patterns of chemical spectra, such as P31 patterns of adenosine triphosphate (ATP) can be recorded. We have injured the isolated rat lung by complement activation and hypoxia.

Effect of adenylate cyclase activators on C5a-induced human neutrophil aggregation, enzyme release and superoxide production.

The effect of adenylate cyclase activators on C5a- and f-Met-Leu-Phe-induced human neutrophil aggregation, enzyme release and superoxide production was investigated. C5a-stimulated superoxide production was markedly inhibited by adenylate cyclase activators, and the order of potency was PGE1 greater than isoproterenol greater than epinephrine greater than PGF2 alpha, which correlated with intracellular cAMP levels. However, neutrophil aggregation was inhibited by PGE1, PGE2, isoproterenol and epinephrine only at concentrations greater than 10(-6) M.

Effect of maternal immunotherapy on immediate skin test reactivity, specific rye I IgG and IgE antibody, and total IgE of the children.

The effect of specific immunotherapy during pregnancy was studied in 14 children, 3 to 12 years after delivery. Fourteen additional children from the same allergic mothers, in whom immunotherapy was not given during the pregnancy, served as controls. The immediate skin test response to grass allergens of the children of mothers given immunotherapy.