Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: a placebo-controlled trial.

BACKGROUND: Patients with chronic urticaria (CU) frequently exhibit positive skin test reactions to autologous serum (ASST). Therapies aimed at inducing tolerance to circulating histamine-releasing factors in ASST+ CU patients, e.g. by treatment with autologous whole blood (AWB), have not yet been tested. OBJECTIVE: To test whether ASST+ CU patients can benefit from repeated low-dose intramuscular injections of AWB. METHODS: We characterized CU severity and duration, anti-Fc(epsilon)RI and anti-IgE expression, use of antihistamines, and quality of life in 56 CU patients (ASST+: 35, ASST-: 21) and assessed the therapeutic effects of 8 weekly AWB injections in a randomized, placebo-controlled, single-blind, parallel-group trial. RESULTS: Numbers, size, intensity, and/or duration of CU symptoms, quality of life, as well as expression of anti-Fc(epsilon)RI or anti-IgE were similar in ASST+ and ASST- CU patients. However, CU in ASST+ patients was of longer duration and required markedly more antihistaminic medication. Interestingly, ASST+ patients, but not ASST- patients, showed significantly (1) reduced CU activity, (2) decreased use of antihistamines, and (3) improved quality of life after AWB treatment. Placebo treatment was ineffective in both groups, but differences of AWB and placebo treatment responses did not achieve statistical significance in either group, most likely due to the limited number of patients treated. CONCLUSION: Our findings suggest that ASST+ CU is clinically different from other CU subforms and that ASST+ CU patients can benefit from AWB therapy.

[Base activity of glycogen phosphorylase b in human serum. Study of reference and discrimination values]. / Basalaktivität der Glycogenphosphorylase b im menschlichen Serum. Referenz- und Diskriminationswert-Studie.

Serum glycogen phosphorylase activity as one of the sensitive indicators for the diagnosis of acute heart infarction was determined at 216 healthy probands using a standardized fluorometric procedure with a detection range from 0.03 to 6 nmol/s x l serum. Basal activity was averaged at 1.22 +/- 0.39 nmol/s x l serum with a confidence interval of C.I.95 1.168 ... 1.272. Due to the estimated Gaussian distribution of the individual activity values (n = 216) the reference range was calculated from 0.5 to 2.0 nkat/l (2.5- to 97.5-percentile, respectively), the latter one being equal to the reference value of the glycogen phosphorylase activity in healthy human beings. The reference value was found to be independent of age (16-65 years) and sex. Using the discrimination value for serum glycogen phosphorylase activity at 3 nkat/l serum two groups of patients suffering either from acute myocardial infarction (n = 79) or chronic ischemic heart disease (n = 92) were separated with a diagnostic sensitivity and specificity of 0.91 and 0.93, respectively, of this diagnostic tool.

Immunoinhibition assay of the serum activity of human glycogen isophosphorylase BB in the diagnosis of the acute myocardial ischaemia.

Polyclonal rabbit anti-human isophosphorylases inhibit selectively the isoenzyme activities of the BB and MM isoenzyme of the human glycogen phosphorylase b with high sensitivity and without crossreactivities. On this basis a serological immunoinhibition assay of the BB isoenzyme in the range of 1-125 nmol s-1 l-1 is described. Preliminary clinical results indicate the BB isoenzyme as a sensitive and specific marker of the acute myocardial ischaemia including bypass surgery and suggest a substantial improvement of the differential diagnosis of infarction.