A multidisciplinary approach of outdoor aeroallergen selection for Skin Prick Testing in the geographical area of Greater Istanbul.

SUMMARY: Background. Aeroallergen selection for skin prick testing and the interpretation of results need to be in line with allergenic sources of a specific geographic area. Objective. To identify aeroallergens for a skin test panel for the specific geographical area of Istanbul in a multidisciplinary approach based on aerobiological parameters, cross-reactivity patterns and clinical symptoms. Methods. Aerobiological parameters, cross reactivity patterns and the European Standard Skin Prick Test Panel determined allergen selection. Atopic adult patients (n = 60) compiled a questionnaire and were skin prick tested with 29 aeroallergens. Aerobiological sampling followed the requirements of the European Aerobiology Society. Results were statistically analyzed. Results. 65% of patients had positive skin reactions. Sensitization to at least one grass allergen was 30%. Key grass allergens were timothy grass (Phleum pratense L.) 25.8% and Johnson grass (Sorghum halepense (L.) Pers.) 22.6%; correlations between grass-sensitizations were significant at p (minor) 0.01 and so was the correlation of Pooideae sensitization with symptoms and medication. Sensitization to at least one woody plant was 23%; to ash (Fraxinus excelsior L.) 8.1%; hazelnut (Corylus avellana L.), olive (Olea europaea L.) and mulberry (Morus alba L.) 6.5%; juniper (Juniperus ashei J.Buchholz) 4.8%. Correlations between Fagales allergen sensitizations were significant. Sensitization to at least one weed was 22%, sensitization to dock (Rumex crispus L.) 12.9%, ragweed (Ambrosia artemisiifolia L.), and mugwort (Artemisia vulgaris L.) 4.8%. Sensitization rates correlated significantly with the length of the Main Pollen Season. Conclusions. The European Standard Panel is suitable for the geographical area of Greater Istanbul, if it comprises Johnson grass and ash. Ragweed has become clinically relevant in this region. Mulberry and dock were exclusively associated to polysensitized individuals suggesting pan-allergen involvement.

Bronchial asthma and wheeze in a desert country.

A cross-sectional, population-based study was conducted among school children (3300), aged 7-12 years, in the Kingdom of Saudi Arabia, during the period January, 1988-February, 1990. The aim of the study was to investigate the association between asthma, allergic rhinitis, wheeze and eczema among Saudi school children. The relationship between pet-ownership and respiratory allergy was also studied. Detailed information was collected about wheeze and asthma in 3041 children and history of asthma and allergic rhinitis in their parents. The population sample had a high prevalence rate of diagnosed asthma (6.8%), history of wheeze (10.5%), allergic rhinitis (17.9%), and eczema (10.8%). Allergic rhinitis was the most frequently seen respiratory illness when compared to other respiratory symptoms. The prevalence rate of asthma, allergic rhinitis and eczema among parents reflected the same pattern as that seen in the children. Prevalence rate for asthma in children with pets is twice that of children without pets (OR: 2.4; 95%, Cl: 1.8-3.1). The odds of having chronic cough (OR: 3.9; 95% Cl: 2.8-5.2), chronic wheeze (OR: 4.2; 95%, 3.3-5.4), allergic rhinitis (OR: 8.0; 95% Cl: 6.3-10.3) and eczema (OR: 2.8: 95 Cl: 2.1-3.7) was higher in children with pets than in children without pets. The present study revealed that pet-ownership was associated with increased respiratory symptoms.

Passive smoking effects on wheezy bronchitis.

Previous epidemiological studies have associated parental smoking with an increased incidence of lower respiratory illness and bronchial asthma. The aim of the present study was to investigate the association between parental smoking habits and diagnosed wheezy bronchitis in schoolchildren in Saudi Arabia. In a cross-sectional study 3,041 schoolchildren ages seven to 12 years were randomly selected in Dammam, Jeddah, and Riyadh; representing three different geoclimatic regions of Saudi Arabia. Standardized questionnaires were used in our study. The results showed that paternal smoking had a significant effect on the frequency of wheezing when paternal and maternal smoking were considered separately. There was no considerable variation in the parental smoking habits in three areas. The association between passive smoking and diagnosed wheezy bronchitis and frequency of wheezing attacks was highly significant (P<0.0001). Overall, the results tend to confirm that there is a real effect of passive smoking on the respiratory health of children and that paternal smoking is a risk factor for wheezy bronchitis in children.

Prevalence of asthma and wheeze in two different climatic areas of Saudi Arabia.

In a cross-sectional study, the prevalence of asthma and wheeze was studied in 2300 school going children in two different environment and climate regions of Saudi Arabia, Dammam (humid-coastal) and Riyadh (dry-inland). The age range of children studied was 7-12 years (56% boys and 44% girls in Dammam; and 47% boys and 53% girls in Riyadh). A self-administered questionnaire was completed by parents of the children which includes information on age, sex, area, occupation and educational level of parents, history of asthma, allergic rhinitis, eczema, cough, wheeze, animals and pets exposure, family history of allergy and parental smoking habits. The results showed that prevalence of wheeze was more common in Riyadh (11.86%) than in Dammam (6.54%). Also, cough occurred more frequently in Riyadh (7.9%) than in Dammam (6%). The frequency of rhinitis was significantly more common in both areas than wheeze (Riyadh 17% and Dammam 12%). Also, the attack of breathlessness or tightness occurred more frequently in Riyadh (12.13%) than in Dammam (6.10%). When a more formal diagnosis of asthma was sought, this having been made by a doctor, the figures were 9.28% for Riyadh and 3.59% for Dammam. These figures showed major differences between the coastal and inland areas in the prevalence of bronchial asthma and wheezing with Dammam being relatively low risk whereas children in Riyadh region describe this more commonly.

The motility of human milk macrophages in collagen gels.

The hypothesis that the diminished motility of human milk leukocytes is due to a decrease in adherence was tested by using a collagen gel system in which leukocyte movement is less dependent on adherence. Unfractionated human milk leukocytes (HML) or fractionated peripheral blood leukocytes were placed on collagen gels in microwells and the leading edge of migration was determined by inverted phase microscopy. The mean rates of invasion of HML, blood neutrophils, and mononuclear blood leukocytes were 14, 240, and less than 1 mu/h, respectively (p less than 0.01). We then examined the identity of motile HML by immunoperoxidase techniques using antibodies to selected cell markers. Motile HML were positive for a specific macrophage marker (cathepsin B) and a neutrophil and monocyte marker (Mac-1) but were negative for specific neutrophil (cathepsin G) or lymphocyte markers (CD3 and CD5). The directed motility of these cells was not enhanced by exposure to the chemoattractant, N-formyl-L-methionyl-L-phenylalanine, but was inhibited by a T cell lectin, phytohemagglutinin. The movement was actin dependent but was not dependent on calcium or Mac-1 surface glycoproteins. Thus, the diminished motility of milk neutrophils does not appear to be due to decreased adherence per se, and those HML that are motile are macrophages. This suggests a dichotomy for the function of HML. Neutrophils may be relegated to the lumen of th alimentary tract, whereas macrophages may penetrate into mucosal sites for host defense.