Comparison of the efficacy and safety of mometasone furoate dry powder inhaler to budesonide Turbuhaler.

Mometasone furoate (MF) administered by dry powder inhaler (DPI) was composed with budesonide (BUD) Turbuhaler in the treatment of moderate persistent asthma. The patients were randomized to one of four treatment groups: MF DPI (100, 200, 400 microg b.i.d) or BUD Turbuhaler. 400 microg b.i.d in a 12-week, active-controlled, evaluator-blind, multicentre international trial. The primary efficacy variable was the mean change from baseline to endpoint (last treatment visit) in forced expiratory volume in one second (FEV1). Changes in FEV1 showed a statistically significant superiority (p<0.05) of MF DPI 200 and 400 microg b.i.d compared with the BUD Turbuhaler 400 microg b.i.d treatment. Significant superiority (p<0.05) was also seen in scores for several secondary efficacy variables when MF DPI was compared with BUD Turbuhaler treatment. MF DPI 200 microg b.i.d was comparable to MF DPI 400 microg b.i.d in therapeutic benefit. The incidence of oral candidiasis was no more than 3% in any group. All treatments were well tolerated. A total daily dose of 400 microg of mometasone furoate administered by dry powder inhaler provides a well-tolerated treatment for patients with moderate persistent asthma and results in a significantly greater improvement, when compared to a daily dose of 800 microg BUD Turbuhaler in the parameters measured in this study.

Mite-contaminated foods as a cause of anaphylaxis.

BACKGROUND: Although insect and arthropod contamination of certain foods has been recognized for many years, allergic manifestations caused by ingestion of mite allergens have only rarely been reported. OBJECTIVE: The purpose of this study is to present clinical observations in patients who experienced acute anaphylaxis after eating mite-contaminated foods. METHODS: Thirty atopic subjects who were first seen with systemic anaphylaxis precipitated by the ingestion of wheat-containing foods underwent skin prick tests with inhalant and food extracts, as well as with uncontaminated and mite-contaminated wheat flour. Flour samples were examined microscopically for identification and counting of mites. Der p 1 and Der f 1 levels were quantitated by using immunochemical methods. RESULTS: The most common symptoms were breathlessness, angioedema, wheezing, and rhinorrhea, which started between 10 and 240 minutes after eating. Abundant mites were present in the flour obtained from 28 patients; Suidasia spp. mites were found in grated bread from the other two patients. Positive prick test responses to Dermatophagoides farinae-and mite-contaminated flour and negative skin test responses to wheat extract, other food extracts, and uncontaminated wheat flour were found in all patients. Skin test responses were positive in volunteers with mite allergy even after heating the mite-contaminated flour at 100 degrees C. Screening of 35 unselected flour samples demonstrated the presence of mites in 13 of them (37.1%). CONCLUSIONS: Systemic anaphylaxis can occur after the ingestion of heated or unheated mite-contaminated foods. This problem may be more prevalent in tropical and subtropical countries than previously recognized.

Eosinophilia in Hodgkin's disease: a role for interleukin 5.

In order to clarify the mechanisms of the eosinophilia frequently observed in patients with Hodgkin's disease (HD), 18 patients and 16 age- and sex-matched controls were studied. Increased eosinophil numbers in peripheral blood and serum IgE, as well as decreased cell-mediated immunity were present in HD patients compared with control individuals. Advanced disease was accompanied by lower eosinophil levels, increased IgE, and lower CD4+ T cell counts in peripheral blood. Eosinophilia correlated with CD4+ T cell counts, suggesting that eosinophil production could be under CD4+ T cell control. GM-CSF production in vitro by Phytohemagglutinin-stimulated mononuclear cells was significantly lower in HD patients with eosinophilia. On the other hand, an eosinophil-survival-enhancing activity was found in sera and culture supernatants from controls and HD patients; this activity was stronger for HD patients and was higher for those with eosinophilia. Furthermore, this activity was completely abolished by preincubation with monoclonal antibodies to IL-5, but not with normal mouse serum. Our results suggest that defects of cell-mediated immunity present in patients with HD are accompanied by a predominant type 2 cytokine profile. IL-5 is involved in the increased eosinophil production observed in these patients.

Preventive role of atopy in lung cancer.

Incidence of atopic disease, serum and sputum IgE, and sputum IgA levels were studied in lung cancer patients, and compared with those in lung benign disease patients and normal controls. A significantly lower prevalence of personal atopic history was observed in the cancer group in comparison with the other two experimental groups. Patients with lung cancer showed significantly higher serum IgE levels than benign-disease and normal control individuals. At the same time, patients with epidermoid lung carcinoma had significantly increased levels of serum IgE and sputum IgA than those with lung adenocarcinoma.

Laboratory diagnosis in thyroid auto-allergic diseases.

Different parameters of humoral and cellular immunologic sensitization have been described in thyroid autoallergic disease, however, the percutaneous biopsy of the gland remains as one of the principal parameters of diagnostic confirmation, wherein the possible error of the sample being taken in an area not affected by the disease. The present study assesses two different parameters of immunologic sensitization, humoral and cellular as they are determination of thyroid antimicrosomal antibodies by hemagglutination and leukocyte inhibition migration tests against the same microsomal antigen. Both types of sensitization are proposed as being relevant, and can be found present alone or combined in the same patient, which suggests that the determination of antibodies is the most useful proof with diagnostic motives, but this should be followed by the determination of leukocyte inhibition migration when the result is negative.

A role for anaphylactic sensitization in tumor control.

In order to evaluate the possible preventive role of an anaphylactic condition on tumor development, C57BL/6J mice were immunized or hyperimmunized by the intraperitoneal route with egg albumin in alum before the chemical induction of fibrosarcoma. Preimmunization using a protocol which elicits an optimal IgE response produced: (1) a significant reduction of tumor incidence; (2) an increase of survival time, and (3) a decrease of tumor growth rate in animals with higher IgE titers (greater than 640). On the other hand, hyperimmunized mice, which were suppressed in their anti-egg albumin IgE response, showed no changes in tumor incidence and survival time when compared to controls. Our results suggest a suppressive effect on tumor development related to the ability of the animal to mount an IgE response to antigens unrelated to the tumor.

[Induction of immunologic tolerance to transplantation antigens using conditioning of the lymphocyte genome of the recipient with ribonucleic acid from the donor]. / Inducción de tolerancia inmunológica a antígenos de trasplante, mediante condicionamiento del genoma linfocitario del receptor con ácido Ribonucleico del donante.

The phenomenon of specific immunosuppression which we call "immunologic tolerance" constitutes the final result common to diverse processes partially known. The study of the phenomena inter or intra cellular involved in the divese mechanisms of production, however constitutes a field which is quite obscure. The explanation of these phenomena could offer us some fundamental knowledge towards the better understanding and subsequent manipulation of the process. This present project of investigation proposes to study the possibility of transferring one of these states of tolerance which is better established as is the spontaneous tolerance to the proper antigens of an animal (donor) to a second animal (receptor) genetic and for that reason, antigenically different, through an informational molecule such as the ribonucleo acid (RNA) extracted from the donor animal. This hypothesis is based theoretically on the following points: 1) The state of "self-immunologic tolerance" is probably an active and dynamic phenomenon, in which one can determine the presence of lymphocytes with receptors for proper antigens, without establishing in normal conditions an efferent phase of the immunologic answer, which determines an effect on this antigen. 2) The effective immunologic reactivity (allergic answer) of a determined animal is transferable to a second non-sensitized animal through RNA from the first animal. In this study we present the results of the conditioning of the allogenic reactivity of one strain of mice, through the exposition of the same to RNA extracted from one congenic-resistent strain with respect to first.(ABSTRACT TRUNCATED AT 250 WORDS)