In vitro cross-allergenicity of major aeroallergenic pollens by the radioallergosorbent technique

Prospective evaluation of chymopapain sensitivity in patients undergoing chemonucleolysis

Immediate anaphylactic reactions after intradiscal chymopapain (CP) injection may occur in 1% of patients undergoing chemonucleolysis (CN). Skin prick testing to CP (10 mg/ml), a prescreening history, and CP serum-specific IgE determinations by the RAST method were performed in order to identify patients presensitized to CP before CN. Follow-up repeat CP skin testing and serum-specific IgE were done 2 to 6 weeks after CN to detect CP IgE-mediated sensitization resulting from the injection. Three of 84 patients who exhibited positive skin tests to CP before CN did not receive CP injections. Only one of the three patients (33%) was detected with elevated CP serum-specific IgE before CN. No immediate severe anaphylactic reactions caused by CP injection were encountered in the remaining 81 patients with negative CP skin tests and RASTs before CN. Eight (10%) nonlife-threatening immediate and late reactions were associated with conversion from negative skin tests and RASTs before CN to positive skin tests or RASTs after CN. Overall, 19 of 52 (37%) patients who returned for follow-up testing developed cutaneous sensitization to CP after CN. Despite the fact that RAST values after CN in these patients were significantly higher (p less than 0.002) than those with negative skin tests after CN, the sensitivity of the RAST was only 72% for identifying patients who developed positive CP skin tests after CN. This study demonstrated that CP skin testing is essential for prescreening patients because it was more sensitive than RAST for identification of CP sensitivity both before and after CN. Late allergic reactions and cutaneous sensitization to CP were common sequelae of CN.

Allergy in the Mediterranean area. I. Pollen counts and pollinosis of Montpellier

The climatic conditions of the Mediterranean area result in vegetation and pollen very different from that of the other parts of Europe. The pollen content of the atmosphere of Montpellier, southern France, was examined using a filter sampler which was shown to be more efficient than most of the current devices for air sampling. Pollen counts were subsequently compared with pollinosis of patients born and living in and around Montpellier. The mean annual pollen counts showed that grass pollens and Cupressaceae pollens (cypress and juniper) are the highest. Some Mediterranean pollens (Oleaceae, London plane, Parietaria) are also important. Plantain and oak pollens are also present in relatively large amounts. Grass pollen allergy was found to be present in 86.5% of pollen-allergic patients. It was followed by plantain, Parietaria, Oleaceae, London plane and Cupressaceae pollens which were allergenic in 13-36% of pollen-allergic patients. Oak and pine pollens were present in large quantities in the counts but few persons were sensitive to oak and none to pine. By contrast, some patients had positive skin tests to alfalfa, red clover, acacia and lime tree pollens though these pollens were almost absent from the counts. In a few cases local sources of these pollens could account for the positive skin tests but cross-sensitivities could also occur. In summary, pollinosis of the Northern Mediterranean area is intermediate between the southern part of the area and the other parts of Europe.

Characterization of grass pollen allergens by affinity chromatography on Concanavalin A-Sepharose

Glycoprotein allergens of different carbohydrate composition can be separated by lectin interaction in affinity chromatography. The present study shows that several differences exist in the sugar moiety both within the species and between different grass species. Experiments with Bermuda grass and common reed indicate that these 2 extracts possess allergens with a high affinity for Con A-Sepharose. This offers a simple and rapid method for isolation and purification of the major allergenic components of these 2 species in combination with more conventional separation techniques. The purity of single allergens may vary markedly depending on the occurrence of other interfering, non-allergenic substances having free terminal alpha-D-mannopyranoside or alpha-D-glycopyranoside residues which bind to the immobilized lectin.

Cross-reactivity between Acacia (wattle) and rye grass pollen allergens. Detection of allergens in Acacia (wattle) pollen

Immunoglobulin E (IgE), directed against components of Acacia (wattle) pollen, has been detected by radioallergosorbent tests (RAST) in the sera of some children and adults who develop allergic symptoms in the presence of flowering Acacia trees in Australia. All these subjects also had high levels of IgE directed against Lolium perenne (rye grass) pollen. Inhibition by RAST showed that most of the IgE molecules which bound to Acacia pollen components also bound to L. perenne pollen extracts, and to Glycoprotein 1, the major allergen of L. perenne pollen. In these assays, the allergens have been immobilized on polyvinyl chloride microtitre trays: the sensitivity of this approach is compared to that of commercial RAST kits.

Investigation of the involvement of Echium plantagineum (Paterson's curse) in seasonal allergy. IgE antibodies to Echium and other weed pollens

The possible allergenicity of an insect pollinated weed, Echium plantagineum, was investigated in a rural area of Australia. Sixty-one subjects with respiratory allergy were studies. Positive skin test reactions to defatted ammonium bicarbonate extract of pollen were found in over 60% of subjects, and positive RAST tests in a similar number. The question of crossreactivity between weed pollens is discussed. The pollen of E. plantagineum was shown to reach the atmosphere in significant amounts about 1 month before the peak grass pollinating period. Evidence that the pollen of E. plantagineum becomes airborne and elicits an IgE response suggests that further attention should be directed to weed pollens as potential allergens.

Common components in pollen extracts

In order to evaluate the clinical relevance of testing with various pollen extracts in a multi-center investigation from Denmark, 5,052 patients were skin prick tested with the anamnestically relevant extract from a battery of 48. With the aid of a computer program comparing the extracts, two by two calculations were made over the percentage of patients reacting against allergens present in both extracts. Pollen extracts which frequently produce reaction were divided into three separate groups (tree pollen, grass pollen and herb pollen) within which common allergens were so dominant that it seemed advisable in routine examinations to use one extract and one extract only from each group.

Skin prick test reactivity to common allergens in Finnish adolescents

We studied 708 adolescents aged 15-17 years in the 9th grade of school in Imatra. Of the eligible population born in 1962 77% were included. All were skin prick tested with 16 extracts from two manufacturers with 12 common allergens, which included pollens, epithelia, mite, house dust and fish. At least one positive, immediate reaction (weal diameter 3 mm or larger) occurred in 49% and at least two positive reactions in 43% of those studied. The boys were observed to be significantly more reactive than the girls. The allergen preparations to which positive reactions were most prevalent were house dust, cat and horse epithelium, and mite extract. Large differences in the prevalence of positive reactions were observed with different preparations of the same allergen. Pollen allergens tended to cause the largest positive weal reactions, and the weal size distribution with some pollens was distinctly bimodal. A scheme for calculating allergen potency in histamine-equivalent-prick (HEP) units is presented. It is noted that the result is greatly dependent on the population group chosen for testing.

Allergy to coriander. A case report

After 3 years of occupational exposure to powdered coriander - a spice - a woman developed respiratory symptoms of immediate hypersensitivity. Skin tests, nasal and bronchial challenge tests and the RAST were positive to coriander. Column chromatography, enzymatic digestion of the fractions and skin testing suggested that the allergen is a protein.

Species specific grass pollen sensitivity: diagnosis and treatment with single grass species Allpyral vaccines

Skin test titrations and nasal provocation tests in sixty patients with hay fever showed specific reactions to extracts of individual grass species. There was, however, no correlation between skin and nasal sensitivity. Repeat testing after treatment with Allpyral vaccines consisting of only the grass species to which the nasal reaction was most severe, or only one of several pollens to which reactions were equally severe, showed marked diminution of skin and nasal sensitivity not only to the single pollen used for immuno-therapy but to all five common pollens used in the Allpyral grass mix. Clinical results seemed much improved as compared with results in the same year for Allpyral five grass mix vaccines, especially in the case of patients treated with Timothy, rye, or cocksfoot. It was concluded that these three grassees were to be preferred for treatment in England, and that these grasses contain common allergens.

IgE mediated hypersensitivity to pancreatic extract (PE) in parents of cystic fibrosis (CF) children

On exposure to pancreatic extract (PE), four parents of cystic fibrosis (CF) children developed immediate hypersensitivity-like symptoms: i.e. rhinoconjunctivitis, asthma, and/or anaphylaxis. IgE to PE was demonstrated in the subjects by skin testing, leucocyte histamine release and radioallergosorbent test (RAST). No serum precipitating antibodies were found. Bronchial challenge caused an immediate asthmatic response. No delayed asthmatic response or hypersensitivity pneumonitis-like reaction occurred. The responsible antigen for PE induced asthma is unknown; trypsin failed to inhibit PE-RAST and is therefore not responsible in these subjects. Caution should be exercised in using PE for skin testing and bronchial challenge in subjects with suspected hypersensitivity to PE. Certain measures were found useful in preventing the occurrence of symptoms in the four subjects.

[Studies on antigenic relationship between grass- and cult. rye pollens by skin-test, RAST and RAST-inhibition-test in patients with pollinosis (author's transl)]

Skin tests on patients suffering from pollinosis suggest frequently an antigenic relationship between various grass and cult. rye pollens. This problem was further studied using both, RAST and RAST inhibition test. The tests were performed with commercial grass pollen discs as well as with self-prepared disc labeled with cult. rye pollens and a combination of various grass antigens. Good agreement was found between self-made and commercial (single antigen) grass pollen discs (95.9%). RAST and skin test correlated also extremely well (92.3%). Mutual inhibition between grass and cult. rye pollens was measured by RAST inhibition test using self-prepared discs. High antigenic relationship between grass and cult. rye pollens was found, however, it could be demonstrated that the antibody pattern varies and contains "grass specific" antibodies.

An approach to diagnosis and treatment in the migrant allergic population

An approach to allergy diagnosis and treatment in the migrant population of the United States is derived from a review of selected aspects of pollen aerobiology and the nature and distribution of allergenic plants. Pollen distribution and importance are defined and divided into four relatively homogenous geographic regions of the continental United States. Botanic relationships between pollens are then summarized, especially as they relate to the methodology and results of studies of antigenic relationships between pollens. From this information, 13 mixes of tree pollens, 12 mixes of grass pollens, and 12 mixes of week pollens are proposed which would include the pollens of major and secondary importance found in the four defined geographic regions and which would be appropriate for puncture testing. Further grouping of antigens is described for use in intradermal testing and formulating treatment mixtures. A sample skin test sheet is presented which summarizes this information in a practical format.