Clinical value of morphine, pholcodine and poppy seed IgE assays in drug-abusers and allergic people

BACKGROUND

The diagnosis of anaphylactic reactions due to opiates during anaesthesia can be difficult, since in most cases various drugs may have been administered. Detection of specific IgE to poppy seed might be a marker for sensitisation to opiates in allergic people and heroin-abusers. This study assessed the clinical value of morphine, pholcodine and poppy seed skin-prick and IgE determination in people suffering hypersensitivity reactions during anaesthesia or analgesia and drug-abusers with allergic symptoms.

METHODS

We selected heroin abusers and patients who suffered severe reactions during anaesthesia and analgesia from a database of 23,873 patients. The diagnostic yield (sensitivity, specificity and predictive value) of prick and IgE tests in determining opiate allergy was analysed.

RESULTS

Overall, 149 patients and 200 controls, mean age 32.9 ± 14.7 years, were included. All patients with positive prick to opiates showed positive prick and IgE to poppy seeds, but not to morphine or pholcodine IgE. Among drug-abusers, 13/42 patients (31%) presented opium hypersensitivity confirmed by challenge tests. Among non-drug abusers, sensitisation to opiates was higher in people allergic to tobacco (25%), P<.001. Prick tests and IgE against poppy seed had a good sensitivity (95.6% and 82.6%, respectively) and specificity (98.5% and 100%, respectively) in the diagnosis of opiate allergy.

CONCLUSIONS

Opiates may be significant allergens. Drug-abusers and people sensitised to tobacco are at risk. Both the prick and specific IgE tests efficiently detected sensitisation to opiates. The highest levels were related to more-severe clinical profiles.

Clinical significance of cross-reactivity between tobacco and latex

BACKGROUND

Allergen cross-reactivity between tobacco and other species of Solanaceae family (tomato, potato, aubergine and egg plant) have been reported. We have recently studied IgE response to tobacco in asthmatic patients sensitised to Lolium perenne (Perennial rye grass pollen) and have found that 30% of the tobacco responsive patients also have latex sensitisation.

OBJECTIVE

The aim of our study was to investigate the possibility of cross-reactivity between tobacco and latex in asthmatic patients with IgE response to latex.

METHODS

A study was performed on tobacco and latex exposure in 15 patients who suffered from asthma and latex sensitisation and who were randomly chosen from our database of latex-sensitive patients. To identify tobacco and latex as possible allergens that might cause clinical specific responses, all these patients were tested with prick-tests, specific IgE to tobacco, latex and related allergens, bronchial challenge, and patch tests with tobacco, latex and nicotine. Immunological response was evaluated with immunoblotting, immunoblotting-inhibition and EAST-inhibition tests.

RESULTS

Positive prick and bronchial challenge with specific IgE>0.35 kU/L to tobacco was demonstrated in 11 asthmatics who were also sensitised to rye grass. Tobacco IgE level was related with sensitisation to latex (p<0.002), but not to other vegetables belonging to the Solanaceae family. EAST-inhibition and immunoblotting-inhibition showed the existence of cross-reactivity between tobacco and latex.

CONCLUSIONS

Cross-reactivity exists between latex and tobacco allergens. Smoker patients with IgE response to tobacco may be a risk population for latex sensitisation.

Shewanella putrefaciens in a fuel-in-water emulsion from the Prestige oil spill

Microorganisms that colonize the fuel-in-water emulsion from the Prestige spill have been compared with those from Exxon-Valdez. Both emulsions contained non-fermentative gram-negative rods but unlike Exxon-Valdez's, the Prestige's spill contained anaerobic bacteria and no fungi. Our main finding has been the identification of Shewanella putrefaciens , a bacterium promising for bioremediation.

Enhancement of tomato allergenicity after treatment with plant hormones

BACKGROUND

Practical applications to enhance the productivity of agriculture by using plants with improved resistance to pathogens are expected to increase in the near future. Although tomato has been widely investigated for breeding purposes, there have been no studies on tomato allergenicity after plant hormones treatments.

METHODS

Prick by prick tests were carried out with different tomato samples (fruits grown under biological conditions without addition of chemical products, and treated with ethylene and salicylic acid) in eight patients with ages between 12 and 27 years who suffered from anaphylaxis episodes after eating raw tomatoes. An immunoblot experiment with the different tomato extracts was performed using sera from these eight patients and controls.

RESULTS

The wheals obtained in prick tests were significantly higher with the extracts of tomato treated with ethylene and SAA (chi(2) = 31.3, p < 0.0001) and the patients who presented higher wheal diameters in skin tests were those who had more severe episodes of anaphylaxis. Neither the protein stain nor the IgE immunodetection patterns clearly varied between the untreated and the hormone-treated samples.

CONCLUSIONS

In the case of anaphylaxis induced by tomato, the treatment with plant hormones induced a higher cutaneous response than with non-treated tomato, but the "in vitro" response was similar.

Scanning electron microscopy images and energy-dispersive X-ray microanalysis of the stapes in otosclerosis and Van der Hoeve syndrome

OBJECTIVE/HYPOTHESIS

The objective of this study was to evaluate the morphological and microchemical changes that affect sclerotic stapes in otospongiosis and van der Hoeve syndrome.

METHODS

A scanning electron microscope equipped with an energy-dispersive x-ray analyzer was used in the experiments.

RESULTS

In otosclerosis, focal lesions are poorly mineralized, with low calcium salt and reduced calcium-to-phosphorus (Ca/P) ratio (1.9:1). This finding correlates with a spongiotic type of lesion and indicates unstable mineralization with possible change from hydroxyapatite to calcium triphosphate. In van der Hoeve syndrome the presence of magnesium in stapes suggests osteoclastic function stimulation. The osteoclasts secrete many protons, causing an acidified microenvironment. Brushite is formed, and Ca/P ratio decreases in comparison with that of control patients (2.0:1 vs. 2.6:1).

Reference values and methods comparison of a new testosterone assay on the AxSYM system

OBJECTIVES

We have contributed to the Design Validation Protocol of the new Abbott AxSYM Testosterone assay with a study on reference values and methods comparison.

DESIGN AND METHODS

For reference values a population of 45 women and 30 men was tested. In methods comparison, 132 samples for the AxSYM vs. ACS-180, and 30 for the AxSYM vs. Elecsys were used. Pearson and intraclass concordance coefficients and Passing-Bablock test were performed for overall group, men and women.

RESULTS

Reference values were 0.9-3.1 (females) and 1.0-30.2 nmol/L (males). Globally, a good agreement between methods in both the AxSYM vs. ACS-180 (slope: 0.88, y-intercept: 0.67, r = 0.961) and the AxSYM vs. Elecsys (slope: 1.08, y-intercept: 0.31, r = 0.935) studies was found. Slightly worse results were observed for women.

CONCLUSIONS

The reference range of testosterone by the AxSYM system matches with those published for other methods. An acceptable agreement between the AxSYM Testosterone assay and both a classical (ACS-180) and a more recent (Elecsys) methodology was observed.

The first known use of vermillion

Vermillion has been shown to be useful in preserving human bones from 5000 years ago. Remarkably well-preserved human bones have been found in the dolmenic burial 'La Velilla' in Osorno (Palencia, Spain), carefully covered by pulverized cinnabar (vermillion) which ensured their preservation even in non-favorable climatic conditions. We believe the red powder was deliberately deposited for preservative use because no cinnabar mine is to be found within 160 km, because of the large amount (hundreds of kilograms) used, and because its composition, red mercuric sulphide, is similar to that of preparations used in technical embalming. This finding pushes back the data of the use of mercury ore for preservation by four millennia in South America, and by at least one millennium in the Old World. Chemical and thermal analyses of vermillion in La Velilla have demonstrated its great purity and shown that the cinnabar was pulverized and washed (but not heated), producing a bright red-orange tone.

Differential scanning calorimetry investigations on LPS and free lipids A of the bacterial cell wall

Differential scanning calorimetry (DSC) was used to investigate the thermal stability and behaviour of the lipopolysaccharides (LPS) of the outer membrane of Gram-negative bacteria and their lipid portion. DSC curves of LPS show thermal features between 200 and 129 degrees C (depolymerization) and between -13 and -36 degrees C (cooling phase transition). Both effects were related to the relative strength of the linkage types in the O-chain structure and to their capacity for intermolecular hydrogen bonding. DSC curves of lipids A show endotherm peaks between 40 and 24 degrees C, around 15 degrees C and between -23 and -4 degrees C. Based on these effects, strong differences in thermal behaviour can be observed between that of Brucella and Vibrio cholerae on the one hand, and that of Escherichia coli and Shigella flexneri on the other. Fluidity of the acyl chains and lyotropism, which are important parameters in expression of biological activities, are discussed using the above data. To explain some properties, fluidity could be related to the temperature of the gel<==>liquid crystalline (beta<==>alpha) phase transition, which occurs at physiological temperature. Nevertheless, fluidity could be related to temperature of the previous thermal effect (between 6 and 20 degrees C), for which a softening or partial melting of the sample has been evidenced. The thermal effect measured between -23 degrees C and -4 degrees C indicates a greatly reduced water concentration of lipid A from Brucella, thus explaining its early fusion process and its activity by means of hydrophobic interactions.

Thermolytical techniques to characterize fungal polysaccharides and bacterial lipopolysaccharides

The present work constitutes an entirely novel contribution in the scope of microbiology and especially in taxonomy, introducing thermolysis curves as a rapid method of characterization of fungal polysaccharides and bacterial lipopolysaccharides. The thermal analysis techniques applied were thermogravimetry and derivative thermogravimetry (TG-DTG), differential thermal analysis (DTA), and differential scanning calorimetry (DSC). Each thermogram of a sample is represented by one or a few temperatures and, in DSC, by complementary enthalpy data. The temperatures of the thermograms from structurally unknown polysaccharides are compared with those used as references, and thus, information on their composition, linkage types, and anomeric configuration can be deduced. The situation is more complicated for bacterial lipopolysaccharides, but in whatever mode, a structural estimation is always possible. In the course of the development and validation of the thermal method, structural findings on relative stabilities of linkage types (valuable in carbohydrate research) have been recognized and are therefore also described in this work.