Hyposensibilisatie bij pollinosis : veroorzaakt door stuifmeel van gras

Aanleiding tot de onderzoekingen die in dit proefschrift beschreven zijn 1 is de omstandigheid dat twijfel bestaat over het nut van hyposensibilisatie bij pollinosis. Deze twijfel betreft allereerst de klinische effektiviteit van deze behandeling. Voorts vraagt men zich af in hoeverre door de behandeling (immunologische) veranderingen teweeg worden gebracht en in hoeverre deze veranderingen verantwoordelijk kunnen worden gesteld voor de eventuele vermindering van de klachten. Tenslotte wordt wel de vraag gesteld, welke plaats de hyposensibilisatie bij de therapie van hooikoorts-patienten inneemt. De in dit proefschrift beschreven onderzoekingen hebben tot doel 1 het verloop van een aantal objektieve variabelen en van het klachtenpatroon tijdens hyposensibilisatie vast te leggen

Comparison of nasal responsiveness to histamine, methacholine and phentolamine in allergic rhinitis patients and controls

In a selected group of rhinitis patients with an IgE‐mediated allergy to house dust mites the nasal response to insufflation of histamine chloride, methacholine and phentolamine was demonstrated to be higher than in a control group. With the methods used histamine chloride was better at discriminating between healthy subjects and patients than methacholine or phentolamine. This discrimination was shown by assessing the severity of reflex‐mediated symptoms such as the number of sneezes and the amount of secretion, and not by differences in nasal airway resistance. Copyrigh

Nasal allergy to avian antigens

This study describes the case of a patient who developed symptoms of rhinoconjunctivitis on exposure to budgerigars and parrots. An IgE‐mediated allergy to budgerigar, parrot and pigeon antigens was demonstrated using both in‐vivo challenge tests (skin and nasal provocation tests) and in‐vitro investigations (radio‐allergo‐sorbent test, histamine release test). The study shows that the development of nasal disease can be associated with allergy to avian antigens. Copyrigh

Nasal allergy to avian antigens

textabstractThis study describes the case of a patient who developed symptoms of rhinoconjunctivitis on exposure to budgerigars and parrots. An IgE‐mediated allergy to budgerigar, parrot and pigeon antigens was demonstrated using both in‐vivo challenge tests (skin and nasal provocation tests) and in‐vitro investigations (radio‐allergo‐sorbent test, histamine release test). The study shows that the development of nasal disease can be associated with allergy to avian antigens. Copyrigh

Food-induced contact urticaria syndrome (CUS) in atopic dermatitis: Reproducibility of repeated and duplicate testing with a skin provocation test,the skin application food test (SAFT)

IgE-mediated contact urticaria syndrome (CUS) is one of the manifestations of allergy in childhood atopic dermatitis (AD). Allergens such as foods and animal products penetrate the skin easily. They can then cause urticarial reactions in sensitized individuals. A provocation test system for foods, called the skin application food test (SAFT), has been developed. Over more than 5 years, a group of 175 patients with AD was built-up and investigated in a prospective follow-up study with SAFT. SAFT was more frequently positive in AD children aged 6–2 years than in older children. In several children of this population (Group 1), we repeated SAFT within a period of 1 year. In another unrelated group of children (Group 2–1), we compared the results of ‘original’ SAFT and SAFT using square chambers (Van der Bend) or Silver patches. In the 3rd group (Group 2–2) we compared‘original' SAFT with SAFT using big Finn Chambers. The agreement between the tests was high: in Group 1, we observed 88 to 93% concordant scores, and in Group 2, the scores were 96% to 100%. Statistically, the K coefficient ranged from 0.71–0.87 in Group 1, and from 0.83–1.00 in Group 2. SAFT is therefore highly reproducible. Agreement was at least geqslant R: gt-or-equal, slanted88% between the scores (the lowest K value observed was at least 0.71)

Measurement of IgE antibodies against purified grass pollen allergens (Lol p 1, 2, 3 and 5) during immunotherapy

BACKGROUND: IgE titres tend to rise early after the start of immunotherapy, followed by a decline to pre-immunotherapy levels or lower. OBJECTIVES: We were interested to know whether the early increase in IgE antibodies includes new specificities of IgE, and whether these responses persist. METHODS: Sera of 64 patients undergoing grass pollen immunotherapy were tested for IgE against four purified grass pollen allergens: Lol p 1, 2, 3, and 5. At least two serum samples were taken, one before the start of therapy and one between 5 and 18 months after the first immunization (mean: 10 months). RESULTS: The mean IgE responses to Lol p 1, 2 and 3 showed a moderate but not significant increase. In contrast, the mean IgE response to Lol p 5 showed a significant decrease of > 30%. IgE against total Lohum perenne pollen extract moderately increased (> 20%), showing that a RAST for total pollen is not always indicative for the development of IgE against its major allergens. For > 40% of the patients it was found that IgE against one or more of the four allergens increased, while IgE against the remaining allergen(s) decreased. For 10 sera the ratio of IgE titres against at least two allergens changed by at least a factor of 5. The changes in specific IgE also included conversions from negative ( <0.1 RU) to positive (0.6 to 5.0 RU) for five patients. For two patients, the induction of these 'new' IgE antibodies against major allergens was shown to result in a response that was persistent over several years. CONCLUSION: Although active induction of new IgE specificities by immunotherapy was not really proven, the observations in this study indicate that monitoring of IgE against purified (major) allergens is necessary to evaluate changes in specific IgE in a reliable wa

Measurement of IgE antibodies against purified grass pollen allergens (Lol p 1, 2, 3 and 5) during immunotherapy

Background: IgE titres tend to rise early after the start of immunotherapy, followed by a decline to pre-immunotherapy levels or lower. Objectives: We were interested to know wether the early increase in IgE antibodies includes new specificities of IgE, and whether these responses persist. Methods: Sera of 64 patients undergoing grass pollen immunotherapy were tested for IgE against four purified grass pollen allergens: Lol p 1, 2, 3, and 5. At least two serum samples were taken, one before the start of therapy and one between 5 and 18 months after the first immunization (mean: 10 months). Results: The mean IgE responses to Lol p 1, 2 and 3 showed a moderate but not significant increase. In contrast, the mean IgE response to Lol p 5 showed a significant decrease of &gt; 30%. IgE against total Lolium perenne pollen extract moderately increased (&gt; 20%), showing that a RAST for total pollen is not always indicative for the development of IgE against its major allergens. For &gt; 40% of the patients it was found that IgE against one or more of the four allergens increased, while IgE against the remaining allergen(s) decreased. For 10 sera the ratio of IgE titres against at least two allergens changed by at least a factor of 5. The changes in specific IgE also included conversions from negative (&lt; 0.1 RU) to positive (0.6 to 5.0 RU) for five patients. For two patients, the induction of these 'new' IgE antibodies against major allergens was shown to result in a response that was persistent over several years. Conclusion: Although active induction of new IgE specificities by immunotherapy was not really proven, the observations in this study indicate that monitoring of IgE against purified (major) allergens is necessary to evaluate changes in specific IgE in a reliable way.</p

Measurement of IgE antibodies against purified grass pollen allergens (Lol p 1, 2, 3 and 5) during immunotherapy

Background: IgE titres tend to rise early after the start of immunotherapy, followed by a decline to pre-immunotherapy levels or lower. Objectives: We were interested to know wether the early increase in IgE antibodies includes new specificities of IgE, and whether these responses persist. Methods: Sera of 64 patients undergoing grass pollen immunotherapy were tested for IgE against four purified grass pollen allergens: Lol p 1, 2, 3, and 5. At least two serum samples were taken, one before the start of therapy and one between 5 and 18 months after the first immunization (mean: 10 months). Results: The mean IgE responses to Lol p 1, 2 and 3 showed a moderate but not significant increase. In contrast, the mean IgE response to Lol p 5 showed a significant decrease of &gt; 30%. IgE against total Lolium perenne pollen extract moderately increased (&gt; 20%), showing that a RAST for total pollen is not always indicative for the development of IgE against its major allergens. For &gt; 40% of the patients it was found that IgE against one or more of the four allergens increased, while IgE against the remaining allergen(s) decreased. For 10 sera the ratio of IgE titres against at least two allergens changed by at least a factor of 5. The changes in specific IgE also included conversions from negative (&lt; 0.1 RU) to positive (0.6 to 5.0 RU) for five patients. For two patients, the induction of these 'new' IgE antibodies against major allergens was shown to result in a response that was persistent over several years. Conclusion: Although active induction of new IgE specificities by immunotherapy was not really proven, the observations in this study indicate that monitoring of IgE against purified (major) allergens is necessary to evaluate changes in specific IgE in a reliable way.</p