Low molecular weight allergens of the pollen of Parietaria officinalis.

The allergenic composition of a low mol. wt fraction of the pollen extract of Parietaria officinalis (PO) was investigated. Fraction C, that was eluted after oxytocin (mol. wt 1040) when the pollen extract was gel filtered on Sephadex or on Biogel, was cross-reactive in the RAST with the major allergen P015 and was capable of eliciting histamine release from leukocytes of sensitive donors. RAST inhibition (RAST I) analysis of the eluate of gel filtration on Sephadex G-10 revealed several peaks of IgE binding activity. Analysis of fine specificity of response of individual patients carried out by skin-prick tests and by RAST I, revealed individual patterns of reactivity, indicating that allergens contained in fraction C were minor allergens.

HLA-DRB1* and allergy to Parietaria: linkage and association analyses.

In this study, we used the affected sibling-pairs approach to investigate the linkage of HLA (human leukocyte antigen)-DRB* with phenotypes related to allergy to Parietaria, the most common pollinosis in Mediterranean countries. The study population consisted of 51 nuclear families (235 subjects). Linkage was detected with Parietaria skin test positivity (p < (0.01), presence of IgG and IgE antibodies specific for the major allergen Par o 1 (p < 0.020 and p < 0.025, respectively), and absence of Par o 1-specific IgE (p < 0.020). High levels of Par o 1-specific IgG were associated with DRB1*1101 and/or DRB1*1104 (p < 0.0001 and p < 0.0119, respectively) in parents and probands. High levels of Par o 1-specific IgE were associated with DRB*1104 in parents (p < 0.017) and with DRB1*1101 in probands (p < 0.0146). When siblings were categorized according to high/low total IgE levels (> or =125 IU/ml and <125 IU/ml, respectively), high IgE antibody response was associated with DRB1*1104 in siblings with low total IgE (p < 0.034) and with DRB1*1101 in siblings with high total IgE (p < 0.05). These results demonstrate that HLA-DRB1*, or genes in linkage disequilibrium, contributes to susceptibility to Parietaria allergy and that total IgE levels can discriminate population subsets where different alleles (at the HLA region or at loci in linkage disequilibrium) contribute to control allergen-specific IgE synthesis.

Association of responsiveness to the major pollen allergen of Parietaria officinalis with HLA-DRB1* alleles: a multicenter study.

Parietaria, a plant belonging to the family of Urticaceae, is a major source of allergenic pollen in Europe. In the context of a multinational study, we investigated whether in allergic subjects antibody response towards Par o 1, the major allergen from P. officinalis, was associated with defined HLA-DRB1* alleles. The study population consisted of 234 allergic patients: 65 from Bulgaria, 30 from Israel, 99 from Italy, and 40 from Spain. In the Italian study group, the prevalence of ST positivity to Parietaria was 77%. In Parietaria ST-positive subjects, the prevalences of IgG and IgE serum Ab towards Par o 1 were 91% and 75%, respectively. HLA-DRB1*1101 and/or 1104 were significantly positively associated with the presence of IgG Ab and with high levels of IgE Ab towards this allergen (p = 0.0007 and p = 0.012, respectively). In the Spanish study group, the positive association of DR1100 with responsiveness to Par o 1 was confirmed (p = 0.02, RR = 4, and p = 0.002, RR = 7, for IgG and IgE Ab, respectively). None of the Bulgarian patients had IgE Ab to Par o 1, whereas IgG Ab response was observed in 7 out of 65 subjects and was positively associated with DRB1*1101 and/or 1104 (p = 0.025). In the Israeli study group, responsiveness to Par o 1 was not associated with specific HLA-DRB1* alleles. In conclusion, this study shows that in allergic patients from three European populations antibody response to the major allergen from the pollen of Parietaria is associated with HLA-DRB1*1101 and/or 1104. Our data suggest that this association is stronger in subjects monosensitized to Parietaria.

IL-10 levels are decreased in psoriatic lesional skin as compared to the psoriatic lesion-free and normal skin suction blister fluids.

IL-10 is a cytokine produced by B and T-cells, monocytes and keratinocytes with pleiotropic effects, some of which are directed towards suppressing monocyte activities (anti-inflammatory cytokine). No information at the protein level is available concerning IL-10 in suction blister fluids from psoriatic skin, even if contrasting data have been reported on IL-10 mRNA of psoriatic biopsies and on the cytokine patterns of the T-cell clones, isolated from psoriatic skin. The IL-10 blister fluid concentrations in psoriatic lesions were compared to those found in the non-lesional skin of 14 patients effected with plaque-type psoriasis, and to those found in the skin of healthy controls (9 subjects sharing sex ratio and age with psoriatic patients). No difference in the IL-10 levels was found between non-lesional and control skin. In contrast, lower IL-10 levels were observed in blister fluids obtained from lesional psoriatic skin (p < 0.0005). The possible meanings of these results have been evaluated in the context of the mechanisms activating or maintaining the chronic inflammatory components of psoriasis.

Multicenter double-blind comparative study of terfenadine and cetirizine in hay fever.

The efficacy and safety of terfenadine in the management of hay fever were compared with those of cetirizine in a multicenter, double-blind, parallel-group study, carried out during the 1990 spring pollen season. The patients were randomly assigned to one of two groups of treatment, 70 patients being given terfenadine 120 mg, and 72 patients cetirizine 10 mg, once daily for 7 days. The severity of the main symptoms was evaluated at baseline and after treatment by a 4-point rating scale. In addition, the overall symptom severity was recorded daily by the patient on a diary card. Both terfenadine and cetirizine produced significant relief of symptoms by the end of treatment, with a decrease in symptom severity ranging from 46 to 69% for terfenadine and from 40 to 55% for cetirizine. Adverse effects experienced by terfenadine- and cetirizine-treated patients were mainly drowsiness, with minor differences between the two groups. The results of this study confirmed previous experiences, showing that both terfenadine and cetirizine once daily should be regarded as effective drugs for the management of hay fever.

Soluble intercellular adhesion molecule-1 and procollagen III peptide are reliable markers of disease severity in psoriasis.

Levels of soluble intercellular adhesion molecule-1 (sICAM-1) and procollagen III peptide (PIIIP) were measured respectively by enzyme immunoassay (EIA) and radioimmunoassay (RIA) methods in sera from 14 patients affected with psoriasis. The same determinations were also performed on suction blister fluids (BFs) obtained from lesional and non-lesional skin. Fourteen normal subjects were used as controls. Significant correlations were found between the serum levels and psoriasis area and severity index (PASI), (R = 0.62 for sICAM-1 and R = 0.73 for PIIIp, respectively). Of the PASI components, infiltration and erythema represented the variables most closely related to PIIIP (R = 0.85; R = 0.72 respectively). Differently from PIIIP, whose levels were significantly lower in the sera than in skin BFs (serum: median value 1.05, range 0.7-2.3 vs. lesional skin fluid: 11.8, 4.8-30 U/ml), sICAM-1 molecules were found predominantly in the sera (serum: median 316, range 117-579 vs lesional skin fluid: median 70, range 31-252 ng/ml). These data cannot exclude that sICAM-1 molecules detected in suction BFs may derive from serum contamination.

Interleukin-1-beta, interleukin-6, and interferon-gamma in suction blister fluids of involved and uninolved skin and in sera of psoriatic patients.

Interleukin-1-beta (IL-1-beta), Interleukin-6 (IL-6) and Interferon-gamma (IFN-gamma) were measured by enzyme immunoassay (EIA) methods in blister fluids (BFs) obtained from both involved (ISBF) and non-involved skin (USBF) and in sera from 14 psoriatic patients. The same determinations were carried out in 14 sera and in 5 suction blister fluids from 14 normal subjects. IL-6 was always detectable in all skin fluids and in 3 psoriasis sera. IL-1-beta was measured only in 5 ISBFs and in 5 sera from the same patients. IFN-gamma was present in 11 ISBFs, in 5 USBFs and in 5 sera. The analysis of the levels found in the samples shows: 1) a local production of these cytokines, 2) the presence of detectable amounts of IL-6 and IFN-gamma in USBFs, and 3) a significant correlation between the IL-6 levels in the ISBFs and erythema score.

[Fibrofolliculoma, trichodiscoma and acrochordon. The Birt-Hogg-Dubé syndrome]. / Fibrofolliculomes, trichodiscomes et acrochordons. Syndrome de Birt-Hogg-Dubé.

The Birt-Hogg-Dubé syndrome is characterized: a) clinically, by an asymptomatic eruption of dome-shaped papules involving the head, neck, chest, back and arms frequently associated with acrochordons; b) histologically, by multiple follicular tumors, namely fibrofolliculomas and trichodiscomas, representing benign proliferations of mesodermal and ectodermal components of the pilar apparatus; c) by the apparent autosomal dominant mode of inheritance. This study is concerned with two families whose various members belonging to two and three generations have the clinical and histological lesions of this syndrome. In several biopsies performed, the main finding was the fibrofolliculoma isolated or associated with perifollicular fibromas; in five biopsies, was noted a typical trichodiscoma associated, in two of them, with a perifollicular fibroma. Clinically, the fibrofolliculomas were indistinguishable from trichodiscomas. We believe that the Birt-Hogg-Dubé syndrome is an autonomous well individualized skin disease. Its existence supports the view of the close interaction between the epithelial and mesodermal components of the pilar complex.

[Weary hereditary sclerosing poikiloderma]. / Poïkilodermie sclérosante héréditaire de Weary.

INTRODUCTION: Hereditary sclerosing poikiloderma is a genodermatosis with dominant autosomal transmission and variable penetration. The first case was described by Weary in 1969 in 7 members of two black families. CASE REPORT: A 10-year-old girl had localized regional poikiloderma of the fingers and club toes. These lesions were associated secondarily with linear symmetric bands of sclerotic tissue in the axiallary regions. On the X-ray examinations of the distal phalanges of the fingers and the toes showed a proximal growth foyer and absent ungueal phalanges, excepting in the fourth finger of the left hand. Capillaroscopy of the supra-ungueal fold of the fingers showed abnormal capillary circulation. Histology and ultrastructural examinations did not reveal any pathognomonic alterations. DISCUSSION: This case is the first reported in a white patient. The radiological aspect and the results of the capillaroscopy of the fingers and the toes have not been reported previously in this rare genodermatosis. Inheritance of this genodermatosis is poorly defined.

Trauma as a shibboleth in psychoanalysis?

The authors consider that the subject of trauma is a good example of how metapsychological constructs (in this case, in particular, the economic or quantitative point of view) originated as essential working hypotheses necessitated by clinical observation. These conceptualizations may help us to understand what finds expression in processes that are sensed as affects (als Affekte der Empfindung bemerkbar werden) either by the patient or by the analyst. In the case of trauma (in analysis), an object-relations approach is not only compatible (Balint) with metapsychology but seems to be positively implicit in a correct interpretation of the latter. Two clinical vignettes are given as evidence for this assumption. They illustrate an irruption of stimuli through the protective shield (Reizschutz) of the analytic field, initiated by the patient and the analyst respectively. For the purpose of grasping and working through such situations--thus helping the patient to fill the gap (Ablösung) between the quota of affect (Affektbetrag) and the idea (Vorstellung)--it is very useful for the analyst to refer to the concept of trauma, either in the narrow or in the broad sense proposed by Freud. For this reason, the authors believe that the concept of trauma is a shibboleth of psychoanalysis.

[Microparticulate aerosols and respiratory allergy]. / Microparticolato aerosolico e allergopatie respiratorie.

The assessment of allergenic activity in submicronic particles could explain some unknown aspects of pollinosis pathogenesis. Twenty-five 0.5 discs have been obtained using a high volume sampler (Hi Vol Andersen) equipped with 0.3 micron Whatman paper filters. These discs have been challenged with a concentrated pool of sera of Parietaria allergic patients by RIA in order to evaluate the presence of allergenic activity on filters. Discs of non sampled filters and discs of sampled filters challenged with serum pool of patients sensitized to house dust mites were used as controls. The percentage of bound radioactivity was detected by gamma-counter. The radioactivity bound to sampled discs with Parietaria sera was 2.3 +/- 0.55 (Standard Deviation); radioactivity detected on control discs was comparable to background values detected by counter. These preliminary date might suggest that submicronic particles of Parietaria can retain some allergenic activity.

[Evaluation of the inhibition of allergen-specific and nonspecific skin responses by topical oxatomide]. / Valutazione dell'inibizione delle risposte cutanee allergene-specifiche e non da parte dell'oxatomide per uso topico.

A double blind study against placebo was carried out in order to assess the inhibition induced by oxatomide gel in specific and aspecific cutaneous responses (prick test). Twenty allergic patients (8 M, 12 F) aged between 15 and 59 years (average 31) were treated for 7 days with oxatomide gel 5% or with placebo (2 applications a day). The results show a significant reduction of itching and of wheal size (considering either major diameter and area) only in the oxatomide group (p less than 0.01 between times and p less than 0.001 between treatments), whereas among controls itching remained unchanged and wheal size increased. During the follow-up a gradual return of wheal size to initial values in the patients treated was observed.

[A case of idiopathic hypereosinophilic syndrome]. / Un caso di sindrome ipereosinofilica idiopatica.

Idiopathic hypereosinophilic syndrome (IHS) is reported in a 59-year-old farmer. Skin manifestations were represented by pruritic erythemato-squamous and papulonodular lesions, the heart was affected by endomyocardic fibrosis, and periodic intestinal colics denoted a possible gut involvement. A mild and transient beneficial effect was achieved by treatment with antihistamines, sodium-chromoglycate, steroids. Recent studies indicate that IHS hypereosinophilia is caused by interleukins 3 and 5, cytokines able to activate circulating eosinophils and to enhance the survival of these cells.