Upper and lower respiratory airway complaints among female veterinary staff

Objective

Working with animals is characterized by exposure to particulate, biological or chemical matter, and respiratory complaints are common. The aim of our cross-sectional study was to assess the prevalence of respiratory symptoms and diagnoses among veterinary staff.

Methods

Participants working in veterinary practices were examined and a detailed questionnaire was used to collect data. IgE tests to common and animal allergens were performed to specify sensitization. Associations with respiratory outcomes were analysed using logistic regression models while controlling for potential confounders.

Results

Atopy was seen in 31% of the 109 female participants. Symptoms of rhinoconjunctivitis were the most frequent complaints (n = 92; 84%). In 18% the diagnosis was confirmed by physicians. Symptoms of upper and lower airways were highly correlated and an asthma diagnosis was confirmed in 11% of participants. Modelling revealed that sensitization against cats/dogs was a significant risk factor for respiratory symptoms of upper [odds ratio (OR) 4.61; 95% confidence interval (CI) 1.13–18.81] and lower airways (OR 5.14; 95% CI 1.25–21.13), physician-confirmed rhinoconjunctivitis (OR 13.43; 95% CI 1.69–106.5) and asthma (OR 9.02; 95% CI 1.16–70.39) in assistant staff of small-animal practices.

Conclusions

In several cases, rhinoconjunctivitis worsened after entering the profession. Atopy and specific sensitization to cats/dogs were risk factors for health impairments. Thus, to implement preventive measures, veterinary practice staff should be educated that upper respiratory tract symptoms are not harmless and should be diagnosed and treated early.

Discrimination Between Atopic, Allergic, and Asthmatic Volunteers for Human Exposure Studies on Sensory Irritation

Atopic, allergic, and especially asthmatic subjects might be particularly susceptible to sensory irritation induced by airborne chemicals compared to healthy individuals. Therefore, a good characterization of subjects is essential in inhalation exposure studies on sensory irritants. A total of 105 volunteers, 87% of whom reported to be non-allergic, participated in a medical examination that included skin prick test (SPT), measurements of total IgE, specific IgE (sIgE) to an ubiquitous allergen mix (sx1), and fractionated exhaled nitric oxide (FeNO), as well as pulmonary function and methacholine test. The median value of sIgE to sx1 was 0.20 kU/L (0.07-91.3 kU/L) and correlated significantly with total IgE (28.8 kU/L (2-756 kU/L)) and FeNO (14 ppb (5-100 ppb)). Forty-three subjects (41%) had sIgE to sx1 ≥ 0.35 kU/L and were classified as atopic. Thirty-five subjects, all also sx1-positive, were positive in SPT. Obstruction, small airway disease, and/or bronchial hyperreactivity were diagnosed in 18 subjects. Receiver operating characteristics (ROC) were performed to check whether signs of sensitization are useful to discriminate subjects with and without airway diseases. However, sx1, total IgE, FeNO, and SPT reached only low areas under the curve (AUC: 0.57-0.66). Although predominantly young and, according to their own statements, mostly non-allergic subjects participated in the study, almost half of them were atopic, and 10% had airway disease or bronchial hyperreactivity. This indicates that the validity of self-reported data might be inaccurate. In summary, diversified investigations of the allergy-related health status appear necessary for a thorough characterization of subjects for exposure studies on sensory irritants.

Respiratory diseases and allergy in farmers working with livestock: a EAACI position paper

Farmers constitute a large professional group worldwide. In developed countries farms tend to become larger, with a concentration of farm operations. Animal farming has been associated with negative respiratory effects such as work-related asthma and rhinitis. However, being born and raised or working on a farm reduces the risk of atopic asthma and rhinitis later in life. A risk of chronic bronchitis and bronchial obstruction/COPD has been reported in confinement buildings and livestock farmers. This position paper reviews the literature linking exposure information to intensive animal farming and the risk of work-related respiratory diseases and focuses on prevention. Animal farming is associated with exposure to organic dust containing allergens and microbial matter including alive microorganisms and viruses, endotoxins and other factors like irritant gases such as ammonia and disinfectants. These exposures have been identified as specific agents/risk factors of asthma, rhinitis, chronic bronchitis, COPD and reduced FEV₁. Published studies on dust and endotoxin exposure in livestock farmers do not show a downward trend in exposure over the last 30 years, suggesting that the workforce in these industries is still overexposed and at risk of developing respiratory disease. In cases of occupational asthma and rhinitis, avoidance of further exposure to causal agents is recommended, but it may not be obtainable in agriculture, mainly due to socio-economic considerations. Hence, there is an urgent need for focus on farming exposure in order to protect farmers and others at work in these and related industries from developing respiratory diseases and allergy.

Mold Sensitization in Asthmatic and Non-asthmatic Subjects Diagnosed with Extract-Based Versus Component-Based Allergens

Asthmatic patients are suspected of having a higher risk of mold sensitization. Thus, precise diagnosis of fungal sensitization is important. Mold allergen extracts are difficult to standardize, but component-resolved allergy diagnosis may be an alternative to replace extract-based tests. In this research, asthmatic and non-asthmatic subjects were studied for their sensitization to Aspergillus fumigatus (Asp f), Cladosporium herbarum (Cla h), Penicillium chrysogenum (Pen ch), Alternaria alternata (Alt a), and Aspergillus versicolor (Asp v). Extract-based tests were applied using the skin prick test (SPT) and allergen-specific immunoglobulin E (sIgE). Subjects with extract-based sensitization to Asp f or Alt a were further investigated for sIgE response to recombinant (r) single mold allergens. At least one mold sensitization was found in about 50% of asthmatic and non-asthmatics with the most frequent sensitization to Alt a, followed by Pen ch, Asp f, Cla h, and Asp v. Interestingly, sensitization rate to individual mold species was always higher in asthmatics and was only significant for Pen ch. The component-resolved diagnosis with the sum of rAsp f 1 - rAsp f 4 plus rAsp f 6 matched the extract-based results (SPT and/or sIgE) in 50% of asthmatics and 46% of non-asthmatics, whereas, rAlt a 1 covered 59% of asthmatics and 50% non-asthmatics of extract-based Alt a sensitization. In conclusion, individual fungal sensitization rate was higher in asthmatics compared to non-asthmatics. Extract-based tests, especially SPTs, were most sensitive, but component-based tests covered 80% of extract-based serological sensitization to Alternaria and Aspergillus.

Impact of Internal and External Factors on EBC-pH and FeNO Changes in Humans Following Challenge with Ethyl Acrylate

Acute effects of ethyl acrylate exposure at 5 ppm for 4 h include changes of pH in exhaled breath condensate (EBC-pH) and exhaled nitric oxide (FeNO). So far, few data have been reported for atopic persons or the impact of the exposure conditions on biomarkers, e.g., constant versus variable application of irritants. Nine atopic and eighteen healthy volunteers without bronchial hyperresponsiveness were exposed for 4 h to ethyl acrylate concentrations of 0.05 ppm (sham), 5 ppm (constant concentration), and 0-10 ppm (variable, mean concentration of 5 ppm) in an exposure laboratory. A positive atopic status was defined according to specific IgE concentrations to common inhalant allergens (sx1 ≥ 0.35 kU/L). Biomarker levels were assessed before and after challenge and adjusted for levels after sham exposure (net response). Ethyl acrylate at constant, but not at variable concentrations induced a significant change in the net responses of EBC-pH and FeNO. Concerning FeNO, this could be observed only for atopic persons. The changes of biomarker levels were related to their baseline values. Biomarker responses to challenge with ethyl acrylate may be influenced by the patterns of application as well as baseline airway inflammation and atopic status of the volunteers.

Baker's Asthma: Is the Ratio of Rye Flour-Specific IgE to Total IgE More Suitable to Predict the Outcome of Challenge Test Than Specific IgE Alone

Usually the diagnosis of baker's asthma is based on specific inhalation challenge with flours. To a certain extent the concentration of specific IgE to flour predicts the outcome of challenge test in bakers. The aim of this study was to evaluate whether the ratio of specific IgE (sIgE) to total IgE (tIgE) improves challenge test prediction in comparison to sIgE alone. Ninety-five bakers with work-related respiratory symptoms were challenged with rye flour. Total IgE, sIgE, and the sIgE/tIgE ratio were determined. Receiver operator characteristic (ROC) plots including the area under the curve (AUC) were calculated using the challenge test as gold-standard. Total IgE and sIgE concentrations, and their ratio were significantly higher in bakers with a positive challenge test than in those with a negative one (p < 0.0001, p < 0.0001, and p = 0.023, respectively). In ROC analysis, AUC was 0.83 for sIgE alone, 0.79 for tIgE, and 0.64 for the ratio. At optimal cut-offs, tIgE, sIgE, and the ratio reached a positive predicted value (PPV) of 95%, 84% and 77%, respectively. In conclusion, calculating the ratio of rye flour-sIgE to tIgE failed to improve the challenge test prediction in our study group.

Indoor allergen levels in settled airborne dust are higher in day-care centers than at home

BACKGROUND

Early-life sensitization to indoor allergens predicts asthma development. The aim of this study was to compare allergen concentrations in day-care centers (DCC) with those in private homes.

METHODS

Settled airborne dust was collected 4 times a year from 20 German DCC (620 samples) and from the homes of children and day-care workers (602 samples) using electrostatic dust collectors (EDC). The samples were analyzed with fluorescence enzyme immunoassays recognizing domestic mite allergens (DM), Fel d 1, Can f 1, and Mus m 1. Pet allergen thresholds that discriminate samples from homes with cats or dogs from those without were calculated using receiver-operating characteristics. Influences on allergen levels were analyzed using multilevel models.

RESULTS

Allergen loads were on average higher in DCC than in homes. In DCC, 96% of the samples were positive for DM, 95% for Can f 1, 90% for Fel d 1, and 83% for Mus m 1. In homes, 84% contained DM, 48.5% Can f 1, 33% Fel d 1, and 43% Mus m 1. The threshold level for homes with dogs was 75 ng/m² Can f 1 (96.8% sensitivity, 96% specificity), and the threshold level for homes with cats was 46 ng/m² Fel d 1 (92% sensitivity, 94.9% specificity). In DCC, Can f 1 and Fel d 1 loads were higher than these thresholds in 37% and 54% of the samples, respectively. Allergen levels were significantly influenced by the season and room type; however, carpets on floors had no influence.

CONCLUSIONS

Mite, mouse, cat, and dog allergens were mostly higher in DCC than in homes. Exposure to dog and cat allergens in DCC often reached levels of households with pets.

Pigeon tick bite: A neglected cause of idiopathic nocturnal anaphylaxis

Anaphylaxis is a serious systemic allergic reaction with rapid onset and potentially life-threatening. We report in detail a case of severe nocturnal anaphylaxis due to pigeon tick bite showing the diagnostic value of the extract and the recombinant allergen in the diagnostic procedures (basophil activation test, IgE immunoblot, and experimental ImmunoCAP). Apart from the presented case, we describe that during the last 10 years, we have collected 28 cases of allergy to Argas reflexus from several European countries. We suspect that this allergy is underdiagnosed because of the lack of diagnostic reagents. Because of the growing number of pigeons in Middle and Southern Europe cities, some cases of idiopathic anaphylaxis could potentially be caused by A. reflexus in those countries. The identification of pigeon ticks as a trigger of anaphylaxis would greatly improve medical care and advice for these patients as the parasite can be exterminated by eradication measures to avoid further incidents.

Validation of ELISA methods for quantification of the major birch allergen Bet v 1 (BSP090)

To date, the potency of allergen products in Europe is expressed in manufacturer-specific units relative to a product-specific in-house reference. Consequently, cross-product comparability of allergen products from different manufacturers with respect to strength and efficacy is impossible. The Biological Standardisation Programme (BSP) project BSP090 addresses this issue via the establishment of reference standards in conjunction with ELISA methods for the quantification of major allergens in allergen products. Since the initiation of BSP090, the recombinant major allergen Bet v 1 has been adopted by the European Pharmacopoeia Commission as a Chemical Reference Substance (CRS). In parallel, two sandwich ELISA systems for quantification of Bet v 1 were found suitable in preliminary phases of BSP090 to be validated in a large collaborative study. In this study, the candidate ELISA systems were compared with respect to accuracy, precision and variability. Thirteen participating laboratories tested model samples containing the CRS as well as spiked and unspiked birch pollen extracts. Both in pre-testing and in the collaborative study, the 2 candidate ELISA systems confirmed their suitability to quantify recombinant and native Bet v 1. As no clear-cut decision for one of the ELISA systems could be made based on the results of the collaborative study, a post-study testing was performed. Bet v 1 content of 30 birch pollen allergen products was determined in parallel in both ELISA systems. Consequently, 1 candidate ELISA system was selected to be proposed as the future European Pharmacopoeia standard method for Bet v 1 quantification.

The role of allergen components for the diagnosis of latex-induced occupational asthma

BACKGROUND

Recombinant Hevea brasiliensis (rHev b) natural rubber latex (NRL) allergen components have been developed to assess the patients' allergen sensitization profile and to improve the diagnosis of NRL allergy.

OBJECTIVE

To examine whether the determination of specific IgE (sIgE) reactivity to a panel of recombinant allergen components would be helpful for diagnosing NRL-induced occupational asthma (OA) in predicting the outcome of a specific inhalation test.

METHODS

sIgE levels to NRL extract and 12 recombinant NRL allergen components were assessed in 82 subjects with OA ascertained by a positive specific inhalation challenge (SIC) with NRL gloves and in 25 symptomatic subjects with a negative challenge.

RESULTS

The sensitivity, specificity, positive predictive value, and negative predictive value of a NRL-sIgE level ≥0.35 kUA /l as compared to the result of SICs were 94%, 48%, 86%, and 71%, respectively. The positive predictive value increased above 95% when increasing the cutoff value to 5.41 kUA /l. Subjects with a positive SIC showed a significantly higher rate of sIgE reactivity to rHev b 5, 6.01, 6.02, and 11 than those with a negative SIC. A sIgE sum score against rHev b 5 plus 6.01/6.02 ≥ 1.46 kUA /l provided a positive predictive value >95% with a higher sensitivity (79%) and diagnostic efficiency (Youden index: 0.67) as compared with a NRL-sIgE ≥5.41 kUA /l (49% and 0.41, respectively).

CONCLUSION

In suspected OA, high levels of sIgE against rHev b 5 combined with rHev b 6.01 or 6.02 are the most efficient predictors of a bronchial response to NRL.

Occupational hypersensitivity pneumonitis: an EAACI position paper

The aim of this document was to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose practical guidance for the diagnosis and management of this condition. Occupational hypersensitivity pneumonitis (OHP) is an immunologic lung disease resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli, and surrounding interstitial tissue which develops as the result of a non-IgE-mediated allergic reaction to a variety of organic materials or low molecular weight agents that are present in the workplace. The offending agents can be classified into six broad categories that include bacteria, fungi, animal proteins, plant proteins, low molecular weight chemicals, and metals. The diagnosis of OHP requires a multidisciplinary approach and relies on a combination of diagnostic tests to ascertain the work relatedness of the disease. Both the clinical and the occupational history are keys to the diagnosis and often will lead to the initial suspicion. Diagnostic criteria adapted to OHP are proposed. The cornerstone of treatment is early removal from exposure to the eliciting antigen, although the disease may show an adverse outcome even after avoidance of exposure to the causal agent.

How to diagnose mould allergy? Comparison of skin prick tests with specific IgE results

BACKGROUND

Diagnosis of mould allergy is complicated due to the heterogeneity of the test material and the decrease in the number of commercial mould skin test solutions that are currently available.

OBJECTIVES

The aim of this study was to compare skin prick tests (SPT) from different manufacturers to one another and concurrently with sIgE tests for Aspergillus fumigatus (Asp f), Cladosporium herbarum (Cla h), Penicillium chrysogenum (Pen ch), Alternaria alternata (Alt a) and Aspergillus versicolor (Asp v) to ascertain a feasible diagnostic procedure for mould sensitization.

METHODS

In this multi-centre study, 168 patients with mould exposure and/or mould-induced respiratory symptoms were included. Mould SPT solutions were analysed biochemically and tested in duplicate on patients' arms. Specific IgE (sIgE) concentrations to corresponding mould species and mould mix (mx1) were measured by ImmunoCAP. SPTs in accordance with one another and with sIgE were further considered. The test efficiency was calculated using receiver-operating characteristic (ROC) analysis.

RESULTS

Mould sensitization was more frequently detected by the SPT (90 of 168) than by the sIgE tests (56 of 168). Concordances of double SPT positives were only sufficient (≥ 80%) for environmental allergens, two Asp f and three Alt a SPT solutions, whereas all other mould solutions revealed concordances < 80%. The antigen content of SPT solutions was positively associated with concordant SPT double values as well as with sIgE. Taking sIgE as the 'positive standard', all mould SPT solutions revealed test efficiencies > 80%, but varied up to 20% in sensitivity and positive predictive value with the exception of Alt a.

CONCLUSIONS

SPT solutions are sensitive and essential diagnostic tools for the detection of mould sensitization. Our recommendation for diagnosis would be to test at least Alt a, Asp f and Pen ch using SPT and additional sIgE test to mx1.

EAACI Molecular Allergology User's Guide

The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.

Quantification of obeche wood allergen: Development of a sensitive sandwich-ELISA for occupational exposure assessment

Obeche wood is a prominent cause of allergic occupational asthma. To reduce the risk of immunoglobulin E (IgE)-mediated sensitization it is important to assess airborne obeche wood allergen concentrations at exposed workplaces. Therefore, a highly sensitive obeche wood allergen immunoassay was developed and applicability was proven on airborne passive dust samples in Spanish wood workshops. Obeche wood sandwich enzyme-linked immunosorbent assay (ELISA) polyclonal antibodies (pAbs) were developed. Test specificity was verified by different wood and mold extracts. Obeche wood allergen monitoring was conducted in four Spanish wood workshops, including wood-dust-exposed and nonexposed areas inside and outside the workplaces, as well as controls. Dust was collected with electrostatic dust collectors (EDC). Measuring range of the obeche wood sandwich-ELISA was between 36 pg/ml and 1.6 µg/ml. The test system showed only marginal reactivity to other hardwoods and no reactivity to softwoods and molds. Obeche allergen was detected in all EDC from workplaces. The highest concentration was measured in the workshop with the longest obeche wood exposure (geometric mean [GM]: 7548 µg/m²); shorter obeche wood processing periods resulted in lower amounts of allergen (GM: 29 µg/m²). Obeche wood allergen transfer from exposed workplaces to nonexposed areas inside and outside the workshop was assessed. In control EDC from nonexposed facilities/homes no obeche wood allergen was found. The new obeche wood sandwich-ELISA is a valid tool to quantify obeche allergen exposure. Evidence indicates it will be possible to monitor obeche allergen exposure during different processes, as well as transfer effects in nonexposed areas.

Prevalence of work-related rhino-conjunctivitis and respiratory symptoms among domestic waste collectors

Waste collectors may suffer from acute and chronic health effects caused by organic dust (bioaerosols). Pathophysiological symptoms may originate either from allergic or irritative pathomechanisms, but an explicit distinction of the etiology is often complicated although crucial for proper risk assessment and workplace prevention. In this cross-sectional study, a total of 69 male waste collectors from the Ruhr area in Germany underwent a customized testing protocol including a modified questionnaire, basic clinical examination, spirometry, and immunologic parameters. Subjects were classified according to their work tasks into loaders (n=27), floaters (n=29), and drivers (n=13). We found that a high percentage of the workers had complaints (eyes 29.0%, nose 39.1%, and cough 34.8%) which were strongly work-related. Multiple logistic regression analyses indicated that duration of employment in waste collection (per 10 years) was associated with an increased prevalence of cough (OR=1.64, 95% CI 0.81; 3.35) and chronic bronchitis (OR=2.18, 95% CI 0.80; 5.92). An association between rhinitis and cough (OR=2.62, 95% CI 0.94; 7.27) was found, which supports the association between the prevalence of upper and lower airway disease. Furthermore, when adjusting for smoking status, atopic subjects suffered more frequently from irritation of the lower airways as indicated by cough (OR=2.71, 95% CI 0.91; 8.08). In conclusion, the study demonstrates associations between the prevalence of upper and lower airway disease in waste collectors. Notably, an underlying allergic disease in waste collectors could be suspected more commonly than previously reported.

Cow hair allergen concentrations in dairy farms with automatic and conventional milking systems: From stable to bedroom

Bovine hair and dander are considered to be a notable risk factor for sensitization and allergic symptoms in occupationally exposed cattle farmers due to various IgE binding proteins. Farmers are suspected not only to be exposed during their work inside the stables but also inside their homes as allergens could be transferred via hair and clothes resulting in continued bovine allergen exposure in private areas. In recent years a new sensitive sandwich ELISA (enzyme linked immunosorbent assay) test has been developed to measure the cow hair allergen (CHA) concentration in dust. The aim of the present study was to determine the CHA concentration in airborne and settled dust samples in stables and private rooms of dairy cattle farms with automatic milking systems (AM) and conventional milking systems (CM), also with respect to questionnaire data on farming characteristics. For this purpose different sampling techniques were applied, and results and practicability of the techniques were compared. Dust sampling was performed in the stable, computer room (only AM), changing room, living room and bedroom (mattress) of 12 dairy farms with automatic milking systems (AM group) and eight dairy farms with conventional milking systems (CM group). Altogether, 90 samples were taken by ALK filter dust collectors from all locations, while 32 samples were collected by an ion charging device (ICD) and 24 samples by an electronic dust fall collector (EDC) in computer rooms (AM) and/or changing and living rooms (not stables). The dust samples were extracted and analyzed for CHA content with a sandwich ELISA. At all investigated locations, CHA concentrations were above the limit of detection (LOD) of 0.1 ng/ml dust extract. The median CHA concentrations in dust collected by ALK filters ranged from 63 to 7154 μg/g dust in AM farms and from 121 to 5627 μg/g dust in CM farms with a steep concentration gradient from stables to bedrooms. ICD sampling revealed median CHA contents of 112 μg/g airborne dust in the computer rooms of the AM farms and median CHA loads of 5.6 μg/g (AM farms) and 19.8 μg/g (CM farms) in the living rooms. Passive dust sampling by EDC was performed only at two locations in the AM group resulting in median CHA values of 116 μg/m(2) (computer room) and 55.0 μg/m(2) (changing room). Except for the stable samples the median CHA load was lower in AM farms compared to CM farms. The CHA contents of ALK filter samples were significantly correlated in most locations. Differences between the farming types were not significant. Although allergen transfer to the private area of the farmers has been found and results from several locations were correlated, differences in CHA concentrations were not significant with respect to questionnaire data such as the wearing of stable clothes in living room, free access of pets to stable and home, frequency of hair washing. All sampling techniques seem to being practicable for simple and effective CHA measurement.

[Cockroaches and co. The role of health pests as allergen source]

In most of the cases health pests are carriers of pathogens or parasites which have a negative impact on human health or affect the health of other mammals. What is lesser known is that they can also act as allergens. Most of the health pests in this sense belong to the arthropods, such as cockroaches (Blattaria), mosquitos (Culiciformia), lice (Pediculus humanus corporis), fleas (Siphonaptera) and ticks (Argasidae). In the group of vertebrates rats (Rattus norvegicus and Rattus rattus), house mice (Mus musculus) and pigeons (Columba livia domestica) are also classified as health pests. Also storage pests which are not carriers of pathogens can induce secondary infestation with hygiene pests or molds and have an underestimated impact on human health. In this article selected examples of health pests and also storage pests as an allergen source are described, taking into account the sensitization prevalence and identified single allergens.

Occupational anaphylaxis--an EAACI task force consensus statement

Anaphylaxis is a systemic allergic reaction, potentially life-threatening that can be due to nonoccupational or, less commonly, to occupational triggers. Occupational anaphylaxis (OcAn) could be defined as anaphylaxis arising out of triggers and conditions attributable to a particular work environment. Hymenoptera stings and natural rubber latex are the commonest triggers of OcAn. Other triggers include food, medications, insect/mammal/snake bites, and chemicals. The underlying mechanisms of anaphylactic reactions due to occupational exposure are usually IgE-mediated and less frequently non-IgE-mediated allergy or nonallergic. Some aspects of work-related allergen exposure, such as route and frequency of exposure, type of allergens, and cofactors may explain the variability of symptoms in contrast to the nonoccupational setting. When assessing OcAn, both confirmation of the diagnosis of anaphylactic reaction and identification of the trigger are required. Prevention of further episodes is important and is based on removal from further exposure. Workers with a history of OcAn should immediately be provided with a written emergency management plan and an adrenaline auto-injector and educated to its use. Immunotherapy is recommended only for OcAn due to Hymenoptera stings.

Monitoring of occupational and environmental aeroallergens-- EAACI Position Paper. Concerted action of the EAACI IG Occupational Allergy and Aerobiology & Air Pollution

Exposure to high molecular weight sensitizers of biological origin is an important risk factor for the development of asthma and rhinitis. Most of the causal allergens have been defined based on their reactivity with IgE antibodies, and in many cases, the molecular structure and function of the allergens have been established. Significant information on allergen levels that cause sensitization and allergic symptoms for several major environmental and occupational allergens has been reported. Monitoring of high molecular weight allergens and allergen carrier particles is an important part of the management of allergic respiratory diseases and requires standardized allergen assessment methods for occupational and environmental (indoor and outdoor) allergen exposure. The aim of this EAACI task force was to review the essential points for monitoring environmental and occupational allergen exposure including sampling strategies and methods, processing of dust samples, allergen analysis, and quantification. The paper includes a summary of different methods for sampling and allergen quantification, as well as their pros and cons for various exposure settings. Recommendations are being made for different exposure scenarios.

EAACI position paper: irritant-induced asthma

The term irritant-induced (occupational) asthma (IIA) has been used to denote various clinical forms of asthma related to irritant exposure at work. The causal relationship between irritant exposure(s) and the development of asthma can be substantiated by the temporal association between the onset of asthma symptoms and a single or multiple high-level exposure(s) to irritants, whereas this relationship can only be inferred from epidemiological data for workers chronically exposed to moderate levels of irritants. Accordingly, the following clinical phenotypes should be distinguished within the wide spectrum of irritant-related asthma: (i) definite IIA, that is acute-onset IIA characterized by the rapid onset of asthma within a few hours after a single exposure to very high levels of irritant substances; (ii) probable IIA, that is asthma that develops in workers with multiple symptomatic high-level exposures to irritants; and (iii) possible IIA, that is asthma occurring with a delayed-onset after chronic exposure to moderate levels of irritants. This document prepared by a panel of experts summarizes our current knowledge on the diagnostic approach, epidemiology, pathophysiology, and management of the various phenotypes of IIA.

Cellular and Soluble Inflammatory Markers in Induced Sputum of Composting Plant Workers

Inflammatory processes, including respiratory symptoms, can be induced among workers in composting plants exposed to bioaerosols containing microorganisms and their compounds. We evaluated inflammatory processes in the lower respiratory tract via cellular and soluble mediator profiles in induced sputum (IS). IS samples of 140 current (35% smokers) and 49 former compost workers (29% smokers) as well as 29 white-collar workers (17% smokers) were collected and analyzed for the cell count and composition, and for soluble biomarkers. Significant differences between current and former compost workers and white-collar workers were detected for total cell count (p=0.0004), neutrophils (p=0.0045), sCD14 (p=0.008), and 8-isoprostane (p<0.0001). IS of non-smoking former compost workers showed lower concentrations of IL-8, total protein, immunoreactive MMP-9 and sCD14, compared with non-smoking current compost workers. 10.1% of the study population was suffering from chronic bronchitis with significant differences (p=0.018) between former compost workers (24.5%), current workers (5%), and white-collar workers (10.3%). Significantly lower IL-8 (p=0.0002), neutrophils (p=0.001), and MMP-9 (p=0.0023) values were measured in healthy subjects compared with subjects with chronic bronchitis. In conclusion, changes in lower airways were detected by analysis of biomarkers in IS of current exposed and, to a lesser extent, in IS of former compost workers. These effects are especially pronounced in subjects with chronic bronchitis.

Does [3H]2-methoxy-idazoxan (RX 821002) detect more alpha-2-adrenoceptor agonist high-affinity sites than [3H]rauwolscine? A comparison of nine tissues and cell lines

The authors compared [3H]2-methoxy-idazoxan (RX 821002) and [3H]rauwolscine binding in rat cerebral cortex, spleen and kidney; guinea pig kidney; porcine kidney; human kidney and platelets and HEL and NG 108-15 cells. [3H]RX 821002 had less nonspecific binding and higher affinity than [3H]rauwolscine in most models. Although both ligands detected similar alpha-2 adrenoceptor numbers in rat, porcine and human kidney and in NG 108-15 cells in saturation experiments, [3H]RX 821002 detected more alpha-2 adrenoceptors than [3H]rauwolscine in rat cerebral cortex and spleen, guinea pig kidney, human platelets and HEL cells. These differences were seen in Tris and in glycylglycine buffer regardless of whether EDTA, MgCl2, MgCl2 plus GTP or GTP plus NaCl was added to the former and were not explained by additional labeling of serotonin or dopamine receptors or nonadrenergic sites; in contrast, [3H]rauwolscine also labeled nonadrenergic sites in porcine kidney. In prazosin competition experiments, both ligands differentially recognized alpha-2-adrenoceptor subtypes but this could not account for the observed differences in detected receptor numbers. In epinephrine competition experiments, both ligands labeled similar numbers of agonist low affinity sites in all models; [3H]RX 821002, however, labeled more agonist high-affinity sites than [3H]rauwolscine did in models in which it detected a greater total number of receptors. It was concluded that [3H]RX 821002 is a more suitable ligand for the detection of alpha-2 adrenoceptor than [3H]rauwolscine because of less nonspecific binding, higher affinity and greater specificity for alpha-2 adrenoceptors; moreover, [3H]rauwolscine appears not to detect all agonist high-affinity sites of alpha-2 adrenoceptors.

Cellular and mediator profile in bronchoalveolar lavage of guinea pigs after toluene diisocyanate (TDI) exposure

Toluene diisocyanate (TDI) is a volatile, highly reactive chemical widely used as a polymerizing agent in the production of polyurethane foams, lacquers, adhesives, and other items. Repeated airway exposures in the workplace to TDI may cause a concentration-dependent risk of developing chronic airway disorders. Different pathomechanisms are involved. IgE-mediated sensitization and irritative effects were clearly demonstrated in exposed subjects as well as in animals. In this study we examined the cellular and mediator composition in bronchoalveolar lavage fluid (BALF) of guinea pigs (eight in each group) exposed to TDI (10, 20, or 30 ppb) on 5 consecutive days for 2 hours each. Increased numbers of eosinophils and significantly elevated levels of LTB4 and LTC4/LTD4/LTE4 were obtained in BALF of all exposed animals when compared to nonexposed control animals. PGD2 and TXB2 remained unaltered in BALF. Stimulation of BALF cells of exposed and control animals with Ca-ionophore A23187 and arachidonic acid induced an increased generation of LTB4. Furthermore, BALF cells of the exposed animal groups generated immunoreactive LTC4/LTD4/LTE4, whereas controls did not show peptido-leukotriene formation in the presence and absence of stimuli. Our data clearly demonstrate an influx of eosinophils into the airways associated with mediator release and higher cellular responsiveness after TDI exposure.

Analysis of B-cell epitopes in the N-terminal region of Chi t I component III using monoclonal antibodies

The hemoglobins of the midge Chironomus thummi thummi (Chi t I) are known to cause immediate-type hypersensitivity reactions in humans. Further knowledge of the antigenic sites of such allergens will provide new therapeutic approaches. The aim of our study was to identify and characterize linear B-cell epitopes of the hemoglobin component III of Chi t I (136 amino acid residues). Using the antigenic index algorithm of Jameson and Wolf (Jameson and Wolf (1988) Comput. Appl. Biosci. 4, 181-186), three linear binding sequences of this allergen molecule were predicted. Two mouse monoclonal antibodies (mAbs 3 and 6) raised against purified Chi t I component III were investigated by ELISA for their binding to nine synthetic peptides 19-21 residues in length, covering nearly the whole sequence of component III. MAb 6 recognized only one peptide (11-30) while mAb 3 bound to both N-terminal peptides (1-19 and 11-30), suggesting that the antibody binding site is located in the overlapping region. This assumption could be confirmed in ELISA with solid phase-bound recombinant peptides (RP) as well as in inhibition studies with free tryptic peptides indicating that identification of these linear B-cell epitopes is neither influenced by the method of peptide production nor by the kind of used immunoassay. To define the essential amino acid residues we investigated mAbs with solid phase-bound overlapping octamers. In the case of mAb 3, amino acids experimentally identified as essential for antibody binding (aa 13-17) are identical with those residues predicted as a B-cell epitope with the antigenic index of Jameson and Wolf.

Allergen-induced expression of cell surface markers on lymphocytes of Chi t I-sensitized patients

Lymphocyte cultures of persons sensitized to the hemoglobin allergen Chi t I show a highly significant response to the allergen measured in the lymphocyte stimulation assay by (3H)-thymidine uptake. In this study, we investigated by flow cytometry the expression of different cell surface markers on lymphocytes after in vitro stimulation for 7 d with or without the allergen Chi t I. We determined the expression of the low-affinity receptor for IgE (CD23) on lymphocytes of Chi t I-sensitized patients and Chi t I-exposed as well as nonexposed controls. CD23 expression was significantly higher in patients than in nonexposed controls. Exposed but healthy subjects showed intermediate values. We also determined the expression of activation markers CD25 (IL-2 receptor) and HLA-DR on the lymphocytes of patients and nonexposed controls. HLA-DR expression on non-T cells (CD3-) was significantly higher in patients than in controls. HLA-DR on T cells (CD3+), and CD25 as well as CD23 expression, could be significantly enhanced after antigen-specific stimulation in patients but not in controls, whereas alpha/beta-T-cell-receptor expression was significantly reduced in patients. Differences between patients and controls were not observed in response to tetanus toxoid (TT) and phytohemagglutinin (PHA). Our results demonstrate antigen-specific influences on the expression of cell surface molecules. These findings may be valuable diagnostic information.

Increased gamma/delta-positive T-cells in blood and bronchoalveolar lavage of patients with sarcoidosis and hypersensitivity pneumonitis

A small population of T-cells does not express the conventional T-cell receptor (TCR), characterized by the alpha and beta polypeptide chains (alpha/beta TCR) but two polypeptides termed gamma and delta (gamma/delta TCR). Changes in gamma/delta TCR expression may be relevant as the cause or consequence of several diseases. Our study was undertaken to determine and compare the distribution of T-cells expressing gamma/delta TCR in blood and bronchoalveolar lavage (BAL) of patients with sarcoidosis, hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF), and of healthy controls. In addition, the association between gamma/delta TCR of blood T-lymphocytes and accessory molecules was analysed. Using direct immunofluorescence with the anti-gamma/delta TCR and anti-CD3 monoclonal antibodies (MoAbs) followed by flow cytometric analysis, the blood of patients with pulmonary sarcoidosis, HP, IPF and of healthy controls was analysed. To reveal the association between gamma/delta TCR of blood T-lymphocytes and the accessory molecules, expression of CD4, CD8 and CD25 were determined. Calculating the percentage and the total number of CD3+ gamma/delta TCR cells in blood, the data indicated a significant increase of gamma/delta T-cells in individuals with pulmonary sarcoidosis and HP, compared to healthy controls and IPF patients. In sarcoidosis patients with elevated CD3+ gamma/delta TCR levels, significantly lower CD4/CD8 ratios were observed. In addition, our data demonstrate a correlation between the decrease of CD4+ cells in blood and the amplified appearance of gamma/delta TCR expression in sarcoidosis patients, but not in HP patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Occupational-type exposure tests and bronchoalveolar lavage analyses in two patients with byssinosis and two asymptomatic cotton workers

Two workers suffering from stage III byssinosis and claiming for compensation were examined. Bronchial obstruction was present in one case. MEF25-75 values were significantly reduced and bronchial hyperreactivity was present in both subjects. Occupational-type exposure tests with cotton dust resulted in significant decreases in arterial oxygen pressure for more than 2 h and were associated with an obstructive ventilation pattern in one of the patients. Prolonged hypoxemia which is not paralleled by lung function changes is probably typical for byssinosis patients since we have never seen this in inhalative challenge tests with various environmental antigens and other occupational substances including flour dust. No specific IgE or IgG antibodies could be detected. In the two patients a hitherto unknown significant increase in CD23+ lymphocytes and granulocytosis were detected by bronchoalveolar lavage (BAL). Corresponding investigations in two cotton workers without any evidence of byssinosis revealed neither lung function changes after the exposure test nor striking BAL findings. Our results demonstrate the diagnostic value of specific challenge tests and BAL investigations in patients suffering from byssinosis, which is often difficult to diagnose.

Epitope mapping with peptides of Chi t I component III and immunomodulation of the Chi t immune response

BACKGROUND

Hemoglobins of the Diptera family are known as aggressive inhalant allergens.

METHODS

The whole sequence of the insect allergen Chi t I component III was studied for T-cell epitope activity in cell cultures of 15 sensitized patients with a panel of 17 overlapping synthetic peptides and 12 peptides obtained by tryptic cleavage.

RESULTS

All but one of the peptides tested were found to be immunogenic. The nonstimulatory sequence 102-109 and two other tryptic peptides (69-90 and 110-135) were used in inhibition experiments. The Chi t I-induced proliferation was downregulated by all tested peptides when compared with stimulation with Chi t I alone.

CONCLUSIONS

Because stimulation with phytohemagglutinin or tetanus toxoid was not influenced by the above-mentioned peptides, this mechanism seems to be specific for the antigen. Specific immunomodulation with nonstimulating peptides may offer new therapy approaches.

Modulation of leukotriene generation from human polymorphonuclear granulocytes by polychlorinated biphenyls (PCB)

Various isomers of polychlorinated biphenyls (PCB) were studied to induce and modulate the generation of lipo-oxygenase products (leukotrienes) from human polymorphonuclear granulocytes (PMN) under non-cytotoxic conditions. Stimulation of human PMN with PCB did not induce leukotriene generation by themselves, but modulated the subsequent leukotriene formation when opsonized zymosan or sodium fluoride (NaF) were applied as stimuli. The simultaneous addition of PMN with opsonized zymosan and PCB, especially 3,3',4,4'-TCB, led to an increased generation of leukotrienes compared to the control. 3,3',4,4'-TCB exceeded the activity of the remainder PCB in a dose-dependent manner and also induced a chemiluminescence response from PMN. The simultaneous incubation of PMN with NaF and 3,3'-DCB,3,3',4,4'-TCB and 2,2',3,3'-TCB showed an inhibitory effect on leukotriene generation unlike NaF stimulation in the absence of PCB. Incubation of PMN with PCB had no significant effect on leukotriene generation induced by the Ca-ionophore (5 microM). Our data show a direct relationship between the extent of PMN stimulation and the chloro-substitution pattern of the PCB in combination with the different stimuli.

In vitro effects of polychlorinated biphenyls on human platelets

Incubation of human platelets with polychlorinated biphenyls (PCB) induced and modulated cellular responses to a different degree. 3,3',4,4'-tetrachlorobiphenyl (TCB) was a more potent inducer of platelet aggregation, serotonin release and 12-HETE generation compared to the other PCB [2,2',3,3'-TCB,3,3'-dichlorobiphenyl (DCB),2,2',4,5,5'-pentachlorobiphenyl (PCB)]. 3,3',4,4'-TCB showed synergistic effects, in combination with other PCB, such as an enhanced formation of 12-HETE, when 3,3'-DCB and 2,2',3,3'-TCB were applied simultaneously. The combined incubation of platelets with PCB and sodium fluoride (NaF), an activator of G-proteins, resulted in synergistic 12-HETE generation compared to stimulation with NaF or PCB alone. Furthermore, when platelets were incubated with the PCB the enzymatic steps controlling the metabolism of the platelet-activating factor (PAF) were modulated. A direct relationship between the extent of platelet activation and the chloro-substitution pattern of PCB exists.

Effect of staphylococcal delta-toxin and bee venom peptide melittin on leukotriene induction and metabolism of human polymorphonuclear granulocytes

The abilities of delta-toxin from Staphylococcus aureus and melittin to induce and modulate the generation of leukotriene from human polymorphonuclear granulocytes (PMNs) were studied. Stimulation of PMNs with melittin (10 micrograms) induced leukotriene formation, whereas stimulation with delta-toxin did not. Preincubation of the PMNs with delta-toxin modulated the subsequent generation of leukotriene from PMNs induced by Ca ionophore A23187 or opsonized zymosan. The generation of leukotriene B4 (LTB4), induced by the Ca ionophore A23187, was increased when the PMNs were preincubated with delta-toxin for 5 min. When opsonized zymosan was used as a secondary stimulus to activate the delta-toxin-pretreated PMNs, LTB4 generation decreased. In contrast, melittin showed no significant modulatory effect on the generation of leukotriene from PMNs. In addition, preincubation of PMNs with delta-toxin inhibited the conversion of LTB4 to omega-oxidation products. Our data suggest that peptides with similar structures, e.g., delta-toxin and melittin, induce and modify leukotriene generation in different manners.

Effects of the nonsteroidal anti-inflammatory compounds Lonazolac Ca, indomethacin and NDGA on inflammatory mediator generation and release from various cells

The effects of Lonazolac calcium in modulating histamine release, leukotriene and 12-HETE generation and PAF metabolism from various cells were compared with the cyclooxygenase and lipoxygenase inhibitors indomethacin and nordihydroguaiaretic acid (NDGA). For histamine release cells were stimulated with Ca ionophore, A23187. The release of histamine from human basophils was significantly decreased after preincubation of the cells with Lonazolac Ca. Lonazolac Ca and NDGA were equally potent and their activity exceeded that of indomethacin. Preincubation of human polymorphonuclear leukocytes (PMN) with Lonazolac Ca, indomethacin and NDGA at high concentrations led to an inhibition of leukotriene generation induced by either the Ca ionophore or opsonized zymosan. Different concentrations were required for inhibiting the enzymatic and the non-enzymatically generated leukotrienes. Lonazolac Ca was more potent than indomethacin. Incubation of PMN with Lonazolac calcium modulated the metabolism of exogenously added 3H-PAF and 3H-lyso-PAF. In comparison with NDGA. Lonazolac Ca affected different enzymes of the PAF metabolism.

Modulation of leukotriene generation by pertussis toxin

The purpose of our study was to characterize the properties of the interaction of pertussis toxin with human polymorphonuclear leukocytes for the modulation of leukotriene generation and metabolism. The cells were stimulated with either the Ca ionophore A23187, opsonized zymosan, or the bacterial peptide formyl-methionyl-leucyl phenylalanine. Incubation of the cells with pertussis toxin led to a rapid inhibition of LTB4 generation when formyl-methionyl-leucyl phenylalanine was used as the stimulus, whereas there was no effect with the Ca ionophore and just a low effect with opsonized zymosan. The inhibition of leukotriene generation was dependent on the incubation time, temperature, and pertussis toxin concentration. The effect was not dependent on the presence of calcium. Incubation of the cells with guanosine 5'-O-(3-thiotriphosphate) the stable analog of GTP, led to a time-dependent increase in leukotriene generation induced by formyl-methionyl-leucyl phenylalanine which was abolished by the simultaneous addition of pertussis toxin. Our data suggest that the formyl-methionyl-leucyl phenylalanine-induced generation of leukotrienes is dependent on a GTP-binding protein. The participation of the various G proteins has yet to be elucidated.

Generation of leukotrienes from human polymorphonuclear granulocytes of severely burned patients

The Ca ionophore A23187-induced leukotriene (LT) release (LTC4, LTB4, 20-OH-LTB4, 20-COOH-LTB4) of human PMN's from severely burned patients (n = 6) was studied by reversed-phase HPLC. The patients' granulocytes demonstrated a decrease (to zero levels) in LT generation postburn. The level of generated LT's resembled that of healthy donors when the patients recovered from their trauma (after day 40 postburn). In contrast, the granulocytes of patients who finally succumbed to their injuries showed poor responsiveness over the total time. An enhanced LTC4 production by granulocytes correlated with an increase in eosinophils within the granulocyte fraction. In addition, the reduced LTB4 production was accompanied by an enhanced LTB4 metabolism to biologically less active products (omega-oxidated metabolites). Thus, the capacity of patients' PMN's to release chemotactic substances was further decreased. The onset of this PMN dysfunction correlated with the onset of invasive microbial growth as determined by the quantitative bacterial analysis of full-thickness biopsy specimens. Our data provide evidence that the altered mediator release of patients' PMN's is closely related to a depressed host defense.

Modulation of leukotriene release from human polymorphonuclear leucocytes by PMA and arachidonic acid

Stimulation of human neutrophils (PMN) with Ca ionophore A23187, opsonized zymosan and formyl-L-methionyl-L-leucyl-phenylalanine (FMLP) led to a time- and dose-dependent release of LTB4, 20-OH-LTB4, 20-COOH-LTB4, 6-trans-LTB4, 12-epi-6-trans LTB4 and LTC4, as detected by reverse-phase HPLC. Preincubation of the PMN suspension in the presence of Ca2+ and Mg2+ with phorbol-12-myristate-13-acetate (PMA) did not release leukotrienes by itself, but modulated the subsequent Ca ionophore-induced leukotriene release. The release of LTC4, 20-OH-LTB4 and 20-COOH-LTB4 was significantly decreased. Lesser effects were observed for the release of LTB4 and the non-enzymatic LTB4 isomers. In contrast, opsonized zymosan and FMLP enhanced the release of LTB4 and LTB4-omega-oxidation products from cells pretreated with PMA. With arachidonic acid as prestimulus, the amounts of the LTB4 isomers (6-trans-LTB4 and 12-epi-6-trans-LTB4) were enhanced significantly on subsequent stimulation with Ca ionophore. Prestimulation of lymphocytes, monocytes and basophilic granulocytes (LMB) with PMA had no significant effects on the ionophore-induced release of LTC4 and LTB4. PMN, but not LMB, suspensions prestimulated with PMA convert exogenously added LTC4 to LTB4 isomers and LTC4 sulphoxide. Our data suggest that preincubation of human granulocytes with PMA modified leukotriene release by activation or inhibition of different metabolic pathways for LTC4 and LTB4.

Altered arachidonic acid metabolism in granulocytes of polytraumatized patients

The generation and metabolism of leukotrienes (LTs) from polymorphonuclear granulocytes of four polytraumatic patients on stimulation with the Ca-Ionophore A 23187 were studied by high performance liquid chromatography. In contrast to healthy donors the concentration of LTB4 within the supernatant of the stimulated granulocytes from these patients is reduced. The ratio of LTB4 versus the combined amounts of the biologically inactive 6-trans and 12-epi-6-trans-isomers is significantly decreased. In one patient who suffered from an Adult Respiratory Distress Syndrome (ARDS) a pronounced enhancement of LTC4 synthesis was observed.

Characterization of leukotriene B4-omega-hydroxylase activity within human polymorphonuclear granulocytes

Human polymorphonuclear granulocytes (PMN) metabolize exogenous [3H]leukotriene B4 (LTB4) into 20-hydroxy- and 20-carboxy-[3H]LTB4. The conversion was enhanced at acidic pH values (pH 6.0-7.0). Sonication of purified PMN and subcellular fractionation by differential centrifugation showed that major LTB4-hydroxylase activity was associated with the microsomal fraction (105,000 g pellet). In contrast to intact cells, LTB4-hydroxylase activity within the microsomal fraction revealed optimal activity at neutral pH and was inhibited by a wide range of divalent cations. There was a strict requirement for the presence of suitable electron donors such as NADPH. Heterocyclic nitrogenous bases, such as imidazole and pyridine, inhibited the LTB4 conversion induced by intact PMN as well as by their microsomes. These observations combined with the spectrophotometric analysis (carbon monoxide dithionite-reduced difference spectrum) supported the assumption that LTB4-hydroxylase resembled a cytochrome P-450 enzyme. The LTB4-hydroxylase within human PMN was not identical with the cytochrome P-450 of rat liver; hepatic microsomes only showed minute conversion of LTB4.

Release and functional characterization of the leukotriene D4-metabolizing enzyme (dipeptidase) from human polymorphonuclear leucocytes

Polymorphonuclear leucocytes released LTD4-dipeptidase activity in a time-, calcium-, and cell number-dependent fashion. The LTD4-dipeptidase released from polymorphonuclear leucocytes (PMN) by incubation with calcium (0.91 mM) was detectable up to a cell concentration of 1 X 10(6)/ml and increased with higher concentrations. Maximal LTD4-dipeptidase activity within the extracellular environment was detected after 15 min of incubation (2 X 10(7)/ml) in the presence of 2-4.5 mM calcium or after 30 min, when stimulation was carried out with 0.91 mM calcium. The activity of the released LTD4-dipeptidase was modulated by various metal ions and other compounds. The addition of Mn2+, Co2+, and Zn2+ (final concentration 1 mM) enhanced the LTD4-dipeptidase activity, while Cu2+ led to a complete inhibition. In the absence of exogenous calcium EDTA inhibited LTD4-dipeptidase. Calcium up to a concentration of 5 and 10 mM decreased the dipeptidase activity. The LTD4-dipeptidase is not affected by bestatin, leupeptin, or N-ethyl-maleinimide (NEM). The Km of LTD4-dipeptidase for LTD4 was 0.95 +/- 0.2 microM and Vmax was 737.5 +/- 112.5 pmol/min X mg protein (n = 3 +/- SEM). The highest LTD4-dipeptidase activity was obtained at physiological pH values. LTD4-dipeptidase activity can also be released from other cell types, but the enzyme activity from human PMN exceeded that of other cells (e.g. human lymphocytes/monocytes and basophils (LMB) and human lung cell suspension).