Pharaoh Ant (Monomorium pharaonis): Newly Identified Important Inhalant Allergens in Bronchial Asthma

The nonstinging house ant, Monomorium pharaonis (pharaoh ant), was recently identified as a cause of respiratory allergy. This study was performed to evaluate the extent of sensitization to pharaoh ant, and its clinical significance in asthmatic patients. We carried out skin prick tests in 318 patients with asthma. Specific IgE (sIgE) to pharaoh ant was measured by ELISA, and cross-reactivity was evaluated by ELISA inhibition tests. Bronchial provocation testing was performed using pharaoh ant extracts. Fifty-eight (18.2%) of 318 patients showed positive skin responses to pharaoh ant, and 25 (7.9%) had an isolated response to pharaoh ant. Positive skin responses to pharaoh ant were significantly higher among patients with non-atopic asthma than among those with atopic asthma (26.0% vs. 14.9%, p<0.05). There was significant correlation between sIgE level and skin responses to pharaoh ant (rho=0.552, p<0.001). The ELISA inhibition tests indicated that pharaoh ant allergens had various pattern of cross-reactivity to house dust mites and cockroaches. Bronchial provocation tests to pharaoh ant were conducted for 9 patients, and eight showed typical asthmatic reactions. In conclusion, pharaoh ant is an important source of aeroallergens, and it should be included in the skin test battery for screening the causative allergens in patients with asthma

Effect of Cosensitization with Buckwheat Flour Extract on the Production of House Dust Mite-specific IgE

There are studies reporting food sensitization in infancy increases the risk of sensitization to inhalants later in life. We performed a study to evaluate whether cosensitization with buckwheat (BW) has an effect on the production of house dust mite-IgE. C3H/HeJ mice (4 weeks, female) were sensitized with house dust mite (HDM)/Al (OH)3, intraperitoneally on day 0, followed by 4 intranasal sensitizations (on days 14, 15, 16, and 21). Group 1 was cosensitized intragastrically with BW/cholera toxin (CT) (on days 0, 1, 2, 7, and 18) during sensitization with HDM, group 2 was cosensitized intragastrically with CT only (on days 0, 1, 2, 7, and 18), and group 3 was used as controls. HDM- and BW-IgE and antigen-specific T-cell proliferation and cytokine production were evaluated. In Group 1, BW-IgE levels were highest at week 4, and the HDM-IgE at week 3 (98.45±64.37 ng/mL and 169.86±55.54 ng/mL, respectively). In Group 2, HDM-IgE levels reached a peak at week 3, remarkably higher (810.52±233.29 ng/mL) compared to those of Group 1 (169.86±55.54 ng/mL). The interleukin (IL)-4 and interferon (IFN)-γ in the HDM-stimulated culture supernatants of splenocytes were not significantly different among groups. We postulate that the cosensitization with BW may down-regulate the specific IgE response to HDM

Cytokeratin Autoantibodies: Useful Serologic Markers for Toluene Diisocyanate-Induced Asthma

To evaluate the clinical significance of autoantibodies to three major epithelial cytokeratins (CK) - CK8, CK18, and CK19 - we compared 66 patients with toluene diisocyanate (TDI)-induced asthma (group I) with three control groups: 169 asymptomatic exposed subjects (group II), 64 patients with allergic asthma (group III), and 123 unexposed healthy subjects (group IV). Serum IgG, specific for human recombinant CKs, were measured by ELISA (enzyme linked immunosorbent assay), and ELISA inhibition tests were performed. The existence of these antibodies was confirmed by IgG immunoblot analysis. Anti-TDI-HSA (human serum albumin) IgE and IgG antibodies were measured by ELISA in the same set of the patients. The prevalence of CK8, CK18, and CK19 auotantibodies in group I was significantly higher than in the other three groups. Results of the ELISA inhibition test showed significant inhibition with the addition of three CKs in a dose-dependent manner. No significant association was found between CK autoantibodies and the prevalence of anti-TDI-HSA IgG and IgE antibodies. These results suggest that autoantibodies to CK18 and CK19 can be used as serologic markers for identifying patients with TDI-induced asthma among exposed workers

Effect of an Air Cleaner with Electrostatic Filter on the Removal of Airborne House Dust Mite Allergens

PURPOSE: The effects of air cleaners on the removal of airborne indoor allergens, especially house dust mites (HDM), are still controversial. The objective of this study is to evaluate the effect of an air cleaner with an electrostatic filter on the removal of airborne mite allergens. MATERIALS AND METHODS: A dried HDM culture medium that contained mite body particles and excretions was dispersed in a chamber equipped with an electrostatic air cleaner. The number of airborne particles was recorded continuously by a dust spectrometer for 60 minutes. Airborne particles in the chamber were collected on a sampling filter at a flow rate of 10 L/min and the Der f 1 concentration in the filter extracts was measured by two-site ELISA. RESULTS: The air cleaner efficiently removed airborne HDM particles. The air cleaner removed airborne HDM particles (size 2-12.5 µm) 11.4 ± 2.9 fold (cleaner operating for 15 minutes), 5.4 ± 0.7 fold (cleaner operating for 30 minutes), and 2.4 ± 0.2 fold (cleaner operating for 60 minutes) more than the removal of HDM particles by natural settle down. Removal kinetics differed according to the particle size of the airborne particles. The air cleaner decreased the concentration of Der f 1 in the extraction of airborne particles collected on the air sampling filter by 60.3%. CONCLUSION: The electrostatic air cleaner can remove airborne HDM allergens and may be useful as a supplementary environmental control tool for HDM sensitized respiratory allergic patients.ope

Spontaneously Reported Hepatic Adverse Drug Events in Korea: Multicenter Study

Hepatic adverse drug reactions (ADRs) to certain drugs may differ within each country, reflecting different patterns of prescription, socioeconomic status, and culture. The purpose of this study was to assess the suspected cause of hepatic ADRs using the spontaneously reported pharmacovigilance data from Korea. A total of 9,360 spontaneously reported adverse drug events (ADEs) from nine Pharmacovigilance Centers were analyzed. Risk of hepatic ADEs was assessed by calculating the reporting odds ratio (ROR). Of the 9,360 cases, 567 hepatic ADEs were reported. The most frequently prescribed drug classes inducing hepatic ADEs were anti-tuberculotics, cephalosporins, valproic acids, penicillins, quinolones, non-steroidal anti-inflammatory drugs (NSAIDs), anti-viral agents, and statins. ROR values were especially high in anti-tuberculosis drugs, systemic antifungal drugs for systemic use, anti-epileptics, propylthiouracil, and herbal medicines. Underlying diseases such as tuberculosis (6.9% vs 0.9%), pneumonia (4.9% vs 1.7%), intracranial injury including skull fracture (4.5% vs 0.9%), HIV (3.4% vs 0.4%), subarachnoid hemorrhage (2.8% vs 0.5%), and osteoporosis (2.4% vs 1.4%) were significantly more common in hepatic ADE group. In conclusion, anti-infective drugs, anti-epileptics, NSAIDs and statins are the most common suspects of the spontaneously reported hepatic ADEs, in Korea. Careful monitoring for such reactions is needed for the prescription of these drugs

2년이상 관찰중인 성인 기관지 천식 환자의 치료효과 및 예후인자에 관한 연구

Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was 20.3±9.7 months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.ope