Diagnostic tests in ragweed-allergic asthma *1A comparison of direct skin tests, leukocyte histamine release, and quantitative bronchial challenge

Bruce, C.Allen; Rosenthal, Richard R.; Lichtenstein, Lawrence M.; Norman, Philip S.

doi:10.1016/0091-6749(74)90085-2

Cited by 54 publications

(1 citation statement)

References 36 publications

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“…As described below, we showed that antigen-induced mast cell de granulation in skin and airways was asso ciated with inflammation which, in turn, was associated with increased airway re sponsiveness to pharmacologic agents [3][4][5]. We also found a close correlation between skin responsiveness to antigen and bronchial challenge with antigen [28][29][30]. Finally, we observed correlations between specific IgE antibodies against ragweed and antigen-induced responses in skin and airways.…”

Section: Characterization Of the Effect Of Antigen In Airwaysmentioning

confidence: 57%

Mechanisms of Antigen-Induced Reactions in Skin and Lung

Gold¹

1986

Respiration

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Investigators have tried to develop various experimental preparations suitable to study the effects of antigen on skin and airways in order to understand the mechanisms involved in asthma and to develop new methods of diagnosis, prevention and treatment. We have gained considerable experience in studies of specific antigens in inbred dogs with increased levels of serum IgE antibodies to aeroallergens. By using a new method of sensitization, combining an attenuated live virus with a specific and potent antigen, we have developed an experimental preparation that has many features resembling human asthma: (1) High serum levels of IgE antibodies were specifically directed against ragweed antigen. (2) Skin and airway responses to antigen were specific and reproducible. (3) Airway responsiveness to histamine and methacholine aerosols was significantly increased in immunized dogs. (4) Similar to human asthma, ragweed-induced bronchoconstriction in ragweed-sensitized dogs was severe and associated with profound abnormalities in cardiopulmonary function and appeared to be of greater magnitude than usually seen in Ascaris-induced reactions. (5) Ragweed-sensitized dogs had atopic dermatitis, particularly during grass pollen season, confirmed by biopsy and described previously in atopic dogs [1]. (6) Ragweed-sensitized dogs did not have spontaneous wheezing, but usually had diffuse, severe wheezing during induction of anesthesia; cardiac arrhythmias were also common during anesthesia. (7) Ragweed-sensitized dogs appeared to differ from Ascaris-sensitive dogs with respect to skin responsiveness. There was a surprisingly narrow range of skin responsiveness to antigen, whereas Snapper et al. in 1980 [2] reported a wide range of skin responsiveness to Ascaris suum antigen in a group of mongrel dogs. Skin responsiveness to histamine was greater in ragweed-sensitized dogs than in nonimmunized dogs. (8) Similar to human atopic patients, we found frequent late-phase reactions to ragweed antigen. As described below, we showed that antigen-induced mast cell degranulation in skin and airways was associated with inflammation which, in turn, was associated with increased airway responsiveness to pharmacologic agents [3–5]. (9) The generation of thromboxane by inflammatory cells induced by antigen challenge in ragweed-sensitized dogs appears to play a critical role in altering the response of both airways and skin to pharmacologic agonists.

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Section: Characterization Of the Effect Of Antigen In Airwaysmentioning

confidence: 57%

Mechanisms of Antigen-Induced Reactions in Skin and Lung

Gold¹

1986

Respiration

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Recent Advances in Bronchial Asthma

Flod¹,

Franz²,

Galant³

1976

Arch Pediatr Adolesc Med

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\s=b\Bronchial asthma in childhood is a major pediatric problem for the physician, both as an acute emergency and as a chronic disease. To adequately manage asthma, one must have a firm understanding of its pathogenesis, and the clinical aspects of diagnosis and therapy. We review important developments in the area of the basic mechanisms causing bronchial obstruction, and methods of measuring the abnormalities present. This presentation includes the fields of neuropharmacology, biochemistry, immunology, and pulmonary physiology. With this background, the clinical aspects of diagnosis and therapy are explored. The role of the allergy history, skin testing, measurement of serum IgE antibodies, and target organ provocation testing are placed in perspective. Therapy involving avoidance measures, use of pharmacologic agents and injection therapy with inhalant allergens are discussed in detail.(Am J Dis Child 130: [890][891][892][893][894][895][896][897][898][899] 1976) Many new and exciting advances in the understanding of bron¬ chial asthma have been made in the last decade. These developments have resulted in a more rational approach to the asthmatic child. The review presented here summarizes this new information by considering the basic scientific aspects of the pathogenesis of asthma, followed by discussion of the recent developments in diagnosis and therapy. PATHOGENESIS OF BRONCHIAL ASTHMA NeuropharmacologyBronchial asthma can no longer be viewed solely as an immunologie disease. The clinical observation that several stimuli, including chemical mediators, irritants, certain respira¬ tory infections, emotional and physi¬ cal factors, as well as allergen chal¬ lenge, can result in bronchospasm, created the need for a broader concept in underlying abnormality.In the early 1960s, Szentivanyi1 advanced the theory of /3-adrenergic blockade as a possible unifying path¬ ogenic mechanism in asthma. This theory proposes that many of the stimuli that result in the clinical syndrome of asthma do so by causing release of potent chemical mediators of inflammation such as the kinins, slow-reacting substance of anaphy¬ laxis (SRS-A), histamine, serotonin, and acetylcholine. The mediators, in turn, cause both bronchoconstriction and secretion of epinephrine as a homeostatic response. If /5-adrenergic receptors are normally responsive, activation by epinephrine will balance concurrent a-adrenergic and cholinergic receptor stimulation, and airway patency will be maintained. However, if /3-receptors are defective, bronchoconstriction will result.Evidence for generalized /^-blockade in asthma includes metabolic, pulmo¬ nary, and hématologie changes. There is less elevation of serum glucose, lactate, and pyruvate levels following administration of the ß-adrenergic stimulants, isoproterenol hydrochloride and epinephrine hydrochloride, in asthmatics than in normal subjects.2 ;' Administration of the /5-blocking agent, propranolol hydrochloride, leads to increased airway resistance in asthmatic patients'; in patients with allergic ...

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Lung function and bronchial responsiveness in children who had infantile bronchiolitis

Duiverman

Neijens

Strik

et al. 1987

Pediatric Pulmonology

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A number of studies have shown that children who had infantile bronchiolitis are at increased risk of recurrent episodes of wheezing. A genetic predisposition to atopy is mentioned in some studies and is contested by others. Lung function abnormalities and increased bronchial responsiveness (BR) have been described after infantile bronchiolitis. We investigated children who had had the clinical syndrome of bronchiolitis during infancy and compared them with asthmatic and healthy children of the same age regarding bronchial caliber, smooth muscle tone, and responsiveness to histamine. Lung function was measured by forced oscillometry. We found that most children with current symptoms had either decreased baseline bronchial caliber, increased bronchial smooth muscle tone, or increased BR. These patients are comparable to mild asthmatics. The children without current symptoms are comparable to healthy children in these respects. Recurrent respiratory symptoms after bronchiolitis should be regarded as mild asthma and treated as such.

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Diagnostic tests in ragweed-allergic asthma *1A comparison of direct skin tests, leukocyte histamine release, and quantitative bronchial challenge

Cited by 54 publications

References 36 publications

Mechanisms of Antigen-Induced Reactions in Skin and Lung

Mechanisms of Antigen-Induced Reactions in Skin and Lung

Recent Advances in Bronchial Asthma

Lung function and bronchial responsiveness in children who had infantile bronchiolitis

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