Allergy to iguana.

BACKGROUND: Furry animals produce allergens that can cause allergic rhinitis and asthma. In contrast, scaly animals, such as lizards, are assumed not to be allergenic. OBJECTIVE: We sought to evaluate a 32-year-old man who complained of allergic rhinitis and asthma symptoms that occurred exclusively in his own home. He had dogs and cats at home but denied any increase in symptoms specifically associated with these pets. Skin prick testing initially performed to 42 common aeroallergens, including cat, dog, and house dust mite, elicited negative results. He later reported that the symptoms were worse on exposure to his pet iguanas. METHODS: Skin prick tests were subsequently performed to an extract made from scales from his pet iguana. Extracts were also prepared from several zoo reptiles. Immunoassays for IgE antibody, as well as IgE immunoblots, were performed by using these extracts and the patient's serum. RESULTS: The skin prick test result with the pet iguana scale extract was positive. The patient's serum contained IgE antibody to his own pet iguana and to a zoo iguana. CONCLUSION: Our patient's history, skin test results, and in vitro studies clearly demonstrate that he is allergic to iguana. Physicians should be aware that such allergy to scaly pets may occur and should not restrict history taking to questions about furry pets.

Pulmonary function studies in healthy Filipino adults residing in the United States.

BACKGROUND: Differences in lung volumes among various ethnic groups are known to occur; however, this has not been studied in Filipinos. OBJECTIVE: We sought to assess pulmonary function in healthy, nonsmoking Filipinos residing in the United States compared with standards for white subjects. METHODS: Healthy adult Filipinos, age 18 years or greater, were recruited. All subjects were screened with health questionnaires to exclude those with cardiopulmonary disease. Pulmonary function tests were performed by using forced expiratory maneuvers. Values for FEV(1 ), forced vital capacity (FVC), FEV(1 )/FVC, forced expiratory flow from 25% to 75% of FVC, and peak expiratory flow rate were compared with predicted values for white subjects (ie, without a racial adjustment). RESULTS: Two hundred twenty-four healthy subjects (121 men and 103 women) completed the study. The group means (as a percentage of the predicted standard for white subjects) were as follows: FEV(1 ), 86%; FVC, 84%; FEV(1 )/FVC, 103%; forced expiratory flow from 25% to 75% of FVC, 96%; and peak expiratory flow rate, 107%. These findings are very similar to those for African Americans and other Asians. CONCLUSION: We conclude that it is appropriate to use an 85% racial adjustment for FEV(1 ) and FVC when interpreting pulmonary function test results in Filipinos.

Common allergens in avian meats.

BACKGROUND: Reports of allergy to bird meats are uncommon, and most have been in patients with "bird-egg syndrome." OBJECTIVE: We sought to evaluate 3 patients who reported allergic reactions to several avian meats, but who denied allergic reactions to eating eggs. The patients required yellow fever vaccine for entry into the military. METHODS: Patients were skin tested with commercial extracts of chicken, turkey, and egg, as well as with crude extracts made from dove and quail meat, and with yellow fever vaccine. Immunoblots for IgE antibody were performed by using the same materials used for skin testing plus extracts of duck and goose meat. RESULTS: Skin tests were positive in all 3 patients to chicken, turkey, dove, quail, and yellow fever vaccine and negative to egg. This included some positive skin test responses to bird meats the patients denied ever having eaten. The vaccine was administered in graded doses. Immunoblots revealed IgE binding to several proteins of similar molecular weights in all of the avian meats but not to egg or yellow fever vaccine. Again, this included IgE antibody to some bird meats the patients denied ever having eaten. CONCLUSION: Patients allergic to one bird meat may be allergic to others, including game birds, probably because of cross-reacting allergens. Such patients may have to exercise caution even when eating bird meats they have not previously ingested. The relationship of this allergy to yellow fever vaccine, if any, remains to be determined.

Anaphylaxis from yellow fever vaccine.

BACKGROUND: There are very few reports of anaphylactic reactions to yellow fever (YF) vaccine in the literature, and these date from the 1940s. OBJECTIVE: We sought to estimate the rate of YF vaccine-related anaphylaxis. METHODS: All reports of adverse reactions to YF vaccine submitted to the Vaccine Adverse Event Reporting System between 1990 and 1997 were reviewed for those meeting criteria for probable or possible anaphylactic reactions. RESULTS: Of 243 reports submitted, 40 describe probable or possible anaphylactic reactions. In 22 of these 40, YF vaccine was the only vaccine administered. There were 5,236,820 doses of YF vaccine distributed in the United States during this period. By using all 40 cases, the rate of YF vaccine-related anaphylaxis would be 40 in 5, 236,820 or about 1 in 131,000. In 35 of the reports, information was provided on whether previous doses of YF vaccine had been given. In 34 of these 35, the reaction occurred after the first dose of YF vaccine, suggesting that vaccine constituents other than the viral proteins may have been the allergens. The vaccine is grown in chicken embryos and contains gelatin as a stabilizer. CONCLUSION: YF vaccine can cause anaphylactic reactions. Persons presenting for YF vaccine should be asked if they have had adverse reactions to previous doses of this or other vaccines and if they are allergic to eggs, chicken, or gelatin. Health care workers administering YF vaccine should be prepared to recognize and treat anaphylactic reactions should they occur.

An age-associated correlation between cellular bioenergy decline and mtDNA rearrangements in human skeletal muscle.

Post-mitotic tissues such as skeletal muscle develop a tissue bioenergy mosaic during the process of normal aging that eventually culminates into a bioenergetically diverse tissue containing cells ranging in their oxidative phosphorylation capacity from normal to grossly defective. The mosaic is postulated to develop continuously from birth with the relative proportions of cytochrome c oxidase (COX) proficient (positive) and COX deficient (negative) muscle fibers differing dramatically as a function of age. Generally, young individuals only display the rare fiber deficient in COX activity while aged individuals show a significantly higher proportion of negative fibers. There appears to be a random element governing which cells will be affected. Consequently, adjacent cells within a given tissue may exhibit vastly differing COX activities. Multiple mitochondrial DNA (mtDNA) deletions also appear to accumulate in skeletal muscle, similarly displaying a dramatic disparity as a function of age. Our previous findings have indicated that the accumulation of multiple mtDNA deletions, along with a concurrent decrease in wild-type mtDNA, strongly correlates with the age-associated decrease in COX activity observed in skeletal muscle. Although no definitive associations were established at the cellular level, an important prediction arose from this study. Cells that accumulate large numbers of mitochondrial mutations and have reduced levels of full-length mtDNA would be expected to be severely affected and show reduced COX activity as a consequence. Cells that accumulate fewer mutations or retain adequate amounts of wild-type mtDNA would be predicted to be less affected or even retain normal oxidative metabolism. In order to establish a link associating COX activity to the status of mtDNA within individual fibers, we developed single cell extra-long PCR (XL-PCR). The procedure was used to assess the relative concentration of full-length mtDNA with respect to any mtDNA deletions detected in individual human skeletal muscle fibers of 'pre-established' COX activity. Single cell XL-PCR analysis of COX positive fibers dissected from a 5-year old and 90-year old individual showed that 80% or more of the fibers contained full length mtDNA and few, if any, mtDNA rearrangements. COX deficient or COX intermediate fibers taken from the same individuals, by contrast, depicted a heterogeneous population of rearranged mtDNA species with no detectable full-length mtDNA. The data presented here indicates that COX deficient muscle fibers extracted from individuals, regardless of age, were accompanied by extensive mtDNA rearrangements and reduced levels of full-length mtDNA. This provides compelling evidence linking mtDNA mutations to COX activity decline in skeletal muscle and has important implications when considering the molecular basis of the aging process.

Deltoid human muscle mtDNA is extensively rearranged in old age subjects.

Extra long PCR analysis of mitochondrial DNA (mtDNA) isolated from skeletal muscle of humans of different ages revealed three phenomena: (i) the amount of normal length mtDNA (16.5 kb) was progressively reduced with age, such that the cells of old age individuals (about 90 years) contained little, or undetectable amounts of normal length mtDNA; (ii) the total amount of mtDNA did not appear to be greatly decreased rather the extent of mtDNA deletions greatly increased; (iii) in old age subjects, considerable amounts of over-sized mtDNA (more than 16.5 kb) was observed. Enzyme histochemical analysis of cytochrome-c oxidase (COX) activity in the muscle tissue of all subjects evidenced a cellular bioenergy mosaic with cells ranging from high to zero detectable enzyme activity in the muscle samples. The frequency of COX deficient muscle fibres was highly dependent on the age of the subject. We have found that the extent of the mtDNA mutational changes strongly correlate with the observed progressive decrease in COX activity. Therefore, it was suggested that the total extent of mtDNA mutation is very large in old age subjects and is sufficient to account for the decline in cellular COX activity with age and for a progressive decrease of overall mitochondrial bioenergetic capacity.

In vitro effects of MOCA and dapsone on rat hepatic and splenic immune cells.

The industrial curing agent 4,4'-methylene-bis(2-chloroaniline) (MOCA) and the structurally related medicinal agent 4,4'-sulphonyldianiline (dapsone), are two commonly used aromatic amine compounds and documented animal carcinogens. In this study the effects of in vitro exposure to MOCA and dapsone (over a dose range of 1-200 microM on spleen and liver immune cell functions were investigated. MOCA exposure caused a dose-dependent inhibition of natural immune activities (i.e. natural killer, NK and natural P815 killer, NPK) and mitogen-stimulated proliferation of T- and B-lymphocytes, with 50% inhibition (IC50) of splenic-cell activities occurring at 145, 85, 21 and 31 microM, respectively. Liver NK and NPK activities were less sensitive to MOCA exposure and exhibited higher IC50's of 165 and 160 microM, respectively. Dapsone exposure slightly enhanced both T- and B-cell mitogenesis at low doses (1 microM) but decreased B-cell mitogenesis at high doses (IC50 = 130 microM). Natural tumouricidal activities were generally unaffected by dapsone, whilst natural cytotoxic (NC) activity was unaffected by both compounds. These results indicate that MOCA is generally immunotoxic in vitro, and may have the potential to enhance the carcinogenic effects of its genotoxic metabolite by inhibiting the tumour surveillance activities of the immune system. The relationship between immune effects and the carcinogenicity of dapsone remains unclear.

Monospecific allergy to swordfish.

BACKGROUND: Fish allergy is a relatively common and potentially fatal condition. Most fish allergic subjects are allergic to multiple fish species. We encountered a patient clinically allergic only to swordfish. OBJECTIVE: To characterize the in vivo and in vitro IgE antibody responsiveness of this patient solely allergic to swordfish. METHODS: Prick skin tests, as well as immunoassay and protein immunoblotting for IgE antibody were performed using commercial fish extracts and fresh swordfish. A more typical multiple fish-allergic subject and a subject not allergic to food were also studied for comparison. RESULTS: The multiple fish-allergic subject demonstrated IgE antibody to a 13-kD protein in all fish tested (probably Gad c 1 and its analogues in other fish). The swordfish-allergic subject did not recognize this 13-kD band but did demonstrate IgE directed against a 25-kD band only in swordfish. The negative control showed no IgE binding to either the 13 or 25 kD bands. CONCLUSIONS: It is possible to be allergic to a single fish species, such as swordfish, and such monospecific allergy may be due to the presence of species-specific allergens, in this case a 25-kD allergen in swordfish.

Skin test results in related and unrelated persons with allergic rhinitis.

BACKGROUND: First degree relatives of patients with allergic rhinitis are at increased risk of having the disorder. It is not yet clear whether or not two such related persons with allergic rhinitis are more likely to be skin test positive to the same specific allergic extracts than unrelated persons with allergic rhinitis. OBJECTIVE: To determine whether or not first degree relatives (parent and child or full siblings) with allergic rhinitis are more likely to be skin test positive to the same allergen extracts than unrelated persons with the disease. METHODS: A retrospective chart review of Allergy Clinic patients was performed. Skin test results for 12 common aeroallergen extracts were compared in 32 pairs of genetically related subjects and 32 pairs of age-matched and sex-matched unrelated subjects, all with allergic rhinitis. The percent of concordant results (both members of a pair skin test positive or both negative) and discordant results (one member of a pair positive and the other negative) were calculated and compared for related and unrelated groups. Also, the expected rates of positive concordance (both skin tests positive) based on the prevalence of skin test positively in the two groups were calculated and compared with the corresponding observed rates. RESULTS: Results were concordant in 242 of 384 skin tests (63%) in related pairs versus 233 of 384 skin tests (61%) in unrelated pairs (P = .28, not significant). The expected and observed rates of positive concordance were not significantly different in the related (P = .38) or unrelated (P = .49) groups. When the groups were subdivided into parent-child pairs and sibling pairs, a similar lack of significant differences between the groups was found. CONCLUSIONS: It is concluded that first degree relatives, both with allergic rhinitis, are no more likely to be skin test positive to the same allergen extracts than unrelated persons with this disease. Further, it seems appropriate to advise patients with allergic rhinitis that their first degree relatives who also have the disorder will not necessarily have the same specific allergies.