Social behaviors and gray matter volumes of brain areas supporting social cognition in children and adolescents with prenatal alcohol exposure

The goal of this study was to examine: 1) differences in parent-reported prosocial and antisocial behaviors between children and adolescents with and without prenatal alcohol exposure (PAE); 2) differences in gray matter volumes of brain areas supporting social cognition between children and adolescents with and without PAE; 3) correlations between gray matter volumes of brain areas supporting social cognition and parent-reported prosocial and antisocial behaviors. Parents of children and adolescents ages 8-16 years completed measures on their prosocial and antisocial behaviors (i.e., Behavior Assessment Scale for Children, Vineland Adaptive Behaviors Scales, and Child Behavior Checklist) (n = 84; 41 with PAE, 43 without PAE). Seventy-nine participants (40 with PAE, 39 without PAE) also completed a structural Magnetic Resonance Imaging (MRI) scan with quality data. Gray matter volumes of seven brain areas supporting social cognitive processes were computed using automated procedures (FreeSurfer 6.0): bilateral fusiform gyrus, superior temporal gyrus, medial orbitofrontal cortex, lateral orbitofrontal cortex, posterior cingulate cortex, precuneus, and temporal pole. Children and adolescents with PAE showed decreased prosocial behaviors and increased antisocial behaviors as well as smaller volumes of the precuneus and lateral orbitofrontal cortex, even when controlling for total intracranial volume. Social brain volumes were not significantly correlated with prosocial or antisocial behaviors. These findings suggest that children and adolescents with PAE show worse social functioning and smaller volumes of brain areas supporting self-awareness, perspective-taking and emotion-regulation than their same-age peers without PAE.

Executive and Social Functioning Across Development in Children and Adolescents With Prenatal Alcohol Exposure

BACKGROUND

Prenatal alcohol exposure (PAE) is linked to a variety of neurodevelopmental challenges, including social functioning (SF) and executive functioning (EF) deficits. These deficits present differently across developmental stages from preschool age to adolescence.

METHODS

The post hoc analyses described here were conducted on data from 83 preschool-age children with PAE (early childhood group; ages 2.5 to 5.0) and 95 adolescents (49 with PAE, 46 controls; ages 8 to 16). Each child completed EF tasks as part of several prior studies. Parents completed social and communication inventories about their child's abilities. Thirty-three participants from the early childhood group returned for a 4-year follow-up and completed both SF and EF measures.

RESULTS

Both the early childhood and adolescent groups with PAE showed deficits in SF and EF. There was a relationship between SF and EF within the adolescent PAE group that was not present in the adolescent control group or the early childhood PAE group. However, at the 4-year follow-up (M_age  = 8.45), participants originally in the early childhood PAE group also demonstrated this relationship.

CONCLUSIONS

These findings support previous research on EF/SF deficits in adolescents with PAE while also addressing a gap in the literature concerning early childhood research on this topic. Additionally, these findings suggest that the relationship between EF and SF deficits may strengthen throughout development. This line of research highlights potential sensitive periods for SF and EF training in children with PAE and suggests that fetal alcohol spectrum disorders programs consider targeting EF training as a component of social skill interventions.

Para-limbic Structural Abnormalities Are Associated With Internalizing Symptoms in Children With Prenatal Alcohol Exposure

BACKGROUND

Prenatal alcohol exposure (PAE) is associated with a variety of structural abnormalities in the brain, including several within the para-limbic system. Children with PAE have higher rates of internalizing disorders, including depression and anxiety, which may be related to underlying limbic system anomalies.

METHODS

Children aged 8 to 16 with PAE (n = 41) or without PAE (n = 36) underwent an magnetic resonance imaging of the brain and parents completed behavioral questionnaires about their children. Semi-automated procedures (FreeSurfer) were used to derive para-limbic volumes from T1-weighted anatomical images.

RESULTS

There were significant group differences (PAE vs. nonexposed controls) in the caudate, hippocampus, and the putamen; children with PAE had smaller volumes in these regions even after controlling for total intracranial volume. A trend-level association was seen between caudate volume and internalizing symptoms in children with PAE; smaller caudate volumes (presumably reflecting less optimal neurodevelopment) were associated with higher levels of anxiety and depression symptoms in these children.

CONCLUSIONS

Caudate structure may be disproportionately affected by PAE and may be associated with the later development of internalizing symptoms in those affected by PAE.

A randomized controlled trial of transcranial direct-current stimulation and cognitive training in children with fetal alcohol spectrum disorder

BACKGROUND

This study was a randomized double-blind sham-controlled trial examining the effects of transcranial direct current stimulation (tDCS) augmented cognitive training (CT) in children with Fetal Alcohol Spectrum Disorders (FASD). Prenatal alcohol exposure has profound detrimental effects on brain development and individuals with FASD commonly present with deficits in executive functions including attention and working memory. The most commonly studied treatment for executive deficits is CT, which involves repeated drilling of exercises targeting the impaired functions. As currently implemented, CT requires many hours and the observed effect sizes are moderate. Neuromodulation via tDCS can enhance brain plasticity and prior studies demonstrate that combining tDCS with CT improves efficacy and functional outcomes. TDCS-augmented CT has not yet been tested in FASD, a condition in which there are known abnormalities in neuroplasticity and few interventions.

METHODS

This study examined the feasibility and efficacy of this approach in 44 children with FASD. Participants were randomized to receive five sessions of CT with either active or sham tDCS targeting the dorsolateral prefrontal cortex, a region of the brain that is heavily involved in executive functioning.

RESULTS

The intervention was feasible and well-tolerated in children with FASD. The tDCS group showed nominally significant improvement in attention on a continuous performance test compared to sham (p = .043). Group differences were observed at the third, fourth and fifth treatment sessions. There was no effect of tDCS on working memory (p = .911). Further, we found no group differences on a trail making task (p = .659) or on the verbal fluency test (p = .826). In the active tDCS group, a significant correlation was observed between improvement in attention scores and decrease in parent-reported attention deficits (p = .010).

CONCLUSIONS

These results demonstrate that tDCS-augmented CT is well tolerated in children with FASD and potentially offers benefits over and above CT alone.

Stability of fresh and preserved fetal and adult lymphocyte cell surface markers

Delay between blood collection and immunophenotyping of peripheral blood (PB) and umbilical cord blood (UCB) lymphocytes occurs frequently. Holding media address this problem, but there are few reports of their limitations. We tested the ability of Cyto-Chex (CC) to preserve the ability of lymphocyte subpopulations to be immunophenotyped after time delays. Ten UCB and 10 PB specimens were kept up to 48 hr and then placed in CC for 1 week, with removal of aliquots for staining with CD3, CD4, CD8, CD19, and CD45 at intervals. There were no significant changes in the number of nonpreserved PB or UCB cells stained with any of the reagents after 48 hr. Aside from a small decrease in UCB B-cell numbers, there were no changes in UCB or PB lymphocyte numbers after placing them in CC for 1 week. However, PB and UCB CD19+ cells and CD8+ T cells lost capacity for bright staining after 1 week in CC. The results suggest that UCB and PB can be held for up to 48 hr before being placed in CC and then kept for up to 1 week in CC with no decrease in T-cell numbers and only a minor reduction of B-cell numbers, albeit with a marked reduction in staining intensity.

Neutralization of bee venom lethality by immune serum antibodies

The lethal effects of Africanized honey bee venom depend on the absorption of venom delivered during simultaneous sting attacks by large numbers of bees. The hypothesis that antibodies to whole bee venom and bee venom components could neutralize the lethal effect of bee venom was tested. Antibodies from beekeepers and immunized rabbits were incubated with bee venom and neutralization was studied by survival of intravenously injected mice. Beekeeper serum antibodies were found effective in protecting mice challenged with whole venom, and serum from rabbits immunized with phospholipase A2 (PLA2) was effective in protection against lethal effects of PLA2. Serum antibodies from rabbits immunized with whole venom or melittin were ineffective in neutralizing whole venom in vivo and had low titers in a venom enzyme-linked immunosorbent assay. The results suggest the need for development of more effective methods for raising antitoxic antibodies to bee venom components in other animals as a means of developing an antiserum that would be effective for treatment of human victims of multiple bee stings.

Heterogeneity of pollen proteins within individual Betula pendula trees

To determine the variation of antigenic water soluble proteins in white birch (Betula pendula) pollen, extracts of pollen from different sides of individual trees were analyzed by isoelectric focusing (IEF), crossed immunoelectrophoresis, and crossed radioimmunoelectrophoresis. IgE-antibody-binding patterns were also studied in samples analyzed by IEF by probing with serum pooled from patients with birch pollen allergy, followed by radiolabelled anti-IgE. Antigenic proteins and allergens per unit weight of extracted protein were greatest in pollen extracts from the south side of the trees. Allergens decreased progressively in pollen from west-through east- to north- facing branches. Proteins with high isoelectric points (pI > 8.5) and proteins between pI 4.5 and 5.6 were infrequent in extracts from the north side. Extracts from branches facing north were poor in allergens: in general, only one or two precipitin lines were found, and in some cases they did not bind to IgE antibodies. Differences between numbers of proteins and allergens found in extracts from south, west and north branches were statistically significant for all methods used. The results indicate the need to collect birch pollen for allergen extract manufacture from south-facing branches.

Significance of Africanized bees for public health. A review

Although massive sting attacks by Africanized bees are currently rare, this type of bee is now endemic in parts of Arizona and Texas, and will probably spread to other warm climate areas in the United States. Treatment of severe toxic reactions to multiple stings usually includes management of shock, hypoxia, and other effects of organ damage. New approaches to reduce blood levels of venom including production of a bee antivenom and hemodialysis require further study. Patients with a trivial allergy to single stings could be at risk from systemic anaphylaxis to multiple bee sting. Those who wish to remain in endemic areas in spite of histories of systemic anaphylaxis to bee stings should be treated with venom immunotherapy, possibly administered more intensively and for longer periods than currently recommended. Continued public education is needed to limit contact with aggressive Africanized bee colonies.

Immunoreactivity of umbilical cord blood and post-partum maternal peripheral blood with regard to HLA-haploidentical transplantation

Recent clinical reports have demonstrated that umbilical cord blood (CB) may be utilized as a source of transplantable hematopoietic stem cells when bone marrow is not available. However, it is not apparent that CB can be used to transplant partially HLA-matched siblings or matched, non-familial recipients. In this study the immunoreactivity of CB has been investigated within familial confines; 14 families were analyzed at the time of birth of their child and six of these families were reassessed at 6 months post-partum. In mixed lymphocyte reactions, CB was unable to significantly respond to stimulation with cells from either the mother or father. Furthermore, unlike adult peripheral blood, CB displayed depressed immune responses to alloantigen and T cell mitogen. At 6 months, the immune responses of the infant demonstrated normal development in terms of alloantigen and mitogen responses. However, at 6 months both the mother and the infant demonstrated a continued immune tolerance to one another. The data suggest that CB could be used in familial transplant situations when siblings are HLA-haploidentical if the donor/recipients are chosen based on the paternal haplotype. Furthermore, maternal bone marrow harvested during the 6 months immediately following delivery of a child also should be suitable as a stem cell graft in haploidentical situations.

Rate and quantity of delivery of venom from honeybee stings

To determine the rate and completeness of delivery of venom from honeybee stings, European bees were collected at the entrance of a hive and studied with the use of two laboratory models. In one model bees were induced to sting the shaved skin of anesthetized rabbits. The stings were removed from the skin at various time intervals after autotomization, and residual venom was assayed with a hemolytic method. In the other model the bees were induced to sting preweighed filter paper disks, which were weighed again after removal of the sting at various intervals. Results of both experiments were in agreement, showing that at least 90% of the venom sac contents were delivered within 20 seconds and that venom delivery was complete within 1 minute. The data suggest that a bee sting must be removed within a few seconds after autotomization to prevent anaphylaxis in an allergic person. The extensive variation found in the amount of venom delivered at each time point may explain inconsistencies in relationships among reactions to field stings, sting challenge testing, venom skin tests and RAST.

Collection, separation and cryopreservation of umbilical cord blood for use in transplantation

Bone marrow transplantation (BMT) is limited by the paucity of HLA-matched donors and the frequent occurrence of graft-versus-host disease (GVHD). Recent clinical reports have implied that the use of umbilical cord blood (UCB) may alleviate some of the problems associated with BMT. Banks of frozen UCB could make the problem of finding suitable stem cell donors easier and stem cell grafts would be more readily available. However, definitive experiments are needed to develop optimal methods for collection, separation and storage of cryopreserved UCB for extended periods of time. We have found that several simple techniques may be utilized to collect large volumes of UCB (up to 220 ml). Also, modification of a common density gradient separation method permits recovery of large quantities of UCB mononuclear cells. Finally, we have examined the effects of prolonged frozen storage on the ability to recover viable and functional UCB, particularly stem/progenitor cells. It was observed that storage of UCB in liquid nitrogen for as long as 7 years had minimal effects on cell viability, cellular composition of UCB and progenitor/stem cell capacity. Thus, the establishment of UCB banks for use in transplantation appears to be a feasible approach.

Phenotypic and functional immaturity of human umbilical cord blood T lymphocytes

Successful implementation of bone marrow transplantation for hematopoietic reconstitution is limited by the lack of suitably HLA-matched donors and by the occurrence of graft-versus-host disease that frequently accompanies this procedure. Recent clinical reports have implied that the use of umbilical cord blood as a source of transplantable stem cells may solve these problems. To date, definitive experiments have not been performed to assess the immunological potential of T cells found in umbilical cord blood, which could mediate graft-versus-host disease. In the present study we have observed that umbilical cord blood contains T lymphocytes that appear to be phenotypically immature. In addition, umbilical cord blood lymphocytes appeared to be functionally immature as shown by minimal responses to stimulation with interleukin 2, phytohemagglutinin, or alloantigens. Thus, umbilical cord blood may be more suitable for allogeneic transplantation than bone marrow in that these cord blood cells may not be as capable of mediating graft-versus-host disease.

Biochemical variability of venoms from individual European and Africanized honeybees (Apis mellifera)

To study biochemical differences between venom from individual honeybees, venom sacs from 103 European (EU) bees and 92 Africanized bees representing 12 different colonies were dissected, and the dry weight (DW) of venom from each bee was determined. Venom from each of these bees was studied with isoelectric focusing and functional assays for phospholipase A2 and melittin. Phospholipase concentrations in individual EU bee venoms varied between 1.8% and 27.4% (wt/wt). The melittin concentration in EU bee venom varied less and, on the average, was found to be much lower than previously reported. There was an eightfold to ninefold difference between lowest and highest venom sac DW contents, suggesting the possibility of highly variable venom delivery from bee stings. One EU bee contained greater than 300 micrograms of venom, three times the recommended maintenance dose for venom immunotherapy. Isoelectric focusing also demonstrated large differences between individual bees, with respect to major and minor components of their venoms. Africanized bees contained significantly less venom but more phospholipase than did EU bees. Bee venoms from different colonies differed in their DW content and in their concentrations of phospholipase and melittin. The results are relevant to the uncertainty of responses from sting challenges and field stings in allergic patients and massive stinging attacks on normal subjects.

Characterization of the major allergen of Cynodon dactylon (Bermuda grass) pollen, Cyn d I

An allergen from Cynodon dactylon (Bermuda grass) pollen, Cyn d I, has been purified by a combination of concanavalin A-Sepharose affinity chromatography, and carboxymethyl-Sepharose chromatography. The allergen constitutes the major allergenic component of the pollen extract as observed by immunoelectrophoretic techniques, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, an IgE-inhibition experiment, and skin testing. In sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Cyn d I is presented as a dominant 32 kd band and a minor 29 kd band, both binding IgE. Both bands are identified by monospecific rabbit antibodies (Abs) raised against Cyn d I. These Abs only weakly precipitate allergens from other grass species, indicating that Cyn d I possesses some unique immunochemical properties. Two of four purified murine monoclonal Abs raised against Cyn d I also bind to both bands of Cyn d I, indicating that the bands represent isoallergens with slightly different immunochemical properties. All four monoclonal Abs cross-react with pollen components from other grass species, especially Poa pratensis and Dactylis glomerata. The NH2-terminal sequence corresponding to approximately 10% of the complete sequence was determined, and it revealed high homology to the corresponding sequence of the major allergen of Lolium perenne, Lol p I. From the amino acid composition determination and immunoelectrophoretic comparison, the amount of Cyn d I in the source whole-pollen extract was estimated to be 15% wt/wt.

Quantity, analysis, and lethality of European and Africanized honey bee venoms

Venom from Africanized honey bees (derived mainly from Apis mellifera scutellata) was compared with venom from domestic, European bees by study of lethality, immunological cross-reactivity, venom yield, isoelectric focusing (IEF) patterns, and melittin titers. The LD50s of European and Africanized bee venom by iv injection in mice were similar. In venom neutralization experiments, Africanized bee venom was mixed with antibodies from a beekeeper exposed only to European bees and used to challenge mice. Survival times of mice given these mixtures were significantly prolonged, indicating that human serum antibodies to European bee venom neutralized the lethal effects of Africanized bee venom. Reservoirs from Africanized bees contained less venom than European bees (94 and 147 micrograms venom/bee, respectively) and Africanized bee venom had a lower melittin content. The IEF patterns of venom from individual European bees varied considerably, as did IEF patterns of individual Africanized bees. Pools of venom from 1,000 bees of each population of A. mellifera showed noticeable but less obvious electrophoretic differences. The findings suggest that multiple stinging, and not increased venom potency or delivery, is the cause of serious reactions from Africanized bee attacks.

An immunoelectrophoretic analysis of the allergens of Cynodon dactylon (Bermuda grass) pollen

A crude extract of Cynodon dactylon (Bermuda grass) pollen was obtained by extraction, centrifugation, dialysis, and lyophilization. The corresponding polyspecific rabbit antibodies were obtained by immunization, bleeding, and purification and were used for a cross immunoelectrophoretic analysis of the crude extract. At least 52 antigens (Ags), of which 47 migrated toward the anode, and five, toward the cathode, were revealed. Crossed radioimmunoelectrophoretic analysis performed with sera from 32 patients allergic to Bermuda grass and a pool from 1000 normal individuals revealed specific IgE binding to 13 of these Ags. The approximate molecular weights (MWs) for 10 of these IgE-binding Ags were determined by a combination of gel filtration and immunochemical analysis. These Ags had apparent MWs greater than 14 kd. A combination of preparative sucrose gradient isoelectric focusing and immunochemical analysis was used to determine the approximate isoelectric point values of five of the IgE-binding Ags. Most precipitating Ags had isoelectric points between 4.5 and 5.5. Four of the Ags (Ag 24, MW, less than 65 kd; Ag 31, MW, 33 kd; Ag 33, MW, 20 kd; and Ag 34/35, MW, 32 kd) were classified as major allergens.

Recognition of pollen and other particulate aeroantigens by immunoblot microscopy

Most grass-pollen types appear identical by normal light microscopy. Restricted antigenic cross-reactivity of Cynodon dactylon (Bermuda grass) pollen allowed development of a new method to identify antigens associated with grass-pollen grains. Pollen applied to the surface of an adhesive tape was blotted onto nitrocellulose, and the blots were identified by anti-Bermuda-grass antibodies, second antibody, and fluorescence microscopy. Of the 44 species of grass pollen studied for specificity of the method, the only species to demonstrate uniformly bright staining were Cynodon dactylon, Elymus triticoides, Elymus cinereus, and Koeleria cristata. Thirty-one species were negative, and nine other species demonstrated occasional brightly fluorescent spots, suggesting contamination. The immunoblotting method was used to study Tucson air collected continuously by a Burkard pollen and spore trap throughout April 1986. Each 2-hour transect of the adhesive tape from the trap was examined by immunoblotting and by normal light microscopy to compare antigen particle counts with grass-pollen counts. The mean antigen-particle concentration, 52.8/m3 of air, was higher than the mean grass-pollen concentration, 21.9/m3 of air, suggesting presence of amorphous Bermuda-grass antigens in air samples. Antigen-particle concentration, not grass-pollen concentration, correlated significantly with wind velocity, temperature, and time of day.

Fiberoptic nasopharyngolaryngoscopy: a procedure for allergists?

Fiberoptic endoscopy of the nose is not essential for routine evaluation of allergic rhinitis when the allergist is skilled in performing a thorough speculum examination. However, it is useful in the diagnosis of nasal polyps, malformations, tumors, and foreign bodies; when severe septal deviation or small nasal valves preclude good visualization; and in assessment of adenoid size in small children when lateral neck radiographs are inconclusive and digital examination is unacceptable.

Clinically relevant allergens from laboratory and domestic small animals

Most of the major allergens that have been isolated from laboratory and domestic animals have been found to be acidic proteins, with molecular weights lower than that of serum albumin (Table II). Recent advances in characterization of antigens from these animals have emphasized that urine and saliva can be as important as epithelia as sources of relevant allergens. Urinary protein allergens are found in mice, rats, guinea pigs and rabbits, whereas cat saliva contains all the major allergens found in cat pelt extract. Urinary proteins from mice, rats and guinea pigs and salivary proteins from cats have been identified in air samples of rooms inhabited by these animals. There is now sufficient immunochemical data to standardize allergens from mice, rats and cats for diagnosis and immunotherapeutic trials.

Pulmonary response to nasal-challenge testing of atopic subjects with stable asthma

Nasal deposition of allergen or histamine could cause bronchoconstriction in subjects with asthma by a reflex mechanism. To investigate this possibility, six atopic subjects with stable asthma and five normal control subjects were studied by nasal-challenge testing with saline, Bermuda grass-pollen allergen, and histamine on paper disks. Challenges were done on 3 separate days by use of a double-blind, randomized trial design. Fivefold serial dilutions were used to determine threshold doses for provocation of at least a twofold increase in the postsaline nasal airway resistance. No patient developed cough or wheezing or required treatment at the end of the nasal-challenge tests, even when persistent sneezing was provoked or in the subject who had a dual nasal response to nasal challenge. In spite of changes in nasal airway resistance that generally conformed to expectations, there were no significant effects of nasal challenge on lung function, including forced expiratory flow rates, vital capacity, residual volume, and partial expiratory flow-volume curves.

Anti-Bermuda grass RAST binding is minimally inhibited by pollen extracts from ten other grasses

This article addresses the question, Does sensitization with Bermuda grass pollen generate IgE antibodies that cross-react with other grasses? We found that none of ten non-Bermuda grass extracts attained 50% inhibition of RAST binding between sera from patients in Arizona and Bermuda-coupled disks whereas Giant Bermuda grass extract was completely cross-reactive with Common Bermuda grass.

Computer-aided rhinometry: analysis of inspiratory and expiratory nasal pressure-flow curves in subjects with rhinitis

Airflow through the nose was measured by posterior rhinometry with the aid of a microcomputer to study reproducibility of pressure-flow curves, the ease of detection of nasal congestion and decongestion, and mathematical modelling of P-V curves. In twelve subjects with rhinitis, the median coefficient of variation of nasal airway resistance was between 4.9% and 14.4% and was not significantly affected by inspiration and expiration, congestion and decongestion, or the flow rate at which it was measured. Fitting of 630 P-V curves to a quadratic equation was usually excellent, particularly during expiration.

Intranasal immunotherapy and polymerized grass pollen allergens

The effects of immunotherapy by intranasal insufflation of Lolium perenne allergens modified with glutaraldehyde (Glu-Rye) was tested by a stratified placebo-controlled trial in 16 adult subjects with hay fever. The purpose of this pilot study was to determine whether the treatment could reduce nasal sensitivity to allergen in provocation tests. Modification of the allergen was shown to include polymerization and reduced allergenicity, but retained immunogenicity. Nasal sensitivity to unmodified L. perenne allergens was measured by threshold-type quantitative nasal challenge and posterior rhinometry for measurement of nasal airway resistance. In challenge tests after a 10-week course of intranasal preseasonal treatment with Glu-Rye, nasal sensitivity was reduced, but this effect was not maintained when testing was repeated 9 months after treatment. Post-seasonal serum levels of IgE antibodies to L. perenne were also not significantly affected by the treatment.

Allergy to murine antigens in a biological research institute

Symptomatic and immunologic responses to allergens from laboratory mice were studied in a research institute. Subjects who had been exposed to mice and 50 unexposed subjects were studied by questionnaire and by prick tests with seven prevalent aeroallergens and allergens from mouse urine and pelts. Of the 121 exposed subjects, 39 (32.2%) had respiratory, ocular, or cutaneous symptoms after exposure to mice; occurrence of these symptoms correlated with positive skin tests to purified mouse urinary proteins (MUP) and pelt allergens from CBA/H mice. Serum levels of IgG antibodies correlated with the frequency of mouse exposure. In subjects with seasonal allergic rhinitis, nasal symptoms from exposure to mice, positive prick tests to MUP, and IgE antibodies to MUP were significantly more prevalent. The possibility of genetic influences on susceptibility to mouse allergy were also suggested by a negative association between the incidence of HLA-DRW6 and positive prick-test responses to urinary proteins from C57BL and BALB/c mice among the 54 subjects who were exposed to mice and tested for DR locus antigens (p = 0.05). However, no significant differences in any of the loci studied could be shown in subjects with and without nasal symptoms from exposure to mice.

Effect of a beta-adrenergic agonist, fenoterol, on nasal sensitivity to allergen

Fenoterol hydrobromide, 1 mg/ml, was given by nasal spray in doses between 204 and 576 microgram in an attempt to reduce nasal sensitivity to Lolium perenne allergen in a nasal provocation test during a 2-hr period following the drug. In a randomized double-blind comparison between fenoterol and placebo in 11 patients, reduction of nasal sensitivity be fenoterol was small but significant in a one-tailed test (p = 0.03). In the 15 min following the fenoterol spray the increase in the average nasal airway resistance (NAR) was significantly higher than the increase in NAR after placebo (p = 0.026), suggesting that fenoterol may also act as a vasodilator in the nose. This effect is consistent with findings by other investigators who showed that isoproterenol also increased nasal airways resistance.

Inhibition of murine reaginic antibody responses by nasal immunotherapy with modified allergen

Optimal conditions were established for induction of reaginic antibodies to Lolium perenne pollen allergens in mice by intranasal dosing of allergens with Bordetella pertussis vaccine. This antibody response could be inhibited by pretreatment of the mice by nasal administration of 100 microgram of glutaraldehyde-modified L. perenne allergens 9 times in 3 weeks before priming, whereas native allergens, in doses of 5 microgram, did not inhibit an IgE response to subsequent priming. It was not possible to suppress an ongoing reaginic antibody response by intranasal treatment with either native allergens, or glutaraldehyde-modified allergens. Relevance to immunoprophylaxis of allergic disease is discussed.

Myasthenia gravis and lymphoma. A clinical and immunological association

Myasthenia gravis and lymphoma rarely coexist, but the occurrence of myasthenia shortly after the treatment of a patient with poorly differentiated nodular lymphoma suggested that an immunological disorder may have contributed to the development of both diseases; the fundamental defects in this association may be impaired immunological surveillance and impaired regulation of immune responses to autoantigens. The finding of T-cell immunodeificiency, including profound T-cell lymphopenia, impaired delayed hypersensitivity responses, and failure to a thymus-dependent antibody response to Salmonella adelaide flagellin, is consistent with this hypothesis.

Nasal challenge testing in grass pollen hay fever

Nasal sensitivity to rye grass pollen allergens was evaluated by provocation testing in patients with hay fever due to grass pollen using measurements of nasal airways resistance (NAR), a reproducible system for delivery of allergen, and stringent criteria for allergen storage. Reproducibility was assessed in 24 subjects with hay fever by nasal provocation with serial dilutions of Lolium perenne allergens on 3 occasions: during the grass pollen season, immediately after the season, and in early winter. Threshold doses of allergen required to double the saline control NAR or to provoke persistent sneezing and rhinorrhea were slightly higher 1 mo after the pollen season, but there was no significant differences between threshold doses during the pollen season and 8 mo later. When the threshold doses during challenges were exceeded, there were late reactions in 4 of 24 patients. Normal subjects and patients with perennial rhinitis and with negative skin tests to L. perenne extract were unresponsive in nasal challenge tests.

Effect of quantity and quality of IgG antibodies on blocking of allergenic histamine release in vitro

In a study of the protective role of IgG antibodies in allergen injection therapy, serum antibodies to timothy grass allergens were raised in rabbits and tested for inhibition of histamine release from basophils of grass pollen-sensitive human subjects. Rabbit sera were not inhibitory until late in the immune response when large amounts of relatively low affinity IgG antibodies were detected by primary binding. Inhibition of histamine release by late sera required preincubation of allergen and antibody prior to addition of sensitive basophils, and could not be demonstrated when basophils and IgG antibodies had simultaneous access to allergen. Hence intravascular inhibition of mediator release in allergen-treated patients may require high affinity IgG antibodies. The predominantly low affinity of antibodies raised in the rabbits precluded testing of this possibility.

Variability of Alternaria alternata: biochemical and immunological characteristics of culture filtrates from seven isolates

Biochemical variability of culture filtrates from the common allergenic mold Alternaria alternata was studied. Differences between culture filtrates from 7 different isolates and between 4 batches of culture filtrate from the same isolate were observed, suggesting the unreliability of presently employed biochemical methods in the routine standardization of mold allergens and the possibility of difficulties in developing standard techniques for their purification. Dextranases, cellulases, and agarases, found in one culture filtrate, may be a further source of problems in laboratory techniques employing A. alternata. The proportions of nitrogen:carbohydrate:dialyzed dry weight were different in culture filtrates from each isolate. Polysaccharides in culture filtrates from 3 of the 7 isolated contained glucose, mannose, xylose, galactose, and a fifth, unidentified sugar. Polysaccharides from one isolate lacked xylose, and the fifth sugar was not demonstrable in 4 of the isolates. Despite the biochemical differences, extensive antigenic cross-reactivity between different isolates was found in precipitin studies and inhibition of antibody binding.

Primary interaction between antibody and components of Alternaria. I. Immunology and chemical characteristics of labeled antigens

Components were isolated from Alternaria tenuis and its culture filtrate, and were radiolabeled with 123-I. The labeled antigenic components had a high polysaccharide content as determined by staining patterns following electrophoresis in polyacrylamide gels and by inactivation with sodium metaperiodate. A primary binding test was employed to detect and measure serum antibodies to the components from A. tennuis. This procedure was more sensitive in detecting antibodies that bound to antigens than were comparable tests dependent upon precipitin types of reactions. The labeled components of A. tenuis cross-reacted or shared antigens with 3 other species of molds: Stemphylium sp., Curvularia sp., Aspergillus fumigatus, but not with a variety of other fungal and nonfungal materials.

Primary interaction between antibody and components of Alternaria. II. Antibodies in sera from normal, allergic, and immunoglobulin-deficient children

Antibodies in sera from normal, allergic, and immunoglobulin-deficient children were studied for binding to radiolabeled components of Alternaria tenuis. Significant binding levels were found in 103 of 105 sera from normal children. The levels were age-dependent, rising from a low point in the 7- to 12-month age group to adult levels by the age of 8 years. Levels of binding to two antigens, a culture filtrate derivative (125I-CLF) and a mycelial derivative (125-I-HS), were similar. Sera from asthmatic children with strong immediate skin test reactions to Alternaria extracts bound significantly higher levels of 125-I-CLF than did sera from allergic children with negative skin tests or from control children. Binding levels in sera from children with hypogammaglobulinemia were significantly less than binding levels in sera from normal children in any age group. Sera from children with selective IgA deficiency bound 125-I-CLF at normal levels. The almost universal occurrence of anti-Alternaria antibodies in children was partly explained by the finding of partial cross-reactivity and/or shared antigens among several fungal species, including A. tenuis, Stemphylium sp., Curvularia sp., and Aspergillus fumigatus. The biological significance of these antibodies is not clear, but the procedures described lend themselves to further investigations.

Serum immunoglobulin and transferrin levels after childhood splenectomy

IgG, IgA, IgM, and transferrin levels were measured in sera from a group of children who had been subjected to splenectomy in the previous 10 years. In those children splenectomized for hereditary spherocytosis, idiopathic thrombocytopenic purpura, or traumatic rupture, mean IgM levels were significantly lower and mean transferrin levels were significantly higher than in sera from control children. Children splenectomized for thalassaemia major had a significantly raised mean IgG level, while children splenectomized for portal hypertension had a raised mean IgA level. However, IgG and IgA levels in patients who had suffered splenic rupture did not differ from control values. The finding of high transferrin levels after splenectomy supports the concept of an immunological function for this protein in addition to its iron-binding capacity.