Drug allergy: diagnosis and management

Drug allergy is one of the most commonly encountered medical problems in family practice. The symptoms may range from trivial to life threatening. As drug use continues to increase, the incidence of drug allergies will also continue to rise. Many drugs are available without doctors' prescriptions, which further increase the risk of fatal reactions. Drug allergy can become a major problem for patients with the multiple drug allergy syndrome, and more so with the emergence of antibiotic resistant organisms that limits the choice of antibiotics available. This article reviews the current understanding in the mechanisms of drug allergy, the management of patients with allergy to commonly used drugs such as penicillins, NSAIDs, local anaesthetics and radiocontrast media. After reading this article, the reader should be able to recognise patients at high risk of serious drug reactions and to formulate a management plan for such patients.published_or_final_versio

Increased apoptotic blood neutrophils and macrophages and decreased clearance of apoptotic neutrophils in systemic lupus erythematosus

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The effects of topical triptolide in an animal model of contact dermatitis

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Osteopontin in rheumatoid arthritis and osteoarthrits

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B cells from SLE patients display accelerated apoptosis and reduced anti-apoptotic response to sIgM and CD40 ligation

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Effects of triptolide, an active ingredient of trypterygium Wilfordii Hook F (Thunder God Vine, a traditional Chinese herb), on rheumatoid synovial fibroblast function

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Inhaled corticosteroid therapy in bronchiectasis - a 12-month study

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DNA immunization using a secreted cell wall antigen Mp1p is protective against Penicillium marneffei infection

None of the vaccines used in dimorphic fungal infections utilized the mucosal route for immunization, whereas only one utilized a secreted protein as antigen, despite knowing that infections caused by dimorphic fungi are usually acquired through inhalation. In this study, we investigated the usefulness of Mp1p (a secreted cell wall antigen encoded by MP1)-based vaccines for generation of protective immune responses against Penicillium marneffei infection using a mouse model, and compared the relative effectiveness of intramuscular MP1 DNA vaccine, oral mucosal MP1 DNA vaccine delivered by live-attenuated Salmonella typhimurium, and intraperitoneal recombinant Mp1p protein vaccine. The serum IgM level of the Mp1p protein vaccine group at day 7 and the serum IgG levels of the Mp1p protein vaccine group at days 7 and 21 were significantly higher than those of the other groups (P<0.0001). The serum IgG level of the MP1 DNA vaccine group was significantly higher than that of the corresponding control group and oral mucosal MP1 DNA vaccine group (one dose) at day 21 (P<0.0001 and <0.05, respectively). The groups of mice immunized with intramuscular MP1 DNA vaccine, oral mucosal MP1 DNA vaccine, and intraperitoneal Mp1p protein vaccine showed significantly higher Mp1p-specific lymphocyte proliferation index (LPI) than the control groups. The interferon-γ (IF-γ) levels of supernatant of splenic cell cultures obtained from mice after intramuscular MP1 DNA vaccine, mucosal MP1 DNA vaccine (three doses), or intraperitoneal Mp1p protein vaccine administration were higher than that which occurred after mucosal MP1 DNA vaccine (one dose) administration or those of controls. Interleukin-4 (IL-4) was not detectable in the supernatant of splenic cell cultures obtained from all groups of mice. The percentage survival of the mice immunized with intramuscular MP1 DNA vaccine, oral mucosal MP1 DNA vaccine (three doses), oral mucosal MP1 DNA vaccine (one dose), intraperitoneal recombinant Mp1p protein, oral live-attenuated S. typhimurium control, and intramuscular pJW4303 DNA control at day 60 after wild type P. marneffei challenge were 100, 60, 40, 40, 40, and 0%, respectively. The survival of mice in the MP1 DNA vaccine group was significantly better than those of the oral mucosal MP1 DNA vaccine (three doses) group (P<0.05), oral mucosal MP1 DNA vaccine (one dose) group (P<0.005), recombinant Mp1p protein group (P<0.005), S. typhimurium aroA strain group (P<0.05), and pJW4303 group (P<0.00001). Although, the mechanism by which intramuscular MP1 DNA vaccine offered the best protection against P. marneffei infection remains to be elucidated, the present observation prompted further clinical trials on the use of MP1 DNA immunization on asymptomatic human immunodeficiency virus carriers in P. marneffei endemic areas. © 2002 Elsevier Science Ltd. All rights reserved.link_to_subscribed_fulltex

Thermo- And acid-responsive photochromic spironaphthoxazine containing organogelators

A series of photochromic spironaphthoxazine derivatives has been designed, synthesized, and characterized by using 1H NMR spectroscopy, FAB mass spectrometry, and elemental analysis. Their photophysical and photochromic behavior have been investigated. Two of the compounds (G12-enSA-SO and G16-en-SA-SO) have been shown to be capable of forming stable thermoreversible organogels in organic solvents, tested by the "stable-to-inversion of a test tube" method. Addition of p-toluenesulfonic acid was found to induce the formation of stable organogels at concentrations below that of the critical gelation concentration (c.g.c), with a concomitant change in color from colorless to purple. Transmission electron microscopy and scanning electron microscopy of the xerogels showed typical fibrous structures in the micrometer scale. The activation parameters for the bleaching reaction of G8-en-SA-SO in the solution state and G 16-en-SA-SO in the gel state have been determined in ethanol through kinetic studies at various temperatures. The results showed that the rate of the bleaching reaction in the gel state was much slower than that in the solution state. © 2010 Wiley-VCH Verlag GmbH & Cu. KGaA. Weinheim.link_to_subscribed_fulltex