ABSTRACT
For patients with severe allergies, allergen immunotherapy can lessen or eliminate reactions, reduce the need for medication, and improve quality of life. Here's what you need to know to provide this treatment safely and minimize its risks.
Subject(s)
Desensitization, Immunologic , Hypersensitivity/therapy , Desensitization, Immunologic/nursing , Humans , Hypersensitivity/diagnosis , Hypersensitivity/nursingABSTRACT
BACKGROUND: Chronic atopic dermatitis (AD) lesions are associated with colonization by exotoxin-producing Staphylococcus aureus. Evidence suggests that cytokine production in AD, particularly of GM-CSF, prolongs survival of both peripheral blood monocytes and dermal monocyte-macrophages, the predominate inflammatory cell in lesions caused by chronic AD. OBJECTIVE: We sought to determine whether the staphylococcal exotoxin, toxic shock syndrome toxin-1 (TSST-1), could stimulate prosurvival cytokine production in monocytes and thereby inhibit apoptosis. METHODS: Cultures of peripheral blood monocytes from normal donors and subjects with AD were incubated with various concentrations of TSST-1, and the incidence of apoptosis was assessed by examining cytospin preparations and the appearance of hypodiploid DNA in the flow cytometer. Culture supernatants were analyzed for GM-CSF, IL-1beta, and TNF-alpha by ELISA. RESULTS: TSST-1, in a concentration-dependent manner starting at 0.1 pg/mL, significantly inhibited monocyte apoptosis and resulted in the production of the prosurvival cytokines GM-CSF, IL-1beta, and TNF-alpha. In coculture conditions with conditioned media from TSST-1-stimulated monocytes, with or without neutralizing antibody to the various cytokines, the data show GM-CSF production was responsible for the inhibition of apoptosis. CONCLUSIONS: The data strongly suggest that staphylococcal exotoxins known to colonize skin lesions on patients with chronic AD may induce the production of GM-CSF, resulting in inhibition of monocyte-macrophage apoptosis, and thereby contribute to the chronicity of this inflammatory disease.
Subject(s)
Bacterial Toxins , Enterotoxins/pharmacology , Monocytes/cytology , Superantigens , Apoptosis/drug effects , Dermatitis, Atopic/blood , Dermatitis, Atopic/pathology , Dose-Response Relationship, Drug , Granulocyte-Macrophage Colony-Stimulating Factor/biosynthesis , Granulocyte-Macrophage Colony-Stimulating Factor/blood , Humans , Staphylococcus aureus/immunologyABSTRACT
The useful life of agar in aerosol samplers is greatly extended by treatment with a dilute emulsion of oxyethylene docosanol. Growth of viable organisms is unaffected.
