It is shown that apple allergens are probably proteins and that they can be extracted in an active form only if reactions with phenolic compounds present in apple are inhibited. This is accomplished by incorporating chelators and solid polyvinylpolypyrrolidone in the extraction medium. Phenol, commonly used as a preservative, should not be added. With the RAST, serum-IgE antibodies capable of reacting with apple allergens were detected in 90% of patients with clinical apple allergy, in 44% of patients with clinical birch-pollen allergy and in 5-10% of patients with other atopic allergies. RAST inhibition indicated that apple and birch-pollen allergens cross-react.
Objective-To assess whether monthly treatment with intravenous methylprednisolone enhances or accelerates the effect of disease modifying drugs in patients with rheumatoid arthritis. Design-A 12 month double blind, placebo controlled, multicentre trial in which patients with active
Summary It is shown by regression analysis that the risk of immediate hypersensitivity to birch pollen, as measured by a skin test, is positively correlated with the quantity of birch male flowers and the number of non‐rainy days in the first birch flowering season (May) met in infancy. The risk is also dependent on the month of birth, with maximal risk associated with birth in Februarys–April. The results suggest that early pollen contacts, particularly during the first 6 months of life, increase the risk of pollen allergy for a period of 20 years. We estimate that elimination of early birch pollen contacts could have reduced the prevalence of immediate hypersensitivity to birch by 28% in our age group 0–19 years.
Allergens extracted from apple, carrot, celery tuber and orange were coupled to radioallergosorbent test (RAST) discs. These and commercial birch, mugwort and timothy pollen discs were used to study sera from 90 patients for the presence of IgE antibodies which react with the allergens in question. Individual sera frequently gave positive results with several discs – in particular with birch pollen, apple, carrot and celery tuber discs. If IgE antibodies to birch pollen or apple allergens were detected, there was a 90% chance of antibodies being found also to the second one of these two source materials. Skin tests and patient histories indicated similar clustering of allergies. RAST inhibition experiments showed that the clustering phenomenon was due to cross-reactivity. All immunological determinants in fruits and vegetables appeared to be present also in birch pollen, but all birch pollen determinants were not present in fruits and vegetables. 45 children with atopic dermatitis were studied to establish whether a positive orange RAST would correlate with a history of atopic dermatitis aggravated by orange. The results were negative.
Early markers of atopic predisposition are needed for targeting allergy preventive measures to high‐risk infants. An elevated cord serum immunoglobulin E (CS‐IgE) level is considered a risk factor for subsequent allergy in childhood. However, the previous studies have not assessed the predictive value of CS‐IgE in a follow‐up extended to adulthood. We aimed at clarifying whether CS‐IgE is useful in predicting subsequent atopic manifestations up to age 20 yr. A cohort of 200 unselected, full‐term newborns were prospectively followed up from birth to age 20 yr. The CS‐IgE level was successfully measured in 190 subjects at birth. The subjects were re‐examined at ages of 5, 11 and 20 yr with assessment of the occurrence of allergic symptoms during the preceding year, skin prick testing and measurement of serum total IgE. An elevated CS‐IgE level was associated with allergic symptoms and skin prick test positivity at age 5 yr (p = 0.03 and 0.01), with allergic rhinoconjunctivitis at age 20 yr (p = 0.04) and with an elevated serum total IgE at ages of 11 and 20 yr (p = 0.02 and 0.01). The sensitivity of CS‐IgE, i.e. the probability of an elevated CS‐IgE in an infant who subsequently develops atopy, in predicting skin prick test‐verified atopy at ages of 5 and 20 yr was 50% and 26%, respectively. The combination of elevated CS‐IgE and positive family history of allergy was strongly associated with subsequent atopic manifestations. Nevertheless, it showed a reduced sensitivity as compared to CS‐IgE or family history of allergy. We conclude that an elevated CS‐IgE level predicts subsequent atopy up to age 20 yr.
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