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Resume L'introduction dans l'organisme de protheses metalliques peut induire, tres exceptionnellement, des lesions dermatologiques a distance de type allergique. Le probleme le plus frequent est celui de tests epicutanes positifs a des metaux chez des patients porteurs d'une prothese de hanche. La revue de la litterature permet aujourd'hui de conclure que seules les protheses metal/metal subissant un descellement aseptique s'accompagnent d'une sensibilisation plus frequente au chrome, au nickel et surtout au cobalt. L'allergie parait resulter d'une liberation excessive des metaux lors du descellement. La sensibilisation est la consequence et non la cause de ce descellement, lui-meme induit peut-etre par les enzymes lysosomiales macrophagiques. Des tests epicutanes sont utiles dans le bilan d'un descellement de prothese metal/metal.

The synthesis of blocking antibodies has been demonstrated in ten patients undergoing rush immunotherapy (R-IT) with mite extracts: basophil degranulation performed on washed cells (Allergolam technique) did not differ significantly before and 10.8 (+/- 6.8) months after R-IT. Preincubation of allergen (100, 25, 10, and 5 micrograms/mL) with individual serum collected before R-IT did not decrease degranulation, but degranulation was significantly decreased when the allergen was incubated 30 minutes at 37 degrees C with individual serum collected after R-IT or with the IgG-fraction of a pool of sera collected in 22 treated patients. A linear correlation between the mean of degranulation and the log allergen concentration was observed in the two latter groups. The antigen neutralizing capacity of the IgG-fraction was studied on basophils of 11 "allergic donors." Antigen neutralizing capacity clearly increased with time of incubation with the allergen (15, 30, and 60 min), but was also significant without preincubation, eg, for 10 and 5 micrograms/mL allergen concentrations. These results indicate that the improvement of asthma usually noticed 2 months after R-IT is probably due, essentially, to blocking antibodies, since the sensitivity of the basophils is not modified significantly.

Total eosinophil count (TEC) was done in 13 normal subjects, in 8 subjects before and 90 mn after a "French" breakfast and in 29 asthmatic patients. The geometric mean is higher (p less than 0,001) in asthmatic than in normal subjects: 304 (231--391) versus 144 (101--197). The breakfast does not interfer with the result of the TEC. In asthmatic subjects, a significant inverse correlation appears (r = 0,57, p less than 0,01) between the logarithm of TEC and the quotient: formula; see text. This correlation persists whatever may be the subject's age, the duration of the asthma or age at which he first contracted the illness. Asthma appeared after 40 years in 4 of the subjects: their TEC was higher (p less than 0,01) than in subjects who had become asthmatic before the age of forty. The respiratory function was lowered more in these 4 patients than in others who had been ill for the same time (p less than 0,001). The TEC is not related to results of skin testine with usuel inhalant allergens (grass pollen, house dust, cat's or dog's dander) or by result of a provocation test (by inhalation of allergen). Eosinophilia and bronchial obstruction are connected by one (or more) factors that may be inhalant allergens in extrinsec asthma and circulating immune complexes in intrinsec asthma.

In stimulated cultures, a proportion of human T lymphocytes form multilayer rosettes with sheep red blood cells (SRBC) and they can be easily separated from common E rosettes by velocity sedimentation. We have developed a simplified method for harvesting multilayer rosettes and quantifying them. Practical applications of this technique are discussed.

From a series of 30 cases of immediate allergy to the latex of Hevea Brasiliensis, the authors recall the principal clinical aspects of these allergies, specially contact urticaria (during the use of surgical or cleaning gloves) and systemic anaphylactic accidents, essentially the anaphylactic shock during surgical procedures. They mention the diagnostic procedures; skin tests and measurement of specific IgE (RAST). They show the interest of biological research, yielding to the identification of the allergens of the latex in order to obtain non allergenic latex. Such a result would be of interest to limit the number of the accidents in a period where the use of rubber protective material is much larger/gloves and condoms).

A total eosinophil count (TEC) and a white blood cell count (WBCC) were performed simultaneously in 213 patients. Discrepancies were found between TEC and WBCC. WBCC did not allow detection of hypereosinophilia (TEC exceeding 300 eosinophils/microliter) in 45 patients. Patients were classified in three groups : controls (n = 27), benign disease (n = 65), and apparently cured cancer (n = 36). There was no significant difference between total eosinophil counts for these three groups (Wilcoxon non-parametric test). The incidence of hypereosinophilia (TEC exceeding 300) was similar in the three groups (11%, 14% and 6%). Average TEC levels were determined in 20 patients with decompensated hepatic cirrhosis, in 31 patients with active cancer, and in 14 patients with infection. These levels were significantly different from those found in each of the three previous groups. (Wilcoxon test). The incidence of hypereosinophilia (greater than 300/microliter) was significantly higher among patients with cirrhosis (50%) or active cancer (58%). The possible mechanisms of this hypereosinophilia and it's eventual prognostic utility are considered.

Skin reactions to heparin are rare, the most frequent manifestation being skin necrosis. Reactions occur either as an isolated manifestation or within a context of heparin-induced thrombopenia. Urticarious and eczematous reaction, either localized at injection sites or with a general distribution, have been recently reported. In all cases, it is mandatory to withdraw heparin therapy. Such accidents can be observed with all types of heparin (standard heparin and low-molecular weight heparin). Cross-reactions between two types of heparin are frequent. Skin tests can be used to guide heparintherapy.

Total eosinophil count (TEC) was done in 13 normal subjects, in 8 subjects before and 90 mn after a "French" breakfast and in 29 asthmatic patients. The geometric mean is higher (p less than 0,001) in asthmatic than in normal subjects : 304 (231-391) versus 144 (101-197). The breakfast does not interfer with the result of the TEC. In asthmatic subjects, a significant inverse correlation appears (r = 0,57, p less than 0,01) between the logarithm of TEC forced expiratory volume in one second and the quotient : vital capacity. This correlation persists whatever may be the subject's age, the duration of the asthma or age at which he first contracted the illness. Asthma appeared after 40 years in 4 of the subjects : their TEC was higher (p less than 0,01) than in subjects who had become asthmatic before the age of forty. The respiratory function was lowered more in these 4 patients than in others who had been ill for the same time (p less than 0,001). The TEC is not related to results of skin testing with usual inhalant allergens (grass pollen, house dust, cat's or dog's dander) or by result of a provocation test (by inhalation of allergen). Eosinophilia and bronchial obstruction are connected by one (or more) factors that may be inhalant allergens in extrinsec asthma and circulating immune complexes in intrinsec asthma.

After a 10 day treatment with total adreno-cortical extract, administered to 11 subjects, the following results were obtained: increase of delayed cutaneous responses to various antigens, increase in the number of null lymphocytes, decrease in the number of B lymphocytes. These changes did not occur in 16 control patients who were not treated.

In the last ten years, progress in the field of allergy research has led to the purification of some of the major allergens and to a better knowledge of their physico-chemical properties. A number of studies have shown that some allergens have enzymatic activities. Molecular biology has provided the means to clone and sequence genes encoding these allergens and to produce recombinant allergens in yeast and bacteria. Epitope mapping of natural and synthetic allergens, using polyclonal or monoclonal antibodies and cell-stimulation tests, has also contributed greatly to the understanding of their immunogenicity and allergenicity. Analysis of these new data allow us to explain why some allergens are enzymes.