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Background: The expression of CD64 (FcgammaRI) is increased from an almost negligible to a marked level on neutrophils in patients with bacterial infections. CD64 expression on neutrophils might therefore be a potential candidate for the diagnosis of bacterial infections in infants.Aim: This study was performed to monitor changes of neutrophil expression of CD64 during the postpartum period to further evaluate the usefulness of this analysis. The possible influence on the expression of this receptor by other factors was also investigated, including respiratory distress syndrome (RDS) and preterm rupture of the membranes (PROM).Methods: Cell surface expression of CD64 on neutrophils from preterm and term newborn infants and healthy adults was analysed by flow cytometry. The expression of the other Fcgamma receptors, CD32 and CD16, and the complement receptors CD11b/CD18 and CD35 was also analysed for comparison.Results: Neutrophils from preterm newborn infants showed a moderately increased level of CD64 expression that, during their first month of life, was reduced to the level observed on neutrophils from term newborn infants and adults. In contrast, the level of neutrophil expression of CD32 and CD16 was significantly lower in preterm than term newborn infants and adults. Neutrophils from all groups indicated similar levels of CD11b expression, but the expression on neutrophils from newborn infants increased after birth.Conclusion: Our results showed that neutrophil expression of CD64 is moderately increased in preterm newborn infants at birth. It seems not to be influenced by RDS, PROM or other factors related to preterm birth but by bacterial infection. [ABSTRACT FROM AUTHOR]

The marked rise in allergies during the past decade has been increasingly perceptible for school personnel. A quarter of Swedish parents of children with allergies are unsatisfied with the school environment and how the schools are organized around their children. The Association of School Physicians has, together with six other medical, teaching and patient organizations, developed written guidelines for the management of asthma and allergies in Swedish schools. The aim was to regulate the responsibility of the school and its personnel for students with asthma and allergies, and to strengthen safety arrangements within schools. A secondary aim was to describe how the curriculum, teaching equipment, excursions, and other school activities, could be arranged appropriately and safely for students with asthma and allergies. Five-hundred copies of the document were circulated to all of Sweden's municipalities, county councils and pediatric departments. There was general agreement regarding the schools' responsibility that no child should risk becoming ill or having exacerbation of symptoms due to conditions at school. Recommendations regarding smoking on school premises and the use of perfumes were criticised. The strength of this document is that all organizations actively involved with schools have agreed upon these recommendations. This document serves to suggest a minimum level of activities thus ensuring that even students with asthma and allergies will receive appropriate schooling. The marked rise in allergies during the past decade has been increasingly perceptible for school personnel. A quarter of Swedish parents of children with allergies are unsatisfied with the school environment and how the schools are organized around their children. The Association of School Physicians has, together with six other medical, teaching and patient organizations, developed written guidelines for the management of asthma and allergies in Swedish schools. The aim was to... [ABSTRACT FROM AUTHOR]

Allergy and asthma are common diseases today. Ways to stop the ongoing increase in incidence of these diseases are highly desired. In this review the scientific basis for allergy and asthma prevention is discussed. Results: Although secondary preventive measures are generally regarded as important, the views regarding the possibility of primary prevention vary. There is today only weak evidence that breastfeeding may reduce the risk of developing allergy, and if it does the effect is limited in degree and duration. There is some evidence that prolonged breastfeeding reduces the risk of developing asthma, at least in allergy-risk infants. There is also some evidence indicating that withholding solid foods in children at risk may have a beneficial effect. A dose-dependent risk of becoming sensitized to house dust mite and pet animal allergens has clearly been shown, but to what extent this sensitization is combined with asthma or clinical allergy is less well elucidated. Passive smoking increases the risk of wheezing problems and the indoor environment in damp houses seems to act synergistically with passive smoke. Conclusion: Primary prevention is rarely possible, but the risk of developing asthma and allergy may to some extent be reduced by taking certain measures, such as avoidance of tobacco smoke and damp houses. Breastfeeding seems to reduce the risk of wheezing, but as allergy-preventive measures, breastfeeding and avoiding pet animals have only marginal effects. [ABSTRACT FROM AUTHOR]

During a 10-year period, 1,050 medical students were questioned regarding allergy and allergy-like symptoms and 612 of them underwent skin prick tests with dog, cat, timothy and birch allergens. Symptoms of eczema, asthma or non-infectious rhmitis, past or current, or current reactions to pollen furred animals, dust, mould or food were reported by 46% of the students. Three per cent reported present eczema of the flexure type and a further 8% reported past symptoms of the same kind. Current contact eczema was reported by 7% and past contact eczema by a further 3%. Daily treatment with ointments was reported by 52% of the students with current flexure eczema and by 17% with current contact eczema. Current asthma was reported by 5% and past asthma by a further 3%. Of these with current asthma, 88% were allergic to pollens and/or furred animals and 75% used anti-asthmatic drugs for at least 2 weeks/year. Current allergic symptoms in the nose and/or eyes were reported by 29% and a further 2% reported past symptoms. Of those with current symptoms 64% were allergic to pollens and/or furred animals, as judged by the history and skin tests. Almost 60% of the students with pollen allergy used anti-allergic drugs for at least 2 weeks/year. Allergy for pollens was reported by 17% to animals by 12%, to house dust by 10%, to moulds by 2% and to foods by 15%. Allergy reported and confirmed by a Prick test was found in 8% against birch, 6% against timothy, 10% against cat and 5% against dog. These prevalence figures are high, but are in accordance with those in other recent studies. Interestingly, no tendency to increasing figures with time was found during the study period. [ABSTRACT FROM AUTHOR]

This double-blind immunotherapy trial in children, using a purified and standardized Cladosporium herbarium preparation, has shown that children with mould asthma and/or rhinoconjunctivitis, responded to immunotherapy with a decrease in specific IgE and a significant increase in specific IgG. There was a marked increase in the ratio specific IgG/specific IgE as a result of active treatment, IgE-CRIE radiostaining patterns showed no pronounced changes after 10 months' actives treatment and no "new sensitivities" could be detected in the studied patients. IgG-CRIE radiostaining, primarily directed towards the important allergens, was significantly increased in the active group and particularly towards Ag-12 (partially identical to a previously described major allergen in Cladosporium herbarium, Ag-54). Children treated with histamine placebo showed no change in antibody patterns during 10 months of treatment. [ABSTRACT FROM AUTHOR]

A double-blind histamine placebo controlled immunotherapy trial was performed to investigate the clinical effect of a purified and standardized Cladosporium herbarium allergen preparation. Thirty children with a clinical history suggesting mould-induced asthma and/or rhinoconjunctivities were included. The diagnosis was confirmed by positive skin prick test and Phadebas RAST® as well as positive bronchial and/or conjunctival provocation test to Cladosporium herbarium. Immunotherapy was given for 10 months in a double-blind manner to randomized groups with either Pharmalgen®/ Cladosporium herbarium preparation or histamine placebo. Allergic side effects to injections were common, especially during the peak of the mould season (July-September in Scandinavia). In the active group, 13/16 patients experienced general reactions during the first 10 months of treatment. After 6 month of treatment, eye, nose and bronchial symptom scores and peak expiratory flow rates were similar for the groups, maybe because most of the children were also sensitive to many other allergens, including Alternaria alternata. However, medication scores were significantly lower in the treated group (P < 0.01). Bronchial (P = 0.01) were significantly reduced in the Cladosporitan-treated group but not in the placebo group after 10 months of treatment. This is the first double-blind clinical trial showing the clinical efficiency of immunotherapy in children with mould-induced asthma. [ABSTRACT FROM AUTHOR]

In order to screen for mould allergy, extracts of five common atmospheric moulds (Cladosporium, Alternaria, Penicillium, Aspergillus and Mucor) from various manufacturers were investigated in 150 patients (5-60 years old) with clinical symptoms indicating possible mould allergy. The patients were screened by skin prick test (SPT) and radio- allergosorbent test (RAST). SPT seemed to be more sensitive than RAST as a diagnostic screening procedure (80% positive reactions to one or more species compared to 50%). With a partially purified, standardized preparation of Cladosporium herbarum more positive reactions were obtained than with crude extracts without evidence of any unspecific reactions. The difference between commercial and standardized extracts is most probably a result of a variation of both the biological potency of allergenic determinants and the allergenic composition. A considerable number of negative RAST reactions with standard discs were found in patients with positive skin reactions to partially purified Cladosporium, but RAST seemed to be more sensitive than SPT with the other commercial mould extracts. Based on the screening, a very convincing tendency to IgE-reactivity to other moulds was found in patients reacting to Cladosporium, the most common cause of mould allergy. The results confirm the inadequacy of most mould extracts used in diagnostic procedures and strengthen the value of using standardized extracts. [ABSTRACT FROM AUTHOR]

Seven variables connected with the function of the neutrophil granulocyte were studied in 24 children who had undue susceptibilities to infections. The phagocytosis rate of IgG-coated latex particles by the patients' neutrophils was significantly reduced compared with an age-matched control group. The chemokinetic effect of patients' sera on normal polymorphonuclear neutrophil leucocytes was reduced too, especially in heated (56 degrees C, 30 min) serum. Spontaneous chemotactic activity in the patients' sera was significantly lower than in sera from healthy adults and from the age-matched control group. A functional index based on the 7 variables of neutrophil function was constructed. The score of the functional index was correlated to the severity of the patients' clinical condition and discriminated well between normal children and those with undue susceptibility to infections. [ABSTRACT FROM AUTHOR]

The IgE levels and food-allergen-specific IgE- and IgG-antibodies (Ab) to ovalbumin (OA), ovomucoid (OVO) and β-lactoglobulin (BLG) were determined up to 18 months of age in 163 infants born to women who were atopic. A high (HIGH group) or a low (REDUCED group) intake of hen's egg and cow's milk by the mother during the third trimester gave no significant differences in the concentrations of IgE or in IgE-Ab (OVO, BLG) and IgG-Ab (OA, OVO, BLG). Similarly, a prolongation of the abstention diet to the early lactation period did not influence the immune response. The IgG-Ab levels to all three food allergens decreased significantly (P < 0.001) in both study groups between birth and 2 months of age, but then increased significantly (P <0.001) between 6 and 18 months of age. The presence in serum of IgE-Ab to OVO (>0.15 PRU/ml) was associated with significantly higher IgG-Ab levels to OVO at 6 months (<0.001) and at 18 months (P < 0.05). Infants with positive skin-prick tests (SPT) to OA and OVO showed higher IgG-Ab levels at 6 and 18 months of age than did infants with negative SPT reactions to the two egg allergens. This indicates a relation between the IgE- and IgG-Ab response and it also suggests that some individuals are 'high responders' to both types of immunoglobulin isotypes while others are 'low responders'. [ABSTRACT FROM AUTHOR]

One hundred and sixty-two women with respiratory allergy to animal danders and/or pollens were randomly allocated to a diet consisting of either a very low ingestion of hens' egg and cows' milk or a daily ingestion of one hens' egg and about II of cows' milk during the last 3 months of pregnancy. One hundred and sixty-three infants were followed prospectively up to 18 months of age when the cumulated incidence of atopic disease in each child was evaluated blindly. No significant differences in the distribution of atopic disease were found among the infants in relation to the maternal diet during late pregnancy. The numbers of skin-prick tests positive to ovalbumin, ovomucoid, β-lactoglobulin and cows' milk were likewise not influenced by differences in the maternal diet during late pregnancy. Genetic factors rather than maternal diet during the perinatal period probably have a greater effect on the incidence of atopic diseases during early infancy. [ABSTRACT FROM AUTHOR]

To investigate the asthma mortality rate in Sweden for the period 1973-88, we reviewed all death certificates for suspected death from asthma coded as 493 of the International Classification of Diseases (ICD)-8 and ICD-9 for the age group 1-24 years Age-related mortality rates were calculated and compared with the results from a previous Swedish study of 1952-72 to identify factors contributing to death, we assessed hospital records. The mortality rate was 3.46 for the period 1973-88 and 3.31 for the earlier period, a net increase of 5%. This small overall increase includes a minor decrease in deaths for the age group 1-14 years and a rather pronounced increase for 15-24-year-old asthmatic patients. More deaths among "mild" asthmatic patients were found in the higher age group for 1986-8 than 1973-81. In younger children, asthma was more severe, and no difference was found between the two periods of the study. Asthma mortality is increasing in Sweden in adolescents and young adults, and there is a tendency to increasing mortality from less severe asthma not treated with anti-inflammatory drugs. [ABSTRACT FROM AUTHOR]

Ten researchers from the Nordic countries have reviewed the literature on early exposure in childhood, to pets and the risk of sensitisation/allergy. A search of the literature resulted in identification of about 120{X} articles, of which 89 were selected for further examination. The group concluded that all exposure to pets involves a risk of sensitisation. Exposure in infancy involves an increased risk (normally RR=1-1,5) of sensitisation and to a lesser degree of the development of symptoms. The group also concluded that pet allergens are present "everywhere", as a result of people bringing allergens in their clothing, etc. The group concluded as a recommendation, that families with atopic individuals should wait until the child is at least two years old before getting a pet. [ABSTRACT FROM AUTHOR]

Unlabelled: The use of hydrolysed cow's milk formula seems to increase beyond what is recommended based on evidence regarding allergy-preventive effect. Infants born preterm are sometimes given such formulas without proven effect.Conclusion: If the use of hydrolysed cow's milk formula is based on allergy-preventive aspects, evidence-based recommendations should be followed. [ABSTRACT FROM AUTHOR]

This article presents information on food-elicited allergy symptoms outside the gastro-intestinal tract. Skin symptoms of allergy caused by food can be elicited by direct contact or by the transport of allergic food molecules via the blood stream from the gastrointestinal tract. In the former situation erythema and urticaria are the most common symptoms, in the latter the symptoms may vary from acute urticaria to a worsening of an eczema or more rarely vasculitis. In severely atopy-prone infants eczema can have its onset already while the infant is on the breast. The small amounts of cow's milk or egg transferred to the infant through breast milk may elicit and maintain a widespread eczema. Such an allergy can be demonstrated by skin prick test or by in vitro test.