Dehydroepiandrosterone in therapy of allergic diseases.

Dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEA-S) are weak androgens produced in the adrenals and serve as primary precursors in biosynthesis of both, androgens and estrogens. These hormones are proposed to perform immunoenhancing activities and may play a crucial role in regulating cytokine production by Th1/Th2 cells; however, their role in immune-mediated diseases is controversial. The primary physiological role of DHEA-(S) and its mechanism is unclear. This review is a brief summary of relevant scientific basis as well as clinical research on the role of dehydroepian drosterone in immune haemostasis and inflammatory diseases, including asthma, atopic diseases, chronic urticaria, pointing also to the significance of dehydroepiandrosterone therapy and the related US patents (1999-2005).

Seasonal changes in platelet activity in pollen-induced seasonal allergic rhinitis and asthma.

BACKGROUND: Previously we reported that patients sensitized to pollen-allergens who had seasonal allergic rhinitis and seasonal asthma may show increased plasma levels of platelet activation markers during grass pollen season. OBJECTIVE: To find out whether the pattern of platelet activity measured by plasma PF-4 level in the same group of patients changed off-season compared with the pollen season as well as in comparison with healthy control subjects. METHODS: Off-pollen season, plasma PF-4 level was determined by enzyme-linked immunosorbent assay (ELISA) in 16 grass pollen allergic patients who had seasonal allergic rhinitis and seasonal asthmatic symptoms (none of them had any history of allergic diseases outside the season) and in 29 healthy nonatopic subjects. RESULTS: Plasma PF-4 level in the patients off-pollen season was significantly lower as compared with the season and did not differ significantly as compared to the healthy subjects. CONCLUSIONS: This observation taken along with our previous results indicates that patients with seasonal allergic rhinitis and asthma symptoms may have an increased circulating platelet activation, yet this phenomenon disappears in the asymptomatic period of the disease. This might indicate that platelet activation within the systemic circulation is an important factor in the development of seasonal allergic airway inflammation.

Pruritic urticarial papules and plaques of pregnancy.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) are among the most common pruritic dermatoses observed in pregnant women. PUPPP appears most frequently in the third trimester, in primigravidas, and in multiple gestation pregnancies. The eruption of changes occurs initially on the abdomen and extends over the thighs, legs, back, buttocks, arms, and breasts. Skin changes typical for PUPPP are erythematous, urticarial plaques, and papules. Rash regression is usually observed within 6 weeks postpartum. Immunologic mechanisms, hormonal abnormalities, and abdominal skin distension have been suggested as etiologic mechanisms. PUPPP is thought to be harmless for the mother and fetus and usually requires intervention only for symptom relief. In some cases, laboratory investigation, histologic examination, and immunologic study should be performed to exclude more serious disorders of pregnancy, such as herpes gestationis or intrahepatic cholestasis of pregnancy. This article reviews the epidemiology, clinical manifestation, etiology, differential diagnosis, and treatment of PUPPP.

Effect of allergen-specific immunotherapy on platelet secretory activity in patients with grass-pollen allergy.

Platelet may become activated following antigen challenge to participate then actively in the immune-inflammatory response. Moreover, some evidence proves that specific immunotherapy induces changes in the platelet function. The objective of this study was to determine circulating platelet activity during the early phase of allergen-specific immunotherapy (SIT) in patients with grass pollen-sensitive allergic rhinitis. Twelve grass-pollen allergic patients (seven men and five women) with intermittent allergic rhinitis were treated with specific subcutaneous allergoid preparation. SIT was received by six weekly injections, the vaccine dose increasing until the maintenance level was reached. Blood was sampled at four different time points: before and directly before SIT, 30 min and 24 h after the maximum dose injection of the vaccine. Plasma level of beta-thromboglobulin (beta-TG), marker of platelet activation in vivo was measured using ELISA method. Baseline beta-TG level did not differ significantly among the patients and healthy subjects. Moreover, no significant differences were observed in the degree of platelet activity between the different times of this study in the patients group. We failed to detect any significant changes in circulating platelet activity, the measure of plasma level of beta-TG, in patients with grass-pollen induced intermittent rhinitis during the course of the dose increase phase of grass pollen SIT. In particular, it seems that both early (after 30 min) and late (after 24 h) changes in plasma level of this marker do not occur following the maximum dose administration of the allergen vaccine during the early SIT phase.