Immunochemical and Physical Quantitation of Grass and Olive Pollen Allergens: Correlation With Asthma Admissions in Cáceres, Spain.

BACKGROUND AND OBJECTIVES: The association between pollen counts and allergen levels in the air is controversial. Objectives: The aims of the study were to quantify total and major allergen levels of Phleum pratense and Olea europaea and to analyze their correlation with grass and olive pollen counts and the number of asthma attacks attended at Complejo Hospitalario Universitario, Cáceres, Spain. MATERIAL AND METHODS: A volumetric air sampler and a Burkard spore trap were used for pollen and aeroallergen collection during April- June 2011. Filters were extracted, and major allergens were quantified using enzyme-linked immunosorbent assay. RESULTS: May was the main grass pollination period, with a maximum peak of 1362 grains/m3 (May 13). The main pollination period for olive was April 30-May 20, with a maximum peak of 851 grains/m3 (May 11). A moderate correlation was observed between asthma exacerbations and grass pollen counts or Phleum total allergen levels; this became stronger when a 3-day offset was introduced. A significant association was observed between asthma exacerbations and total olive allergen or olive pollen grain levels when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS: This study reveals a significant correlation between grass and olive pollination and an increase in the number of visits to the emergency room for asthma attacks. The aerobiological pattern of allergen levels in the air is similar to that of pollen counts during the grass and olive pollination periods.

Immunochemical and physical quantitation of grass and olive pollen allergens: correlation with asthma admissions in Cáceres, Spain

BACKGROUND: The association between pollen counts and allergen levels in the air is controversial. OBJECTIVES: The aims of the study were to quantify total and major allergen levels of Phleum pratense and Olea europaea and to analyze their correlation with grass and olive pollen counts and the number of asthma attacks attended at Complejo Hospitalario Universitario, Cáceres, Spain. MATERIAL AND METHODS: A volumetric air sampler and a Burkard spore trap were used for pollen and aeroallergen collection during April- June 2011. Filters were extracted, and major allergens were quantified using enzyme-linked immunosorbent assay. RESULTS: May was the main grass pollination period, with a maximum peak of 1362 grains/m3 (May 13). The main pollination period for olive was April 30-May 20, with a maximum peak of 851 grains/m3 (May 11). A moderate correlation was observed between asthma exacerbations and grass pollen counts or Phleum total allergen levels; this became stronger when a 3-day offset was introduced. A significant association was observed between asthma exacerbations and total olive allergen or olive pollen grain levels when a 1-day offset was introduced. The maximum correlation (moderate-high) was observed 4 days and 6 days away from the maximum olive pollen peak and the maximum Ole e 1 peak level, respectively. CONCLUSIONS: This study reveals a significant correlation between grass and olive pollination and an increase in the number of visits to the emergency room for asthma attacks. The aerobiological pattern of allergen levels in the air is similar to that of pollen counts during the grass and olive pollination periods

ANTECEDENTES: La relación entre los niveles de pólenes en el aire y los niveles de alérgenos es controvertida. OBJETIVOS: El objetivo de este estudio fue cuantificar los niveles de alérgenos principales y totales de Phleum pratense y Olea europaea, y analizar su relación con los niveles de pólenes y el número de crisis asmáticas atendidas en el Complejo Hospitalario de Cáceres, España. MATERIAL Y MÉTODOS: Se captaron pólenes y aeroalérgenos durante Abril-Junio de 2011, utilizando un colector de aire volumétrico y una trampa Burkard. Se extrajeron los alérgenos de los filtros y se cuantificaron mediante ELISA. RESULTADOS: Mayo fue el periodo de mayor polinización, (13 de Mayo, pico máximo de 1.362 granos de polen de gramíneas/m3). El mayor periodo de polinización del olivo fue del 30 de Abril al 20 de Mayo, (11 de Mayo, pico máximo: 851 granos de polen de olivo/m3). Se observó una correlación moderada entre los niveles de polen o alérgenos totales y exacerbaciones de asma, que aumentó al introducir un desfase de 3 días (Phleum), y de 1 día (olivo). La máxima correlación se observó a los 4 y 6 días del pico máximo de polen y de Ole e 1, respectivamente. CONCLUSIONES: Este estudio muestra una correlación significativa entre la polinización de gramíneas y olivo y el aumento del número de visitas a urgencias debidas a crisis asmáticas. Los patrones aerobiológicos de los niveles de alérgenos en el aire son comparables a los recuentos de pólenes durante los periodos de polinización de gramíneas y olivo

Angioedema as a single manifestation of carcinoid syndrome in a bronchial carcinoid tumor.

BACKGROUND: The association of bronchial carcinoid tumours with carcinoid syndrome is extremely rare especially in the absence of metastasic disease, and the angioedema is not a typical sign of this syndrome. METHODS AND RESULTS: We report the case of a 39 year-old woman referred to our allergy department with recurrent episodes of angioedema. The aetiological study of angioedema did not show evidence of hypersensitivity to common inhalants, food allergens and latex. C1-inhibitor, C3, C4, C1q, proteinogram and immunoglobulins (IgA, IgG, IgM) all were normal. TSH determination gave normal results, too. Faecal analyses for parasites were negative. The haemogram showed moderate leucocytosis and hypocromic mycrocitic anaemia. The thoracic radiography showed a mediastinal node image in the right paratracheal region. Histology analyses of the samples were diagnostic of a typical carcinoid tumor. Levels of 5-hydroxyindolacetic acid (5-HIIA) were slightly increased. A superior lobectomy was performed and no new episodes of angioedema appeared after surgical intervention. CONCLUSIONS: We report the first case of typical bronchial carcionid tumour, without metastasic disease, with angioedema as a single manifestation of carcinoid syndrome. In our knowledge, only one case of Quincke's edema as part of typical carcinoid syndrome has been reported, in a case of primary midgut carcinoid tumor with metastasic disease to liver. It is very important to include complementary tests, as thoracic radiography, in the routine study of angioedema to reject malignant diseases.

Angioedema as a single manifestation of carcinoid syndrome in a bronchial carcinoid tumor

Background: The association of bronchial carcinoid tumours with carcinoid syndrome is extremely rare especially in the absence of metastasic disease, and the angioedema is not a typical sign of this syndrome. Methods and results: We report the case of a 39 year-old woman referred to our allergy department with recurrent episodes of angioedema. The aetiological study of angioedema did not show evidence of hypersensitivity to common inhalants, food allergens and latex. C1-inhibitor, C3, C4, C1q, proteinogram and immunoglobulins (IgA, IgG, IgM) all were normal. TSH determination gave normal results, too. Faecal analyses for parasites were negative. The haemogram showed moderate leucocytosis and hypocromic mycrocitic anaemia. The thoracic radiography showed a mediastinal node image in the right paratracheal region. Histology analyses of the samples were diagnostic of a typical carcinoid tumor. Levels of 5-hydroxyindolacetic acid (5-HIIA) were slightly increased. A superior lobectomy was performed and no new episodes of angioedema appeared after surgical intervention. Conclusions: We report the first case of typical bronchial carcionid tumour, without metastasic disease, with angioedema as a single manifestation of carcinoid syndrome. In our knowledge, only one case of Quincke's edema as part of typical carcinoid syndrome has been reported, in a case of primary midgut carcinoid tumor with metastasic disease to liver. It is very important to include complementary tests, as thoracic radiography, in the routine study of angioedema to reject malignant diseases (AU)

La presencia de síndrome carcinoide asociado a tumores bronquiales es poco frecuente, sobre todo en ausencia de enfermedad metastásica; y el angioedema no es una manifestación típica de dicho síndrome. Métodos y resultados: Presentamos el caso de una paciente de 39 años de edad con episodios recurrentes de angioedema. En el estudio etiológico de angioedema no se evidenció hipresensibilidad frente a inhalantes, alimentos ni látex. La determinación de fracciones séricas de complemento (C3, C4, C1q y C1-inhibidor) e inmunoglobulinas mostró resultados normales. Los valores de TSH estaban, asímismo, dentro de la normalidad. En análisis de parásitos en heces fue negativo. En el hemograma se apreciaba una leucocitosis moderada y una anemia microcítica e hipocroma. La radiografía de tórax mostraba una imagen nodular mediastínica a nivel paratraqueal derecho. El estudio histológico fue diagnóstico para carcinoide típico. Los niveles de ácido 5-hidroxiindolacético (5-HIIA) en orina de 24 horas, estaban discretamente elevados. A la paciente se le practicó una lobectomía superior derecha, no volviéndose a presentar nuevos episodios de angioedema tras la intervención. Conclusiones: Presentamos el primer caso de tumor carcinoide bronquial típico, sin enfermedad metastásica asociada, con angioedema como única manifestación de síndrome carcinoide. Sólo tenemos conocimiento de un caso de edema angioneurótico de Quincke asociado a síndrome carcinoide en un caso de tumor primario intestinal con metástasis hepáticas. Creemos que es importante incluir determinados exámenes complementarios, como la radiografía de tórax, en el estudio de rutina del angioedema para descartar enfermedades malignas subyacentes (AU)

Allergy to asticot maggots. Identification of allergens.

UNLABELLED: There are some written reports of allergic reactions after contact with Asticot larvae in anglers and occupationally exposed workers. Clinical and immunological studies were performed to confirm the allergens involved in the case of a 12-year-old male who developed respiratory symptoms shortly after contact with Asticot maggots used as fish bait. METHODS AND RESULTS: Aqueous extracts of Asticot maggots were taken for in vivo and in vitro tests. The protein concentration as determined by turbidimetric assay was 1.4 mg/ml. Skin prick test with Asticot extract was positive with an immediate response. Ten atopic and ten nonatopic control subjects did not react to the extract. Specific serum IgE antibodies against Asticot were found in the patient's serum (ELISA). Coomasie staining after SDS-PAGE separation of Asticot extract showed three protein bands of 30, 40 and 60 kDa. IgE immunoblot showed one antigenic band of 60 kDa specifically recognized by the patient's IgE. Specific nasal challenge test with Asticot extract using a Rhinospir 164 rhinomanometer showed immediate response (1/10 w/v), with a 200% increase in nasal resistances from baseline. CONCLUSIONS: One main allergen of MW 60 kDa was specifically recognized by our patient's IgE. There are no previous reports in the literature that characterize the allergens involved in Asticot hypersensitivity. Asticot maggots should be taken into account as a possible causative agent of respiratory symptoms due to a type I hypersensitivity mechanism in anglers who are exposed to emanations of these live fish baits.

Allergy to asticot maggots. Identification of allergens

There are some written reports of allergic reactions after contact with Asticot larvae in anglers and occupationally exposed workers. Clinical and immunological studies were performed to confirm the allergens involved in the case of a 12-year-old male who developed respiratory symptoms shortly after contact with Asticot maggots used as fish bait. Methods and results: Aqueous extracts of Asticot maggots were taken for in vivo and in vitro tests. The protein concentration as determined by turbidimetric assay was 1.4 mg/ml. Skin prick test with Asticot extract was positive with an immediate response. Ten atopic and ten nonatopic control subjects did not react to the extract. Specific serum IgE antibodies against Asticot were found in the patient's serum (ELISA). Coomasie staining after SDS-PAGE separation of Asticot extract showed three protein bands of 30, 40 and 60 kDa. IgE immunoblot showed one antigenic band of 60 kDa specifically recognized by the patient's IgE. Specific nasal challenge test with Asticot extract using a Rhinospir 164 rhinomanometer showed immediate response (1/10 w/v), with a 200 % increase in nasal resistances from baseline. Conclusions: One main allergen of MW 60 kDa was specifically recognized by our patient's IgE. There are no previous reports in the literature that characterize the allergens involved in Asticot hypersensitivity. Asticot maggots should be taken into account as a possible causative agent of respiratory symptoms due to a type I hypersensitivity mechanism in anglers who are exposed to emanations of these live fish baits (AU)

Hay publicados algunos casos de reacciones alérgicas tras contacto con larvas de Asticot en pescadores aficionados o en trabajadores expuestos a las mismas por su profesión. Se presentan los estudios clínicos e inmunológicos efectuados para demostrar los alergenos implicados, en este caso de un niño de 12 años de edad con síntomas respiratorios tras el contacto con larvas de Asticot usadas como cebo para la pesca. Métodos y resultados: Se prepararon extractos acuosos de larvas de Asticot para su utilización en los estudios in vivo e in vitro. La concentración proteica del extracto por turbidimetría fue de 1,4 mg/ml. El prick test con extracto de Asticot fue positivo en lectura inmediata, con controles negativos (10 pacientes atópicos y 10 personas no atópicas). Por ELISA se demostró la presencia de IgE sérica específica frente al extracto de Asticot. La tinción con azul de Coomasie tras la separación del extracto de Asticot por electroforesis en SDS-PAGE muestra tres bandas con PM aproximado de 30, 40 y 60 kDa. La inmunotransferencia IgE mostró una banda antigénica de 60 kDa reconocida específicamente por la IgE del paciente. La provocación nasal específica con el extracto produjo una respuesta inmediata con un incremento del 200 por ciento de la resistencia nasal medida con el rinomanómetro Rhinospir 164. Conclusiones: Hemos demostrado un alergeno principal de 60 kDa reconocido de forma específica por la IgE del paciente. No hay trabajos publicados que identifiquen los alergenos implicados en las reacciones de hipersensibilidad por Asticot. Las larvas de Asticot deben ser tenidas en cuenta como posibles agentes etiológicos de reacciones alérgicas en aficionados a la pesca y en quienes estén expuestos a las emanaciones de este tipo de cebos de pesca vivos (AU)

Pharmacokinetic and clinical evaluation of ketamine administered by i.v. and epidural routes.

The evolution of the plasma levels of ketamine and its two biotransformation products, norketamine (metabolite I) and dehydronorketamine (metabolite II) was studied after i.v. and epidural administration at doses of 2 and 5 mg/kg, respectively. The results show a good access capacity of ketamine from the epidural space to the systemic circulation as reflected in the high value of its apparent incorporation constant (ka = 5.54 +/- 2.33 h-1) and its good bioavailability (F = 0.77 +/- 0.22). The evaluation of clinical parameters points to a more attenuated cardiovascular and respiratory response after administration of the anesthetic by the epidural route.