Allergy to Parietaria officinalis pollen.

Parietaria pollen allergens (officinalis, judaica, lusitanica, creatica) are one of the most common causes of pollinosis in the Mediterranean (Spain, France, Italy, and Croatia). Parietaria has very long period of pollination, often reaching peaks of more than 500 grains/m3 of air at the beginning of June, and very strong allergenic properties. There is a significantly positive correlation for the newcomers between the intensity of the skin test reaction and concentration of specific serum IgE with the length of residence in the area, whereas autochthonous patients show a negative correlation between the age and intensity of hypersensitivity. This suggests that the environment encountered at birth may have a decisive role in the development of allergic respiratory diseases. Due to structurally similar pollen antigens in different Parietaria species, they are all equally useful in diagnosis and treatment of allergy, regardless of the pollen species to which the patient is sensitive or the prevalent species in the area. In our hands, specific immunotherapy with subcutaneous injections of partially purified, characterized, and standardized pollen extract of Parietaria allergen proved effective. It was possible to define an optimal maintenance dose of antigen per injection. During (years of) therapy, we observed an initial increase in total serum IgE concentration and increase in allergen-specific serum IgG blocking antibodies, decrease in allergen-specific serum IgE concentration and amount of histamine released from peripheral blood leukocytes challenged in vitro with the allergen, as well as in symptom and additional medication scores.

Specific hyposensitization in patients allergic to Parietaria officinalis pollen allergen.

The effects of specific hyposensitization in 40 patients with Parietaria officinalis-sensitive seasonal rhinoconjunctivitis were studied during three years of treatment. The patients were treated with subcutaneous injections of a new, partially purified, characterized and standardized pollen extract of P. officinalis allergen (alum-absorbed depot preparation). Treatment was applied from November to mid March and it was clinically assessed during the plant flowering season (mid March to end of June). Laboratory tests were performed yearly when beginning and ending treatment. Serum concentrations of P. officinalis pollen allergen-specific IgE antibodies decreased (first year: from 18.7 +/- 7.7 to 17.9 +/- 7.6 PRU/ml; second year: from 16.3 +/- 7.1 to 14.1 +/- 6.6 PRU/ml; third year: from 12.3 +/- 5.6 to 10.9 +/- 5.6 PRU/ml) and those of specific IgG increased (first year: from 15.3 +/- 13.2 to 21.7 +/- 14.0%; second year: from 28.5 +/- 13.0 to 36.3 +/- 15.9%; third year: from 29.9 +/- 14.1 to 38.9 +/- 16.8%) during the treatment. Histamine release from peripheral blood leukocytes challenged in vitro with the allergen decreased during the three years of the treatment (first year: from 42.3 +/- 13.0 to 33.1 +/- 10.8%; second year: from 31.9 +/- 11.9 to 19.1 +/- 8.5%; third year: from 19.4 +/- 4.6 to 14.3 +/- 4.6%), whereas the size of skin test reaction and the percentage of eosinophils among white blood cells remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypersensitivity to pollen allergens on the Adriatic coast.

In central south Croatia, i.e., the Adriatic coast with the city of Split at the center, year-long pollen concentrations in the air were determined for typical local plants, and the area's plant pollination calendar was established. High concentrations of Parietaria officinalis pollen dominated during the year (up to 20% from April to June). Pollens of Pistacia lentiscus, Olea europaea, Pinus halepensis, Juniperus oxycedrus, Mimosa and Cistus monspeliensis were found in lower concentrations and for shorter time periods. Using both commercially available standard inhalation allergens and specifically prepared pollen allergens, skin testing was performed and the cause of hypersensitivity was determined in a population of 4116 atopic patients with respiratory symptoms. Some 38.8% of patients were allergic to standard pollen allergens (mixed grass pollen, mixed tree pollen, P. officinalis and Pittosporum tobira). Hypersensitivity to more than one allergen was found in 53% of patients, whereas 19% of patients did not react to any of the standard allergens. Additional testing with newly prepared individual allergens (P. lentiscus, O. europaea, P. halepensis, J. oxycedrus, Mimosa and C. monspeliensis) revealed the causes of hypersensitivity in a number of patients, but the testing of patients nonreactive to standard allergens still left 44% of these individuals without reaction to any of the allergens used. Hypersensitivity to the pollens of P. tobira, C. monspeliensis and J. oxycedrus is described for the first time.

Hypersensitivity to Parietaria officinalis pollen in newcomers to the area with the plant.

Hypersensitivity to Parietaria officinalis (wall pellitory) pollen and other environmental allergens was studied in pollinosis patients allergic to P. officinalis pollen who were born in areas without P. officinalis and later moved to the city of Split, where P. officinalis is responsible for some 65% of pollinosis cases. Highly significant positive correlations were found for both the intensity of skin test reaction and concentration of specific serum IgE with the length of residence in the area. In contrast, the respective data on subjects hypersensitive to P. officinalis pollen allergen, but born and living in the area of Split, revealed a tendency to negative correlation between age and intensity of hypersensitivity to P. officinalis. A number of patients from both groups were tested for presence of serum IgE antibodies specific for 14 common environmental allergens. Hypersensitivity to P. officinalis pollen was associated with hypersensitivity to olive, mugwort, and birch pollen in newcomers; hypersensitivity to birch and, to some extent, olive pollen was significantly more frequent in newcomers than in autochthonous patients who were allergic to P. officinalis pollen. Regardless of whether the patients were autochthons or newcomers to the area with P. officinalis, hypersensitivity to P. officinalis mostly excluded hypersensitivity to Dermatophagoides farinae and D. pteronyssinus, and vice versa.

[Acute lymphocytic alveolitis in sarcoidosis]. / Burni limfocitni alveolitis u sarkoidozi.

Lymphocytic alveolitis is the characteristic feature of active sarcoidosis. High intensity alveolitis (more than 28% of lymphocytes in bronchoalveolar lavage fluid) implicates, according to some authors, specific, most often poor prognosis. Twenty-seven patients with active pulmonary sarcoidosis were grouped according to the intensity of lymphocytic alveolitis. In the first group, there were 13 patients with high intensity alveolitis (more than 28% of lymphocytes in bronchoalveolar lavage fluid, average 42.8 +/- 12%) and in the second group 14 patients with low intensity alveolitis (less than 28% of lymphocytes in bronchoalveolar lavage fluid, average 13.3 +/- 6.5%). The groups did not differ with regard to sex, chest radiologic stage or the number of relapses. All the patients had pulmonary function tests: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), diffusion capacity (DLCO), and rest and exercise arterial blood oxygen tension. The high intensity alveolitis group had significantly lower FVC (p < 0.01) and FEV1 (p < 0.05) as compared with the low intensity alveolitis group, what indicates that the high intensity alveolitis group of patients had more advanced pulmonary disease and was accordingly more often treated with corticosteroids (69.2%). Nine patients with high intensity alveolitis and ten with low intensity were followed up for 6 months. In the group with high intensity alveolitis there was a statistically significant improvement of DLCO (p < 0.01) what could be explained by a frequent use of corticosteroids in this group. Chest radiogram in the high intensity alveolitis group showed complete clearing in one patient only and incomplete in eight.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ketotifen and nasal steroids in the therapy of pollinosis]. / Ketotifen i nazalni steroid u terapiji polinoze.

Thirty-five patients with seasonal pollen rhinitis due to hypersensitivity to Parietaria officinalis pollen were randomized and treated with ketotifen and with a combination of ketotifen and beclomethason diproprionate, a nasal steroid. The study was timed to cover the Parietaria off. pollination period (4 months), which was documented by the determination of air concentration of the pollen. Respiratory symptoms and additional medications were scored according to a defined control. During the peak pollen period, both groups suffered from intensified pollinosis symptoms which prompted additional medication. The increases, however, were less significant in the group treated with the combination of the two drugs, i.e. better results were obtained with the ketotifen-beclomethasone diproprionate combination than with ketotifen alone.

Hypersensitivity to P. officinalis pollen: correlation of IgE with skin testing methods.

Fifty pollinosis patients, who have reported contact with P. officinalis, were tested for skin sensitivity with P. officinalis pollen extract. Intracutaneous testing and the skin prick method were employed and their sensitivity verified with regard to serum concentrations of specific IgE antibodies determined with the RAST method. Two criteria of the skin prick method evaluation were employed. The intracutaneous method correlated best with RAST. In contrast to intracutaneous testing, the skin prick method did not produce any false-positive results; however, due to a few false-negative cases observed, it appeared that in borderline-negative cases the skin prick method would require determination of serum IgE antibodies to reach a clear-cut diagnosis.

[Changes in the electrocardiogram in patients with sarcoidosis]. / Promjene elektrokardiograma kod bolesnika sa sarkoidozom.

Cardiac manifestations of sarcoidosis reflect the presence of granulomata in the myocardium or pulmonary arterial hypertension due to the advanced pulmonary form of the disease. Electrocardiographic changes may point to the form of the underlying pathology. The electrocardiograms of 150 newly diagnosed, untreated sarcoid patients, of whom no one had cardiac symptoms were analysed. Pathologic ECG changes indicative of myocardial sarcoidosis and/or pulmonary arterial hypertension were found in 20 (13.3%) patients. In cases with pathologic changes the ECG following the corticosteroid therapy was examined to test the stability or transitoriness of these changes. Two thirds of them disappeared following the corticosteroid therapy. Patients with the pathologic ECG, compared to the group as a whole, had a significantly more frequent pulmonary form of sarcoidosis and more severe restrictive and obstructive ventilatory changes.

Occurrence and specificity of IgE antibodies to isocyanates in occupationally exposed workers.

The levels of IgE antibodies specific for toluene-diisocyanate (TDI), diphenylmethane-diisocyanate (MDI) and hexamethylene-diisocyanate (HDI) were determined in eight workers with an unequivocal history of professional asthma, all having been exposed to isocyanates in the working atmosphere. Five workers were examined at the clinical onset of asthma. They had serum IgE antibodies specific for TDI, MDI and HDI, and depressed pulmonary ventilation parameters. In contrast, three workers, who had only a mild bronchial obstruction at the time of testing, had no anti-isocyanate IgE antibodies. The results indicated that asthma was induced by type I allergic reaction, but other pathogenetic mechanisms of bronchoobstruction could not be completely ruled out.

Allergy induced by Parietaria officinalis pollen in southern Croatia.

Pollen of Parietaria officinalis causes season-associated respiratory symptoms. In Southern Croatia (Yugoslavia) we found 65% patients with rhinitis and/or asthma to be allergic to this pollen. They showed positive cutaneous reactions and had specific IgE antibodies to the respective isolated allergen. The finding represents the first report on Parietaria officinalis-induced allergy on the east Adriatic coast.