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Background. An in vitro basophil activation test, based on the detection of CD63 upregulation induced by NSAIDs, has been described. Its clinical significance remains controversial. Objectives. In patients with a history of nonallergic NSAID hypersensitivity, stratified according to the severity of the symptoms, to assess with NSAIDs the predictive value of basophil (BAT) and monocyte (MAT) activation tests. Patients/Methods. Sixty patients who had NSAIDs-induced or exacerbated urticaria/angiooedema and 20 controls was included. After incubation with NSAIDs or acetaminophen, leukocytes were analysed for CD63 upregulation. Results. With aspirin, the sensitivity (37%) and specificity (90%) of BAT agree with already published results. In contrast, when patients had had cutaneous and visceral reactions, the frequency of positive BAT 14/22 (64%,P < 0.001) or MAT 10/22 (46%, P < 0.01) were increased. Conclusions. Positive tests were more frequent among patients having a severe hypersensitivity contrasting with the other patients who had results similar to controls. [ABSTRACT FROM AUTHOR]

Background To confirm allergy to β-lactam (BL), a basophil activation test in flow cytometry based on CD63 up-regulation was described. CD203c is a more recent basophil activation marker and up to day there is no consensus about which marker is the more sensitive one. CD203c has not yet been evaluated in the diagnosis of BL allergy. Objective The aim of the study was to compare the reliability of CD203c to CD63 for the diagnosis of amoxicillin (AX) allergy, which is nowadays the most frequent BL allergy. Methods Twenty-seven patients with an immediate positive skin test (ST) to AX, 20 had had anaphylaxis with AX and 7 had urticaria and/or angioedema, were compared with 14 controls with no allergy to BL and to six patients with delayed positive ST to AX. Results In the anaphylaxis group, AX induced up-regulation of CD203c in the basophils of 12 patients out of 20 (60%) and of CD63 in four patients (20%) ( P<0.02). Two patients out of seven with urticaria or angioedema had a positive result with CD203c and CD63. In patients who had anaphylaxis, ampicillin (AMP) induced CD203c up-regulation in eight out of 12 (67%) patients tested, and CD63 up-regulation in 4 out of 12 (33%) (all patients who had anaphylaxis could not be tested with AMP). False-positive results were observed with CD203c as well as CD63, and for 10 patients indeed this was confirmed by a negative drug provocation test. The origin of conflicting results between CD63 and CD203c might be at least the targeting of basophils based on anti-IgE labelling. Among IgE+ gated cells, by means of CD33, a marker of monocytes, a contamination up to 50% by monocytes was detected. In contrast to CD63, CD203c is an activation marker specific of basophils with a basal low-level expression in resting basophils. Thus, IgE and CD203c double targeting of basophils avoids the contamination by monocytes. Conclusion CD203c seems to be a more sensitive activation marker of basophils than CD63 for the diagnosis of amoxicillin allergy. [ABSTRACT FROM AUTHOR]

Abstract: The best measure in preventing allergic reactions due to dust mite is avoidance, for example by isolating the elements of bedding, the major source of allergens. Objective: To determine the relevance of the fabric used for the manufacturing of Immunoctem integral mattress encasings in the retention of dust mite allergens. Methods: House dust was pulverized in a proof chamber and collected in a flask by aspiration. The tests were performed in absence of fabric (control series) and in the presence of fabric pieces (cotton fitted sheet or Immunoctem cover) inserted at the entrance of the aspiration circuit. Determination of total protein (Lowry modified method), Dermatophagoïdes pteronyssinus and mite allergen (ELISA methods) contents were performed in the collected dust. Results: The cotton fitted sheet allowed to pass 11.6% of total proteins, 15.2% of D. pteronyssinus and 12.6% of allergens, compared with the amounts obtained without any fabric. Conversely, these amounts were not detectable in the presence of the Immunoctem fabric. Conclusion: The Immunoctem fabric efficiently prevented the passage of dust mite allergens. It constitutes a good tool for the application of the allergen avoidance measures such as mattress encasement, as recommended by the International Consensus. [Copyright &y& Elsevier]

Background: Atopic dermatitis of the head and neck (HNAD) has been recognized as a separate entity. Malassezia furfur, a lipophilic yeast, is considered to be a pathogenic allergen in this form of atopic dermatitis. Objective: The purpose of this study was to determine the level of IgE anti-M.-furfur antibodies and their relation to the severity of the disease. Methods: IgE anti-M.-furfur antibodies were assayed in 106 patients with HNAD. Controls included 25 patients with non-HNAD, 20 with nonatopic dermatitis and 16 with seborrheic dermatitis (including 4 with AIDS). Results: There was a highly significant correlation between the level of anti-M.-furfur IgE and clinical severity. Furthermore, there was a significant but smaller correlation between total IgE and clinical severity. In patients with HNAD, total IgE was higher amongst men. Conclusion: IgE anti-M.-furfur antibodies are a good and specific marker for HNAD. IgE M. furfur levels are strongly correlated with the severity of the disease. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Breathing is one of the most important modes of sensitization to natural rubber latex (NRL) for health care workers, a group most at risk. Cornstarch powder (CSp) from medical powdered NRL gloves is known to be an allergen carrier, and sensitization to NRL can occur by inhaling airborne particles from such gloves. The aim of this study was to demonstrate, using an experimental model, which CSp may act as an adjuvant in NRL-induced airway hyper-responsiveness. Guinea pigs were exposed to aerosolized NRL contaminated CSp or to NRL in saline solution for 1 h every day for 2 weeks. The control groups were exposed either to CSp or to saline alone. An additional group of guinea pigs was exposed to aerosolized ovalbumin (OVA) in saline. Three weeks after the last exposure, specific bronchial challenges were performed. In addition, Specific IgG and IgGI in sera and thromboxane (Tx) 132 levels in bronchoalveolar lavage fluid (BALF) were measured. The NRL challenge caused significant bronchospasm in the animals that had been exposed to NRL compared with those in the control groups (P<0.02). Guinea pigs exposed to OVA also demonstrated a significant bronchospasm after OVA challenge (P<0.001). The guinea pigs that had inhaled NRL contaminated CSp had a significantly higher bronchoconstriction level than those that had inhaled NRL alone (P<0.02). Specific IgG and lgGI were undetectable in sera from all groups. whereas significant amounts of TxB2 (P<0.001) were found in the lungs of the guinea pigs exposed to NRL or OVA. Inhaling CSp increases the airway response to NRL. The fact that specific IgG and IgGI were not detected might be the result of an immune response limited to the airways. Ibis finding is supported by a significant increase of TxB2 level in the BALE of sensitized guinea-pigs. [ABSTRACT FROM AUTHOR]

Summary Background Cornstarch powder present in medical gloves plays an important role in latex-induced hypersensitivity as allergen carrier either, by the inhalation route, by skin contact or by direct contact with mucous membranes. Objective Our objective was to test the hypothesis that cornstarch could act as an immunoadjuvant in immediate type-I latex-induced hypersensitivity. Methods Guinea-pigs were sensitized by intraperitoneal route with two different antigens (latex proteins and ovalbumin) with or without cornstarch powder. Airway responsiveness after specific bronchial provocation was evaluated and specific IgG and IgG1 levels were determined by enzyme-linked immunosorbant assay (ELISA). Controls were treated with cornstarch powder or saline alone. Results Animals sensitized with latex proteins (n = 7 in each group) showed significant bronchoconstriction (P < 0.03) and higher anti-latex antibody levels than the controls (P < 0.005). Guinea-pigs sensitized with latex-contaminated cornstarch had higher levels of specific antibodies than those sensitized with latex alone (P < 0.05). Animals sensitized to latex mixed with cornstarch showed higher bronchospasm than those treated with latex alone (P < 0.003). Animals sensitized to ovalbumin mixed with cornstarch also showed higher antibody and bronchoconstriction levels (P < 0.05) than those immunized with ovalbumin alone but antibody titres were significantly lower than those of the animals treated with ovalbumin and Freund's complete adjuvant (P < 0.01; n = 5 in each group). Conclusion Our findings show that cornstarch powder increases antigen-induced bronchoconstriction and antibody production. This role of immunoadjuvant is not antigen-specific. The cornstarch powder used as donning agent in latex gloves is an allergen carrier and it can enhance latex-induced hypersensitivity. [ABSTRACT FROM AUTHOR]

Responds to comments on the authors' article on the retention of airborne latex particles by a bacterial and viral filter used in anesthesia. Concern regarding the protection offered by the Pall BB25 filter; Number and size of airborne particles released from powdered and non-powdered surgical latex gloves.

Examines the efficiency of a heat and moisture exchanger filter in retaining latex particles to protect allergic patients during anesthesia. Estimation on the incidence of anaphylactic reactions during anesthesia; Description of natural latex; Results of the cornstarch and protein assays.

Presents studies related to contact dermatitis. Eyelid dermatitis; Hypersensitivity to sesame in foods and cosmetics; Textile dye contact dermatitis.

For the diagnosis of IgE-mediated (immediate) hypersensitivity to natural rubber latex (NRL), skin prick testing with extracts of latex gloves has been widely used, but such extracts are difficult to standardize. The, present study aimed to produce on an industrial scale an NRL extract from. freshly collected NRL and to evaluate, calibrate, and standardize the extract by both in vivo and in vitro testing. The source material latex of the rubber tree, Hevea brasiliensis (clone RRIM 600), was frozen immediately after collection in Malaysia and shipped in dry ice to Stallergènes SA, France. Protein and allergen profiles were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), immunoblotting, isoelectric focusing (IEF), crossed immunoelectrophoresis (CIE), and crossed radioimmunoelectrophoresis (CRIE). Allergen quantification was effected by RAST inhibition. The capacity of the preparation to elicit immediate hypersensitivity reactions in vivo was measured by skin prick testing in 46 latex-allergic patients and 76 nonallergic control subjects. SDS-PAGE and immunoblot profiles of the extract and an NRL standard (E8) provided by the US Food and Drug Administration were almost identical, disclosing several distinct IgE-binding proteins with apparent molecular weights of 14, 20, 27, 30, and 45 kDa, conforming to reported molecular weights of several significant NRL allergens. An arbitrary index of reactivity (IR) of 100 was assigned to the extract at 1 : 200 dilution (w/v) having a protein content of 22 μg/ml. Skin puck testing of latex-allergic patients and controls using the extract at 100 IR revealed 93% sensitivity, 100% specificity, 100% negative predictive value, and 96% positive predictive value. In conclusion, a skin prick test reagent was diagnosis of type I NRL allergy was successfully standardized. The reagent was demonstrated to contain most, if not all, of the currently known clinically significant NRL allergens, and it showed high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

The article considers, successively, the epidemiology of allergy to latex including its prevalence and the risk factors for its development, its clinical manifestations, the nature of latex allergens, immunologic mechanisms of latex allergy diagnostic methods and the prevention of allergic reactions to products made of natural rubber latex. Repeated exposure to natural rubber latex is obviously essential for the development of sensitivity to latex. The variety of articles containing latex is considerable.

Aquagenic urticaria and cold urticaria are two forms of physical urticaria. Although their clinical characteristics are different; they can both be induced by contact with water. This article reports an unusual association of cold urticaria and aquagenic urticaria. Cold urticaria is another form of physical urticaria, characterized by the development of urticarial lesions after cold exposure. Cold urticaria may be induced by exposure to cold air, snow, rain, or cold water; ingestion of cold foods or drinks, handling cold objects; or other stimuli.

The article presents information on acquired cold urticaria after jellyfish sting. Cold urticaria syndromes are characterized by the development of urticaria and/or angioedema after cold exposure. The association of acquired cold urticaria with insect or animal stings is rarely described. The association of acquired cold urticaria with cryoglobulinemia or infections disease is well known. Drugs, such as penicillin, oral contraceptive and griseofulvin, or the presence of cold agglutinins, cryofibrogens and cold hemolysins are also frequently mentioned in the literature.

For the laboratory investigation of allergic diseases, flow cytometric methods to detect leukocytes that have been activated by allergen in vitro have recently been developed. Cellular tests for the detection of in vitro-activated blood basophils are complementary to specific IgE determinations. After in vitro incubation with allergen, basophils are fixed and then labeled with anti-IgE antibodies, and activation is then identified with anti-CD63 or anti-CD203c monoclonal antibodies. Assays based on basophil activation complement the measurement of specific IgE. With some allergens, particularly in cases of drug-induced allergy, flow cytometry has greater sensitivity than specific IgE determination. However, high concentrations of drugs can induce cell toxicity, and this may be confused with basophil activation. Cytometry can also be used to explore allergies with a cell-mediated mechanism. The detection of cytokine synthesis in T cells and basophils incubated with allergen is now technically feasible, but the usefulness of this procedure in the diagnosis of allergy remains to be demonstrated. We believe that the application of flow cytometry to the investigation of allergy is likely to increase. [Copyright &y& Elsevier]

We report two cases of an immediate allergic reaction to leucovorin (folinic acid) with positive skin tests. One patient underwent oral desensitization and was then able to continue complete treatment for a metastatic colon cancer. [Copyright &y& Elsevier]