Introduction:
There is reported high sensitization to grass pollen all over the Europe. The different species have close cross reactivity associated to the strong homology between their protein contents. Despite these evidences, different pattern reactions can be triggered by local environmental exposure to some gramineae species.
Aim
The aim of this study is to evaluate the gramineae species cutaneous sensitization in patients observed in the Immunoallergology Department due to allergic respiratory disease. Establish a correlation between in vivo (skin prick test) and in vitro (radioallergosorbent test) tests and analyse by immunoblotting the main proteins identified.
Methods: A total of 100 consecutive adults with positive 22 gramineae skin prick test were evaluated. The following gramineae were investigated: Dactylis glomerata, Festuca pratensis, Lolium perene, Phleum pratensis, Secale cereale, Triticum sativum, Zea mays, Hordeum vulgaris, Avena sativa, Salsola kali, Cynodon dactylon, Humulus lupulus, Phragmitis communis, Agrpyron repens, Arrhenatherum el, Bromus mollis, Agrostis alba, Cynosurus cristatus., Alopercus pratense, Anthoxanthum oduratum., Holcus lanatus e Poa pratensis. A test was considered positive whenever the papule diameter was 3 mm higher than negative control. According to the skin prick test results the patients were distributed in 4 groups; negative, 3<5 mm; 5<8 mm; 8 mm. Detection of antigen-specific IgE was made by radioallergosorbent test (RAST/ UniCAP System) and the main protein identification by SDS‑PAGE/Immunoblotting (Alablot DPC- Amerlab) for Phleum pratensis, Secale cereale e Poa pratensis.
Results: The average papule value for histamine was 6,1 mm. The skin prick tests positivity range from higher than 90% for Festuca pratensis, Lolium perene, Triticum sativum, Arrhenatherum el, Cynosurus cristatus, Anthoxanthum oduratum, Holcus lanatus to 53% for Humulus lupulus e Salsola kali. Mean diameter values range from 9,7mm for Arrhenatherum el to 4,9mm for Humulus lupulus. It was possible to establish a close connection between in vivo and in vitro tests for all the grass species tested. The proteins most identified by blotting were those considered the major allergens ( 27 to 40 MW).
Conclusion: In portuguese patients there are an high sensitization pattern to most grass species. Despite this, Festuca pratensis, Lolium perene, Triticum sativum, Anthoxanthum oduratum, Holcus lanatus should be considered in the skin prick tests battery, mainly in patients with strong seasonal clinical worsening. The IgE determination can give secure information about grass pollen allergy. The specific protein identification give important informations to the understanding the sensitization mechanisms
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Exposure to endotoxin, atopy and work-related symptoms
among hop growers
Anna Góra, Czesława Skórska, Zofia Prażmo, Ewa Krysińska-Traczyk, Jolanta Sitkowska, Radosław Śpiewak, Jacek Dutkiewicz
Institute of Agricultural Medicine, P O Box 185, Jaczewskiego 2, 20-950 Lublin, Poland
BACKGROUND: Hop (Humulus lupulus) is perennial plant cultivated extensively in Germany, Czech Republic, UK and USA. Hop cones are commonly used as a flavouring agent in breweries. Poland is five biggest hop producer in the word. Some studies suggest that hop may have allergic properties. However, still little is known on the exposure of hop growers to bioaerosols and its impact on health.
The aim of the study was to asses the prevalence of work related symptoms and their relation to atopy and endotoxin exposure.
METHODS: 69 farmers from 19 randomly selected hop farms in Eastern Poland were examined. All participants were interviewed using the standardized questionnaires. The skin prick test with occupational allergens (hop and microbial) was performed. The atopy was define by at least one positive skin-prick for one ore more of eight airborne allergens. Air samples for determination of endotoxin were collected in all farms.
RESULTS: Atopy was found in 23 out of 69 (33%) examined hop growers. The prevalence of chronic bronchitis and physician diagnosed asthma were 23% and 3% respectively.
36 out of 69 (52%) farmers reported work-related symptoms. The most common was: respiratory symptoms reported by 39% of hop growers, skin, eyes and nose symptoms – reported by 33% and general symptoms – by 26%.
Thirteen out of 36 (36%) symptomatic farmers were atopics. Eight farmers (12%) reacted to SPTs with occupational allergens: 5 (7%) farmer reacted to hop allergens and 6 farmers (9%) reacted to antigens of microbe commonly found in work environment.
Moreover, positive reactions to microbial allergens were significantly more frequent in a group of farmers with respiratory symptoms (18%) compared to those without symptoms (2%; p < 0.05).
The concentrations of airborne endotoxin ranged from 26 to 6250 ng/m3 (median 52.2 ng/m3).
Among hop growers with endotoxin exposure higher than 200 ng/m3 the prevalence of work related symptoms and positive skin prick reactions were lower compared to the rest of the group (34% vs. 65%; p<0,05) and (17% vs. 3% p>0,05%)
Conclusion: Despite relatively lower exposure to endotoxin, compared to farmers in other branches of agriculture, over 50% of hop growers complained of work-related symptoms. The inverse relation between occurrence of work-related symptoms and endotoxin concentration may be partly due to healthy worker effect.
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Asthma risk factors in patients with seasonal
rhinoconjunctivitis in Ankara
B. Bozkurt, G Karakaya, A F Kalyoncu
Hacettepe University, School of Medicine, , Dept of Chest Diseases, Adult Allergy Unit, Ankara, Turkey
Background: Asthma and seasonal rhinoconjunctivitis (SR) are frequently seen co-morbid conditions. In some instances, asthma can follow SR. The purpose of this survey was to determine the asthma risk factors in patients diagnosed with SR in our allergy clinic.
Methods: A retrospective study was conducted based on clinical records of 955 patients diagnosed with SR at our clinic between 1 January-31 December 2003. Out of 955 patients, 774 were enrolled since data were available only for these. Logistic regression model was developed to assess the independent association between asthma and the factors which were significantly associated with asthma.
Results: The mean age of the patients was 29.1±9.29 and 485 of them were females. There was a history of family atopy in 56.8% of the patients. The major initial complaints of the patients were nasal in 82.3%, respiratory in 9.7%, cutenous in 6.2% and ocular symptoms in 1.8% . The mean duration of the symptoms was 6.8 years . The patients have been symptomatic with a mean of 3.5±1.7 months a year. Skin prick tests (SPT) were performed with 14 common aeroallergens, and were positive in 685 patients (90.3%), where the allergen spectrum was 88.8% pollen, 15.1% mites, 16.2% cockroach, 13.1% pet animals and 1.2% mould. The most common accompanying allergic diseases were food hypersensitivity (14%), asthma (13.4%) and drug hypersensitivity (9.6%). Older age (OR: 1.77, 95%CI: 1.06-2.94), presence of family atopy (1.72, 1.04-2.85), respiratory symptoms (2.10, 1.75-2.50), ocular symptoms (0.77, 0.61-0.98) and metal allergy (0.25, 0.07-0.89) were associated with the development of asthma in patients with SR.
Conclusion: SR is a disease of the younger age group that could progress to an asthma. History and allergen spectrum of patients should carefully be evaluated in order to determine the risk factors for SR patients.
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Pollen concentrations from March to April in Vilnius, Lithuania:
A two year study
R. Dubakiene1, S. Miseviciute2
1Vilnius University , Allergy Center, Vilnius, Lithuania; 2Vilnius University hospital "Santariskiu Klinikos", Pulmonology and allergology, Vilnius, Lithuania, sandrule@rocketmail.com
Background: The amount of people with allergy to pollen is constantly increasing. The role of pollen is well known in development of such diseases as allergic rhinitis or bronchial asthma. People who suffer from these diseases well know that their symptoms begin in particular season.
Aim: This study was designed to calculate the airborne pollen concentrations during pollen season in Lithuania.
Materials and methods: Materials for comparing pollen concentrations were gained from the joint-stock company IFE Baltic, where the pollen grains were picked by pollen calculator (Burkard Sporen Falle). The calculator was set in 30 meters high. The roll with different pollen used to be taken from the calculator every week and the pollen were differentiated and calculated with the help of microscope.
Results: The period from late March to April is the season of blowing in Lithuania. The bloom of trees begins in March and finishes in July. The peak of trees bloom is in May. The bloom of herbage begins in May and finishes in early autumn. The peak is in June. Main pollen of these months are Corylus, Alnus, Betula, Tilia (trees) and Gramineae, Plantago, Rumex (herbage).
Conclusions: Thus, knowing the concentrations of pollen in different months helps us to create the local scheme of pollen widespreading and use it in everyday allergologist work.
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FOOD ALLERGY AND ITS RELATIONSHIPS TO OTHER ALLERGIC DISEASES IN THE POPULATION OF SCHOOL CHILDREN IN POLAND
Jazwiec-Kanyion B.
Department of Epidemiology, Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
Introduction: In contrast to respiratory allergies, epidemiology of food allergy (FA) in Poland has been little studied. The aim of the study was to investigate the prevalence of FA and its relationships to other allergic diseases among school children living in Silesian voivodeship – the most industrialised part of Poland. In 2001 we carried out a cross-sectional health survey on children 6-7 years old and children 13-14years old living in the city of Sosnowiec.
Methods: Using the CESAR (Central European Study on Air Pollution and Respiratory Health) and ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire we invited for the study all 2500 canditate children. Completed questionnaire was returned by parents of 2000 children (response rate 80%). For statistical analysis computer program STATA 8.0 was employed. Prevalence rates were calculated and chi square tests were used to compare the rates between groups. P values < 0.05 was regarded as statististically significant.
Results: Replies to the questionnaire were received from 519 children 6-7 years old and 1481 children 13-14 years old. The prevalence of FA and other allergic diseases (in %) are shown below.
6-7 yrs 13-14yrs
FA 17.1 7.3
Asthma 5.0 3.6
Atopic dermatitis 19.3 11.9
Pollen allergy 10.3 10.8
Pets allergy 8.8 8.6
Dust allergy 9.5 8.2
Conclusions: Our study suggested that the prevalence of FA and atopic dermatitis was a significantly higher in 6-7 years old group of children. Prevalences of food allergy were more often reported among children with asthma (9.8%), atopic dermatitis (45.3%), pollen allergy (29.5%), pets allergy (26.5%) and dust allergy (27.3%).
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RELATIONSHIP BETWEEN RAGWEED POLLENS IN TUSCANY (ITALY) AND AIR MASSES COMING FROM BALKANS
L. Cecchi*, M. Morabito^, M.P. Domeneghetti°, G. Bartolini*, M. Petralli*, T. Torrigiani*, M. Onorari° and S. Orlandini*
* Interdepartmental Centre of Bioclimatology – University of Florence, Italy
^ Institute of Biometeorology – National Research Council, Italy
° Articolazione Funzionale regionale di Aerobiologia ARPAT - Department of Pistoia, Italy
Ragweed (Ambrosia) is spreading in northern Italy, particularly in north-east; however, many pollens produced by ragweed have been also detected in Tuscany in the last four years although only few plants have been found in the region.
The aim of the study was to evaluate the origin of the ragweed pollens, analasying the meteorological conditions during the peak of pollens at a mesoscale level. Pollens have been collected using volumetric pollen particles samplers VPPS 2000 (Lanzoni) in the cities of Florence, Pistoia and Montecatini. Weather maps based on AVN model (Aviation Model) of the National Center of Environmental Prediction regarding the synoptical situation at 00 UTC and at 12 UTC of the 500 hPa geopotential and air temperature and wind direction at 850 hPa have been also evaluated.
In the period under investigation (1999-2003) a strong association between the peaks of ragweed pollens and air masses originating from east-northeast has been observed.
The highest peak occurred in the period 30th August- 4th September 2002 and was associated with air masses coming from Balkans, after persistent period characterized by low atmospheric circulation.
In that occasion, the easterly air flow was due to a specific circulation pattern characterized by a low pressure located between the Ionic Italian coast and Greece. The peaks of ragweed pollens was always observed two days after the arrival of east-northeast air mass. The finding that pollen count decreased suddenly when air flow coming from Balkans stops, strengths our hypotesis. Furthermore, in the same period of 1999 and 2001, characterized by low atmospheric circulation, no ragweed pollens were detected in Tuscany.
These data suggests that ragweed pollens collected in Tuscany might come from the east, probably from Balkans.
In conclusion, this study highlights the importance of the collaboration between allergologist, meteorologists and aerobiologist, with the aim of forecast the pollination season even at a mesoscale level.
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Allergic diseases –an increasing problem in Serbia and Montenegro
L.Burazer¹,O.Vuckovic¹,M.Gavrovic² and T.Cirkovic²
¹Institute of Immunology and Virology-Torlak, Belgrade
²Faculty of Chemistry, University of Belgrade
Serbia and Montenegro
Epidemiology studies the relationship among factors influencing diseases in human populations. Changes in the burden of diseases over time are of particular interest and it is concern that atopic diseases have been increasing , over the past few decades, both in Europe and world-wide. (1).
The possibility for partial monitoring of the number of patients with allergy problems appears in 1998. , when Torlak Institute-Department of Allergology started with in vitro diagnostics using Pharmacia UNI – CAP –100 SYSTEM (Uppsala, Sweden). 5360 adult and pediatric patients were tested in the period between 1998 to 2002. The tests were performed on the subjects between ages from 5 to 60 years. All subjects had a previously positive prick test results. Skin prick tests were performed with a standard battery (histamine phosphate, PBS, grass pollen, tree pollen, weed pollen, home dust, Dermatophagoides pteronyssinus, bed line dust , animal hair ,mold, bacteriae, bee venom, wasp venom, hornet venom, cockroach) of glicerinated extracts (Torlak Institute, Belgrade).Histamine phosphate at 1 mg/ml and PBS were used, respectively , as positive and negative controls. Specific IgE and total IgE detection of patients’ sera were performed by means of Pharmacia UNI-CAP-100 System (Uppsala, Sweden).The results were expressed as CAP scores from class 0 to 6, according to the manufactures instruction.
The dominant inhalatory allergen is Dermatophagoides pteronyssinus ,d1, making about 21% of the total analyses performed. The next significant group of inhalatory allergen are grass pollen ,gx1, (10%) , then there are weed pollen ,wx1, (8%), followed by tree pollen ,tx5, (3,6% )There is dominant allergen within each group of pollens. Within the grass pollen group, the dominant allergen is Dctylis glomerata ,g3, making about 33% of the total analyses performed. Ambrosia ellatior ,w1,is a dominant allergen in the weed allergen group making about 46% of the total analyses performed , while the most frequent allergen within the tree pollen group is the lime-tree, t208, about 12%. The number of tested patients refers primarily to the bigger cities of Serbia in which allergology service is developed and it also directs us that we must spread it onto the entire territory of Serbia and Montenegro.
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Prostaglandin EP Receptor Agonists Differentially Modulate Aspirin-induced Generation of 15-HETE in Aspirin-sensitive Asthmatics.
M. Jędrzejczak, A. Ptasinska, B. Bieńkiewicz, M. Borowiec, L. DuBuske*,
M.L. Kowalski
Medical University of Lodz, Poland
*Immunology Research Institute of New England, Fitchburg, MA, USA
Rationale. Aspirin triggers generation of 15-hydroxyeicosaterraenoic acid (15-HETE) in peripheral blood leukocytes from aspirin-sensitive (AS) but not aspirin-tolerant (AT) patients with asthma/rhinosinusitis. The aim of this study was to determine the effect of prostaglandin EP receptor agonists (misoprostol and sulprostone) on aspirin-induced 15-HETE generation. Methods. Peripheral blood leukocytes (PBLs) were isolated from AS and AT patients with asthma, and the 15-HETE release into the cell supernatant was measured with a specific immunoassay (Assay Design, MA). Results. Incubation of PBLs from AS asthmatics with 200μM of lysine-aspirin significantly increased generation of 15-HETE (mean increase +260%) but lysine-aspirin did not affect 15-HETE generation in PBLs from AT asthmatics. Preincubation of cells with misoprostol or sulprostone did not affect basal 15-HETE in AS or AT patients. However, both misoprostol and sulprostone inhibited in a dose-dependent manner the ASA-induced increase in 15-HETE generation in AS asthmatics (maximal inhibition being 89% and 80% after misoprostol and sulprostone respectively). In contrast in AT patients preincubation of PBLs with misoprostol or sulprostone resulted in a significant increase in generation of 15-HETE after addition of 200μM lysine-aspirin. The maximal increase of 15-HETE generation was observed with 10 μg/ml of misoprostol or sulprostone (+73% and +86% respectively).
Conclusions. Our data suggest that aspirin-triggered 15-HETE release is differentially regulated by prostaglandin EP receptors in PBLs from AS and AT asthmatics.
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Allergic diseases –an increasing problem in Serbia and Montenegro
L.Burazer¹,O.Vuckovic¹,M.Gavrovic² and T.Cirkovic²
¹Institute from Immunology and Virology-Torlak, Belgrade ²Faculty of Chemistry, University of Belgrade Serbia and Montenegro
Epidemiology is study the relationship of between factors influencing diseases in human populations. Changes in the burden of diseases over time are of particular interest and concern that atopic diseases have been increasing, both in Europe and world-wide, over the past few decades (1).
The possibility for partial monitoring of the number of patients with allergy problems appears in 1998, when Torlak Institute-Department of Allergology started with in vitro diagnostics use Pharmacia UNI – CAP –100 SYSTEM (Uppsala, Sweden). 5360 adult and pediatric patients
were tested in the period between 1998 to 2002.
The test was performed on the subjects between ages 5 to 60 years. All subjects had a previously positive prick test results. Skin prick tests were performed with a standard battery (histamine phosphate, PBS, grass pollen, tree pollen, weed pollen, home dust, Dermatophagoides pteronyssinus, bed line dust, animal hair, mold, bacteriae, bee venom, wasp venom, hornet venom, cockroach) of glicerinated extracts (Torlak Institute, Belgrade).
Histamine phosphate at 1 mg/ml and PBS were used, respectively, as positive and negative controls. Specific IgE and total IgE detection of patients sera were performed by means of Pharmacia UNI-CAP-100 System (Uppsala, Sweden).The results were expressed as CAP scores from class 0 to 6, according to the manufacturer’s instruction.
The dominant inhalatory allergen is Dermatophagoides pteronyssinus ,d1, making about 21% of the total analyses performed. The next significant group of inhalatory allergen are grass pollen ,gx1, (10%) , then there
are weed pollen ,wx1, (8%), followed by tree pollen ,tx5, (3,6% )There is dominant allergen within each group of pollens. Within the grass pollen group, the dominant allergen is Dctylis glomerata ,g3, making
about 33% of the total anayses performed. Ambrosia ellatior ,w1,is a
dominant allergen in the weed allergen group making about 46% of the
total analyses performed , while the most frequent allergen within the
tee pllen group is the lime-tree,t208, about 12%.
The number of tested patients refers primarily to the bigger cities of Serbia in which allergology service is developed and it also directs us that must spread onto the entire territory of Serbia and Montenegro.
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THE BECLOMETAZONE’S IMPACT ON IMMUNE AND CYTOKIN STATUS OF PATIENTS WITH ALLERGIC RHINITIS
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