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Hereditary angioedema (HAE) due to C1-inhibitor (C1-INH) deficiency is a rare hereditary disease characterized by recurrent subcutaneous or submucosal angioedema due to uncontrolled bradykinin production caused by C1-INH dysfunction. Submucosal gastrointestinal swellings provoking abdominal attacks are common and mimic acute abdomen, thus constituting a diagnostic challenge. We aimed to investigate the difficulties in diagnosing abdominal attacks in patients with C1-INH-HAE and to assess the diagnostic value of medical history, the course of the attack, abdominal imaging, and treatment efficacy. The retrospective analysis of diagnostic problems and treatment complications of abdominal attacks in 274 patients with C1-INH-HAE were performed. The value of history, laboratory findings, prodromal symptoms and course of attacks and imaging were assessed. Abdominal attacks were confirmed in 274 of the 322 patients (85%; 190 women and 84 men; age, 4–70 years). In 49% of cases, the abdominal attack was the first and the only symptom for years. The simultaneous presence of marginal erythema (45% of cases), subcutaneous edema (30%), and pharyngo-laryngeal edema (10%) facilitated the diagnosis of an abdominal attack due to C1-INHHAE. Abdominal attacks manifested with recurrent acute abdominal symptoms lasting 2 to 5 days. The disease course was characterized by the phase of progressive prodromal symptoms followed by peak symptoms and spontaneous symptom resolution. Abdominal imaging often revealed abundant ascites and limited bowel edema. In 60 cases (22%), the diagnostic difficulties resulted in exploratory laparotomy, which was inconclusive in 48 patients (80%). The attacks usually subsided within 2 hours from the administration of recommended drugs (plasma-derived C1-INH , recombinant C1-INH or icatibant). We conclude that recurrent abdominal attacks lasting a few days and resolving spontaneously were common symptoms of C1-INH-HAE. Abdominal imaging revealed transitional fluid or bowel edema. The effectiveness of recommended drugs as plasma-derived C1-INH, recombinant C1-INH or icatibant confirmed the diagnosis. [ABSTRACT FROM AUTHOR]

Soil health sustains the biological productivity, maintains environmental quality and promotes plant health. Soil borne diseases are most damaging when soil conditions are poor. Major factors influencing the disease in plants are soil moisture, soil temperature, soil pH and soil nutrients. To manage disease, different methods are used like crop rotation, biological control, cover crops, suppressive soils, organic amendment, plant growth promoting rhizobacterium, vascular arbuscular mycorrhizal fungi, mulching, good compost, good aeration, etc. Implementation of these practices improves the soil health and reduces disease incidence in a sustainable manner. Cover crops, crop rotations and healthy sanitary practices keep the pathogenic populations at low levels and also add beneficial nutrients like nitrogen, phosphorus and potassium to the soil. These all manage the disease by creating physical barrier, releasing antagonistic chemicals, competing with pathogen, increasing nutrient uptake, etc. Biological control agents have different mode of action viz., parasitism, predator, antibiosis, competition for site and nutrition, as well as by inducing the resistance in plants against pathogen [Induced Systemic Resistance (ISR)]. However, all these management strategies are helpful in improving the soil health, decreases the disease incidence and subsequently increases the yield and productivity of the crop. [ABSTRACT FROM AUTHOR]

Background: A major problem of venom-specific immunotherapy (VIT) is the absence of reliable parameters for deciding treatment discontinuation. Aim of the Study: Intracutaneous tests (ICTs), the basophil activation test (BAT), specific IgEs (sIgEs) and blocking factor (BF) activity were measured during VIT. We made an evaluation by means of a protective index (PI) including ICT, BAT and BF values. Material and Methods: A population of 45 patients who had experienced a systemic reaction after an insect sting were tested before VIT (T0), at 1 week (T1w), at 10 weeks (T10w) and at 21 weeks (T21w), and, for a subgroup of 17 patients, at 3-5 years (T3-5y). Basophil activation (expressed in % CD63 and in the area under the curve) and BF activity were measured by flow cytometry using the CCR3/CD63 protocol. Results: The first 21 weeks of follow-up showed no significant variation in the ICT, sIgE and BAT measurements, except for BAT, by eliminating weak negative anti-IgE responses. In these conditions, the decrease in basophil activation was significant at T10w (p = 0.009) and T21w (p = 0.009). Increased BF activity was also significant at T10w (p = 0.008) and T21w (p = 0.002). The PI threshold calculated from the mean ± 3 standard errors (SE) was 64.8 (14.7 ± 16.7, n = 25) at T0. PI increase was significant at T3--5y (3,430 ± 6,282; p < 0.001). Conclusion: VIT induced a significant decrease in ICT values and basophil activation, along with an increase in serum BF activity, significant after 10 weeks of VIT. Evaluated in a larger population, the PI could represent a new tool for the clinico-biological follow-up of VIT efficacy. [ABSTRACT FROM AUTHOR]

Natural language processing (NLP) is a part of the artificial intelligence domain focused on communication between humans and computers. NLP attempts to address the inherent problem that while human communications are often ambiguous and imprecise, computers require unambiguous and precise messages to enable understanding. The accounting, auditing and finance domains frequently put forth textual documents intended to communicate a wide variety of messages, including, but not limited to, corporate financial performance, management's assessment of current and future firm performance, analysts' assessments of firm performance, domain standards and regulations as well as evidence of compliance with relevant standards and regulations. NLP applications have been used to mine these documents to obtain insights, make inferences and to create additional methodologies and artefacts to advance knowledge in accounting, auditing and finance. This paper synthesizes the extant literature in NLP in accounting, auditing and finance to establish the state of current knowledge and to identify paths for future research. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Development in food science and technology from the last five decades led to the discovery of new compounds with various features. Among them are the additives, substances intentionally added in foodstuffs to perform certain technological functions (i.e. to colour, to sweeten or to preserve). EU legislation stipulates that food containing a level of additive hat is unacceptable from a public health viewpoint cannot be put on the market. There is a need for analytical techniques to identify and quantify additives, because the food industry is required to list the type and amount of each ingredient on product labels to help consumers make dietary choices and manage allergies. The analytical tools include UV-VIS spectroscopy method to simultaneously test widely used additives. This study offers some conclusions about the feasibility of the analytical tools, based on their performance characteristics and potential gaps. [ABSTRACT FROM AUTHOR]

The environment is defined by the aggregate of surrounding things, conditions, or influences. The biophysical environment includes the physical and biological factors, along with chemical interactions that affect an organism. Contact dermatitis includes any inflammatory skin reaction to direct or indirect contact with noxious agents in the environment. Although the main clinical expression of contact dermatitis is eczema, other expressions like urticaria, contact urticaria (CoU), or lichenoid eruptions are described. The main objective of this chapter is to review CoU, which is often misdiagnosed, as part of the CoU syndrome (CUS). [ABSTRACT FROM AUTHOR]

Participant dropouts can reduce the power of allergen immunotherapy clinical trials. Evaluation of the dropout rate and reasons for dropout are important not only in the planning of clinical studies but are also relevant for adherence to immunotherapy in daily clinical practice. A systematic review was carried out in order to establish the overall dropout rate among published double-blind, placebo-controlled randomized clinical trials of sublingual immunotherapy for respiratory allergic diseases. Dropouts were analysed in regards to allergen, formulation, treatment schedule, participant age, study size, number of centres and type of allergic disease. Relative dropout rates in placebo and active groups as well as reasons for dropout were also assessed. A total of 81 studies, comprising 9998 patients, were included. Dropout rates in sublingual immunotherapy controlled studies do not appear to be a major problem with a composite dropout percentage of 14% (95% CI:11.9-16). Furthermore, they are not different for active compared to placebo-treated participants. This lends support to the positive clinical outcomes seen in meta-analyses of these trials. [ABSTRACT FROM AUTHOR]

In food industry nowadays, there are various plant-origin protein additives which are meant for production of meat products. Among the most frequent additives of this type there are different kinds of flour, starch, fiber, and plant-origin proteins. Their usage at present is limited by the existing legislation not to prevent consumer deception but also for reasons of possible influence on consumer health. Therefore, this problem is paid a lot of attention not only in the Czech Republic but also all over the world. The main risk is seen in the impossibility to choose a suitable foodstuff for an individual prone to allergic reactions. Potential allergens are also often plant-origin raw materials which are added into foodstuffs for their technological qualities and low price. Wheat is widely cultivated cereal as well as an important source of proteins. After ingestion or inhalation, wheat proteins may cause adverse reactions. These adverse effects include a wide range of disorders which are dependent on the method of contact with wheat protein. These adverse effects can then take the form of various clinical manifestations, such as celiac disease, T-cell mediated inflammatory bowel disease, dermatitis, skin rash, breathing difficulties, allergy to pollen or to wheat flour or food allergy to foodstuffs containing gluten. The only possible protection against adverse immune reactions for those with food allergies is strictly excluding the allergen from their diet. Although the number of studies dealing with the reduction or loss of allergenicity is increasing, yet these practices are not common. Most of the population suffering from food allergies is thus still dependent on strict exclusion of foodstuffs causing adverse allergic reactions from their diet. In order to avoid misleading consumers and also to protect allergic consumers, analytical methods applicable to all types of foodstuffs have been developed. Unfortunately, detection of allergens in foodstuffs is relatively difficult because of the fact that they occur in trace amounts and are often masked by various parts of the product. This paper deals with detection of wheat protein in meat products bought in the retail network of the Czech Republic. Ten cooked meat products, especially types of sausages and soft salami which stated wheat protein in their composition, were examined. The samples were processed using the method of immunofluorescence and stained with Texas Red fluorochrome. The presence of wheat protein was demonstrated in all the examined meat products. From the results it follows that the method of immunofluorescence is suitable for detection of wheat protein in meat products. [ABSTRACT FROM AUTHOR]

Background: Hazelnut and apple are common causes of food allergy in Europe. In northern Europe, symptoms are usually mild and associated with cross-reactivity to the birch pollen allergen, Bet v 1. In the Mediterranean area, symp-toms are more frequently severe and associated with sensi-tization to lipid transfer protein (LTP). This study compared patients with anaphylactic versus mild reactions to hazelnut and apple in The Netherlands, a birch-endemic area, with respect to sensitization to Bet v 1 -homologues (i.e. PR10-pro-teins) and LTP. Methods: Twenty-one patients fulfilling the criteria for anaphylaxis and 21 with only mild symptoms (oral allergy) to hazelnut and/or apple were recruited. Specific immunoglobulin Eto birch pollen, apple, hazelnutand PR10-proteins (rBet v 1, rPru p 1, rMal d 1 and rCor a 1) and recom-binant LTP (rPru p 3 and rCor a 8) was measured by Immuno-CAP. Results: Both mild and anaphylactic apple-allergic pa-tients were sensitized to PRIO-proteins, whereas only 1/7 of the mild and none of the anaphylactic apple-allergic pa-tients was sensitized to LTP. In contrast, anaphylactic hazelnut-allergic patients displayed no such clear sensitization pattern: some were sensitized to both PRIO-proteins and ha-zelnut LTP (1/9), and others to only LTP (2/9) or to only PRIO-proteins (4/9) or to neither PR10-proteins nor LTP (2/9). Con-clusion: This study shows that in a birch-endemic area, the sensitization profile to PRIO-proteins and LTP in anaphylac-tic patients may differ between different plant foods. In this patient group, anaphylaxis to hazelnut can be LTP-associat-ed, whereas anaphylaxis to apple is not. [ABSTRACT FROM AUTHOR]

Background: Hazelnut and apple are common causes of food allergy in Europe. In northern Europe, symptoms are usually mild and associated with cross-reactivity to the birch pollen allergen, Bet v 1. In the Mediterranean area, symptoms are more frequently severe and associated with sensitization to lipid transfer protein (LTP). This study compared patients with anaphylactic versus mild reactions to hazelnut and apple in The Netherlands, a birch-endemic area, with respect to sensitization to Bet v 1-homologues (i.e. PR10-proteins) and LTP. Methods: Twenty-one patients fulfilling the criteria for anaphylaxis and 21 with only mild symptoms (oral allergy) to hazelnut and/or apple were recruited. Specific immunoglobulin E to birch pollen, apple, hazelnut and PR10-proteins (rBet v 1, rPru p 1, rMal d 1 and rCor a 1) and recombinant LTP (rPru p 3 and rCor a 8) was measured by ImmunoCAP. Results: Both mild and anaphylactic apple-allergic patients were sensitized to PR10-proteins, whereas only 1/7 of the mild and none of the anaphylactic apple-allergic patients was sensitized to LTP. In contrast, anaphylactic hazelnut-allergic patients displayed no such clear sensitization pattern: some were sensitized to both PR10-proteins and hazelnut LTP (1/9), and others to only LTP (2/9) or to only PR10-proteins (4/9) or to neither PR10-proteins nor LTP (2/9). Conclusion: This study shows that in a birch-endemic area, the sensitization profile to PR10-proteins and LTP in anaphylactic patients may differ between different plant foods. In this patient group, anaphylaxis to hazelnut can be LTP-associated, whereas anaphylaxis to apple is not. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Paracetamol is a common antipyretic/analgesic and a component of many prescription and over- the- counter preparations. Hypersensitivity reactions to paracetamol appear to be increasing, but there are few prevalence data. The mechanism is poorly understood. We identified the clinical features of 32 patients with suspected paracetamol allergy, investigated the underlying mechanism and examined co-existing non-steroidal anti-inflammatory drug (NSAID) tolerance. Methods: Aclinical history was taken and skin tests and an oral challenge were performed in 32 patients with suspected paracetamol allergy. Results: Patients presented with a combination of urticaria, angio-oedema (face, hands), erythema (cutaneous features in 94%), dyspnoea (including laryngeal oedema), rhinoconjunctivitis, cough, abdominal pain and anaphylaxis. Two patients had a positive skin prick test (SPT) and unequivocal history of acute urticaria/facial angio-oedema/conjunctivitis/cough after paracetamol with no other triggers. One patient had a positive intradermal test. Oral challenge was positive in 15 of 31 patients (including self-challenge in 4), triggering (a combination of) rhinitis, conjunctivitis, pruritus, erythema, urticaria, angio-oedema, dyspnoea and abdominal pain. Sensitivity was evident in 1 patient on the basis of the patient's history. Overall, paracetamol hypersensitivity was confirmed in 16 of the 32 patients (50%). Twelve of the 16 paracetamol-allergic patients (75%)tolerated NSAIDs (negative challenge in 6, negative history in 6). Four of these 16 patients (25%) were intolerant of NSAIDs (positive challenge in 1, self-challenge in 3). Conclusions: In past reports on paracetamol hypersensitivity, only single cases of a positive SPT and detectable specific IgE have been described. Our data confirm that specific IgE may be a mechanism underlying paracetamol hypersensitivity, as in this series 18.8% of the patients had specific IgE. In 81.2% of patients, negative skin tests did not exclude paracetamol hypersensitivity, suggesting that it may be mediated by leukotrienes. However, three quarters of our patients tolerated NSAIDs, implicating an alternative mechanism. In patients with suspected paracetamol allergy, skin tests should be performed in addition to clinical history and oral challenge. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Peanut and tree nut allergies are life-threatening conditions for many affected individuals worldwide. Currently there is no cure. While co-allergy to peanut and tree nuts is a common clinical observation, and IgE cross-reactivity between peanut and tree nuts is reported, T cell cross-reactivity is poorly defined. Methods: Hazelnut-specific T cell lines were established using peripheral blood mononuclear cells from 5 subjects with co-allergy to hazelnut and peanut. These lines were stimulated with hazelnut and peanut extracts and purified major peanut allergens, Ara h 1 and Ara h 2. Proliferation was determined by 3H-thymidine incorporation and secretion of key Th1 (IFN-γ) and Th2 (IL-5) cytokines analysed by ELISA. Results: Hazelnut-specific T cell lines from all 5 subjects proliferated upon stimulation with both hazelnut and peanut extracts and for 4 subjects, to Ara h 1 and/or Ara h 2. Proliferating cells were mainly CD4+ T cells and produced both IL-5 and IFN-γ in response to hazelnut and peanut stimulation. Mitogenicity of extracts and allergens was excluded by their lack of stimulation of house dust mite-specific T cells. Conclusion: Our finding that hazelnut and peanut co-allergy is associated with cross-reactive T cell responses, driven partly by cross-reactivity to the major peanut allergens Ara h 1 and Ara h 2, points to future development of allergen immunotherapy by targeting cross-reactive T cells. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Allergic rhinitis is common worldwide, with significant morbidity and impact on quality of life. In patients who don't respond adequately to anti-allergic drugs. Subcutaneous allergen immunotherapy is effective although requires specialist administration. Sublingual immunotherapy may represent an effective and safer alternative. This Cochrane systematic review is an update of one published in 2003. We searched Cochrane ENT Group Trials Register, Central, PubMed, EMBASE, CINAHL, Web of Science, Biosis Previews, Cambridge Scientific Abstarcts, mRCT and additional sources. We included randomised, double-blind, placebo- controlled trials of sublingual immunotherapy in adults and children. Two authors selected studies and assessed them for quality. Data were put into RevMan 5.0 for a statistical analysis. We used standardised mean difference (SMD), with a random effect model to combine data. Sixty studies were included, with 49 suitable for meta-analysis. We found significant reductions in symptoms (SMD )0.49; 95%CI ()0.64 to )0.34, P < 0.00001)) and medication requirements (SMD )0.32; 95%CI ()0.43 to )0.21, P < 0.00001)) compared with placebo. None of the trials reported severe systemic reactions, anaphylaxis or use of Adrenaline. This updated review reinforces the conclusion of the original 2003 Cochrane Review that sublingual immunotherapy is effective for allergic rhinitis and appears a safe route of administration. [ABSTRACT FROM AUTHOR]

Background: Whether the observed clinical pattern of non-specific lipid transfer protein (nsLTP)-mediated food allergies is attributable to a primary sensitization by Pru p 3 from peach and subsequent cross-reactivity with Rosaceae- and non-Rosaceae-derived foods expressing homologous allergens is still unclear. Objective: To investigate the allergenic properties of nsLTPs from Rosaceae and non-Rosaceae foods. Methods: In peach-, cherry- or hazelnut-allergic patients, prevalence of sensitization, IgE-binding capacity, cross-reactivity and allergenic potency of Pru p 3 was compared with Pru av 3 (cherry) and Cor a 8 (hazelnut). Results: Frequency of sensitization to corresponding nsLTPs was 88, 85, and 77% in peach-, hazelnut- and cherry-allergic patients, respectively. Concomitant allergic reactions to cherry and hazelnut were reported in 51 and 44% of peach-allergic patients, respectively. In contrast to cherry allergy, hazelnut allergy was not strictly associated to peach allergy. Sensitization to Cor a 8 or Pru av 3 was strongly correlated with IgE reactivity to Pru p 3, even when subjects tolerated peach. Specific IgE was highest for Rosaceae LTPs, and cross-inhibition experiments confirmed a stronger IgE-binding capacity of Pru p 3 than Cor a 8. The biological potency of Pru p 3 and Pru av 3 was similar but stronger for both nsLTPs than that of Cor a 8. Conclusion: Clinical cross-reactivity of food-allergic patients in the Mediterranean area is likely attributed to a primary sensitization to Pru p 3 and serological cross-reactivity with homologous food nsLTPs. In comparison to Cor a 8, Rosaceae nsLTPs showed a stronger IgE-binding capacity and allergenic potency indicating a different epitope pattern. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Three commercial sandwich enzyme-linked immunosorbent assay (ELISA) test kits for the detection of hazelnuts and almonds were evaluated. Limits of detection and dynamic ranges were determined for hazelnuts and almonds spiked into cooked oatmeal, dipping chocolate, and muffins (baked). The limit of detection values varied from 1 to 38 μg/g, depending on the food matrix and ELISA test kit. Percent recoveries based on the standards supplied with the test kits varied from 10% to 170%. It is impossible to ascertain whether the percent recoveries reflect the performance of the ELISAs or differences between the protein content of the nuts used to spike the samples and the test kit standards. Unfortunately, reference materials do not exist that can be used to compare the results from different test kits and standardize the test kit standards. Also, insufficient knowledge regarding the epitope specificity of the antibodies used in the ELISAs further hinders interpretation of the results generated by the different test kits. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

The present study aims to investigate the nature and levels of colours in food items and to undertake risk assessment vis-à-vis intake among different age groups of consumers in the State of Uttar Pradesh, India. A total of 478 edible foodstuffs were analysed, and of six permitted colours, Sunset Yellow FCF (SSYFCF) and Tartrazine were most popular, and two non-permitted colours, namely Metanil Yellow and Rhodamine B, were encountered. The study showed a marked improvement in the trend of use of non-permitted colours over previous surveys, with 90% foods now resorting to approved food colours. However, 59% of foods employing permitted colours exceeded the maximum allowable limit, with average quantities crossing the threshold of 100 mg kg−1 in most food commodities. The intake of SSYFCF exceeded the acceptable daily intake (ADI) for children and adolescents by 88% and 39%, respectively, and was statistically significant when analysed by error bars and distribution curves. In adults, SSYFCF saturated 59% of the ADI. For Carmoisine, Tartrazine and Ponceau 4R, saturation of ADI ranged from 27.4% to 90.3% in children and adolescents and from 10.8% to 47.6% in adult subjects. These results indicate that children and adolescents are more vulnerable to higher intakes of food colours compared with the adult population. Allowing a uniform level of all colours in foods under Indian rules, notwithstanding wide variations of 250-fold in their allocated ADIs, could be one reason for the higher intake and hence only technological need-based levels of individual colours are desired to be prescribed. [ABSTRACT FROM AUTHOR]

Background: Assessment of allergenicity of foods is important for allergic consumers and regulators. Immunoassays to measure major food allergens are widely applied, often giving variable results. Using the major apple allergen Mal d 1 as a model, we aimed to establish at the molecular level why different immunoassays for assessing allergenicity of apple cultivars produce conflicting outcomes. Methods: Mal d 1 was measured in 53 cultivars from Italy and 35 from The Netherlands, using four different immunoassays. Purified Mal d 1 standards were molecularly characterized by size-exclusion chromatography (SEC) and mass spectrometry (MS). Results: Three immunoassays using an identical standard gave similar results. Minor differences in sample preparation already resulted in significant loss of allergenicity. The fourth assay, using a different Mal d 1 standard, gave 10- to 100-fold lower outcomes. By SEC, this standard was shown to be almost fully aggregated. This aggregation was accompanied by a decrease of the mass of the Mal d 1 molecule by ∼1 kDa as analyzed by MS. The deviating immunoassay was shown to selectively recognize this aggregated form of Mal d 1, whereas the other three assays, including the one based on IgE antibody recognition, preferentially bound non-aggregated allergen. Conclusions: Variable and poorly controllable major allergen modification in both extracts and standards hamper accurate allergenicity assessments of fruits. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: IgE-mediated allergy to grapes has very rarely been reported in patients from the Mediterranean area. Recently, endochitinase 4 and a lipid transfer protein (LTP) have been identified as major allergens in grape-allergic patients who do not have an associated pollinosis. The purpose of this case study was to identify the allergens responsible for severe anaphylactic reactions after consumption of wine, fresh grapes and raisins in a German patient. Methods: Prick-to-prick tests and the basophil activation test (BAT) were performed to confirm allergy. Specific IgE was further analyzed by immunoblotting and inhibition tests for the determination of crossreactivity. The IgE-binding protein was subjected to N-terminal microsequencing. Results: Prick-to-prick tests were positive to fresh and cooked white and blue grapes, to raisins, to white and red wine, and to grape extract. Specific IgE against grapes (f259) was 2.43 kU/l (class 2). The BAT showed specific IgE-mediated activation of basophils after stimulation with grape extract. IgE binding to a 15-kDa protein was completely inhibited by pre-incubation with recombinant cherry LTP Pru av 3. N-terminal sequencing identified this 15-kDa protein as grape LTP Vit v 1. Conclusion: Our data show that sensitization to LTP can occur outside the Mediterranean area causing severe fruit allergy without association to pollinosis. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Some aspects of sublingual immunotherapy (SLIT)still need to be addressed: magnitude of the clinical efficacy, effect on the bronchial hyperreactivity adherence to treatment, preventive effect. We attempted to clarify these points in a randomized open, controlled, two parallel group study in a real-life setting.Five hundred and eleven patients with allergic rhinitis with or without intermittent asthma were randomized to drugs only or drugs + SLIT (rate 2 : 3) for 3 years. The clinical score (symptoms + drug intake) was measured each year during the allergen exposure. Pulmonary function test, methacholine challenge and skin tests were performed at the beginning and at the end of the study. Adherence to treatment was assessed by measuring the consumed extract.Three hundred and nineteen patients received SLIT and 192 drugs only. Dropouts were 15% in the SLIT group and 12% in the controls. There was a significant improvement of clinical scores in the SLIT group: baseline 147 ± 3.3, first year 72.9 ± 1.3, second year 68.3 ± 1.8, third year 54.7 ± 2.8 (P < 0.0001vsbaseline). Control group: baseline 138 ± 2.3, first year 124.1 ± 3.7, second year 111 ± 3.3, third year 121 ± 3.8 (P = NS). Only four patients reported systemic itching. Adherence was>80% in 72% and>60% in 18% of patients. The number of patients with a positive MCh challenge decreased significantly after 3 years only in the SLIT group. New skin sensitizations appeared in 38% of the controls and in 5.9% of the SLIT patients (P = 0.01).Sublingual immunotherapy approximately halved the clinical scores and significantly reduced the bronchial hyperreactivity. Similarly to subcutaneous immunotherapy, SLIT displayed a preventive effect on the onset of new skin sensitizations. The adherence rate was quantitatively satisfactory. [ABSTRACT FROM AUTHOR]

Background: The present study investigates immunological cross-reactivity between Par o 1, the major pollen allergen of Parietaria , and the VP4 protein of rotavirus, a microorganism that is world-wide the main etiological agent of gastroenteritis in children. Methods: IgG and IgE cross-reactivity was assessed by direct binding and competitive inhibition assays (ELISA and DARIA), using recombinant VP4 from rhesus infectious rotavirus (RR), synthetic peptides and Par o 1-specific antibodies affinity purified from pooled and individual human sera. Results: Antibodies specifically binding Par o 1, affinity purified from the sera of 35 individuals with skin test positivity to Parietaria and from 14 pools, were extensively cross-reactive with RRVP4. Cross-reactive binding was specifically inhibited by synthetic peptides derived from the C-terminal sequences of the VP4 proteins from human and rhesus infectious rotavirus. Conclusions: This study reports the first evidence of cross-reactivity between an allergen and a viral antigen. [ABSTRACT FROM AUTHOR]

Background: Shrimp may cross-react with other crustaceans and mollusks and nonedible arthropods such as insects (cockroach and chironomids), arachnids (house dust mites) and even nematodes. Since the muscle protein tropomyosin has been implicated as a possible cross-reacting allergen, this study characterized the IgE-binding epitopes in shrimp tropomyosin, Pen a 1, that cross-react with other allergenic invertebrate tropomyosins in house dust mites (Der p 10, Der f 10) and cockroaches (Per a 7). Pen a 1-reactive sera from shrimp-allergic subjects were used to evaluate the effect on IgE binding of different amino acid substitutions in Pen a 1 epitopes based on homologous sequences in Per a 7 and Der p 10/Der f 10. Methods: Peptides were synthesized spanning the length of Pen a 1 IgE-binding epitopes and amino acid substitutions were performed based on homologous amino acid sequences from Per a 7 and Der p 10/Der f 10. Results: 7/8 individually recognized Pen a 1 epitopes (2, 3a, 3b, 4, 5a, 5b and 5c) had an identical amino acid sequence with lobster allergen, Hom a 1, 4/8 (3a, 3b, 4 and 5a) with Der p 10 and Der f 10, and 5/8 (2, 3a, 3b, 4 and 5a) with Per a 7. In addition, even homologous regions of other arthropod tropomyosins that differ in one or more amino acids from the sequences of Pen a 1 epitopes are still recognized by shrimp-allergic IgE antibodies. In total, shrimp-allergic sera recognize 6/8 peptides homologous to Pen a 1 epitopes in Per a 7, 7/8 in Der p 10/Der f 10, and 7/8 epitopes in Hom a 1. Conclusions: The IgE recognition by shrimp-allergic individuals of identified and/or similar amino acid sequences homologous to Pen a 1 epitopes in mite, cockroach and lobster tropomyosins are the basis of the in vitro cross-reactivity among invertebrate species. Based on amino acid sequence similarity and epitope reactivity, lobster tropomyosin has the strongest and cockroach the least cross-reactivity with shrimp. The clinical relevance of these cross-reactivities in developing allergic reactions to different arthropods needs to be determined.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Several cross-reacting proteins have been identified as responsible of the co-occurrence of pollinosis and plant-derived food allergy. This association has been mainly described in the birch–apple syndrome but other pollens such as Olea europaea and other fruits may also contain homologous proteins. Objective To evaluate the associations between sensitization to allergens of Olea europaea pollen and confirmed plant-derived food allergy, in addition to investigate if any pattern of clinical hypersensitivity of food allergy reaction (oral allergy syndrome (OAS) or anaphylaxis) and/or any fresh fruit or nut allergy, are associated to one or several Olea pollen allergen(s). Methods One-hundred and thirty-four consecutive patients diagnosed with pollinosis by Olea were studied. Of these patients only 40, reported adverse reaction to plant-derived food. Twenty-one (group A) were classified as OAS and 19 (group B) as anaphylaxis. Skin-tests with six Olea pollen allergens and several groups of fruits, were performed. Double-blind placebo-controlled food challenge (DBPCFC), confirmed the diagnostics of food allergy with the exception of patients who suffered previous anaphylactic reaction. Results All patients, showed a positive skin prick test (SPT), against one or more of Olea europaea allergens. Sensitization to Ole e 7, was more frequent (P = 0.02) in patients from group B. A total of 84 DBPCFC were performed with 44% positive results. Challenge confirmed at least the 50% of positive SPT in any case (peach: 68.42%; pear: 50%; melon: 71.42% and kiwi: 53.84%). In patients from group B, significant association with O. europaea pollen allergens were found between positive SPT to Rosaceae fruits and Ole e 3 (P = 0.045) and Ole e 7 (P = 0.03); Cucurbitaceae and Ole e 7 (P = 0.03) and Actinidiaceae with Ole e 3 (P = 0.04). Conclusions The results of this study, establish a new spectrum of associations between pollens and plant-derived foods: sensitization... [ABSTRACT FROM AUTHOR]

Editorial. Comments on the adverse effect of chronic stress on health and life expectancy. Social dysfunction markers; Association of stress with infections; Impact of stress on the progression to acquired immune deficiency syndrome; Psychosocial interventions reported to improve the evolution of inflammatory and skin diseases.

Reports global developments related to allergic contact dermatitis. Detection of ester gum resin among patients with leg ulcers; Use of ticlopidine and clopidogrel in platelet aggregation inhibition; Allergic reactions to hyaluronidase during opthalmic surgery.

Discusses results of research studies on contact dermatitis, published in the volume 42, 2000 edition of the periodical 'Contact Dermatitis.' Food dermatitis due to non-disperse azo dyes; Occupational contact dermatitis from headphones containing diethylhexyl phthalate; Contact dermatitis due to flurbiprofen.

Oral allergy syndrome (OAS) is a complex of clinical symptoms in the mucosa of the mouth and throat, that result from direct contact with food allergens in an individual who also exhibits respiratory allergy to inhaled allergens, usually pollens, and especially birch pollen. Symptoms include itching and irritation of oral tissues, swelling of the lips, tongue, and sometimes papules or blistering of these tissues. Because many systemic allergic reactions start with oral symptoms, confusion and concern have arisen regarding the limitations and application of this definition of the syndrome, and the degree to which cross-reacting food should be avoided in individuals with pollen allergy. Profilins and pathogenesis-related proteins, common to many plants that are botanically unrelated have been identified as allergens responsible for OAS. Latex allergy and its associated food allergy is another example of cross-reacting allergens in botanically unrelated plants; in this case the component responsible has been identified as a hevamine. In the management of food allergy, the subject of cross-reactivity of allergens is becoming increasingly complex. This review examines the problems of OAS, cross-reacting allergens and co-existing allergies in light of recent research into the characteristics of allergens and the factors that predispose to food allergy. Some suggestions are provided for the application of this information in the clinical setting. [ABSTRACT FROM AUTHOR]

Confectionery workers are exposed to a wide variety of organic dusts and aerosols. Previous studies with workers in a confectionery plant working with cocoa and rye flour indicate that these workers are at risk of developing adverse respiratory symptoms and lung function impairment. The effects of cocoa and rye flour extract on isolated guinea pig tracheal smooth muscle were studied using water-soluble extracts from cocoa and rye flour obtained from the studied confectionery plant. Dose-related contractions of nonsensitized guinea pig tracheal rings were demonstrated using both cocoa and rye flour extracts. Pharmacologic studies were performed by pretreating guinea pig tracheal tissue with drugs known to modulate smooth muscle contraction: atropine, indomethacin, pyrilamine, nordihydroguaiaretic acid (NDGA), acivicin, bromophenacyl bromide (BPB) , 3,4,5-trimethoxybenzoate 8-( N,N -diethylamino)octyl ester (TMB8), captopril, and capsaicin. Constrictor effects of the dust extracts were inhibited by these agents, the pattern of which depended on the dust extract. Atropine consistently and significantly reduced the contractile effects of both extracts. These observations suggest a release of parasympathetic mediators by these extracts or more directly an interaction with muscarinic receptors. In addition, the constrictor effect of cocoa and rye flour extracts was significantly, but only partially, reduced by indomethacin, pyrilamine, BPB, and TMB8. Acivicin also partially decreased the constrictor effect of cocoa extract. Pretreatment of tracheal tissue with capsaicin also decreased the constrictor effects of high concentrations of cocoa and rye flour extracts. Data suggest that cocoa and rye flour extracts cause a dose-related constriction of airway smooth muscle by non immunological mechanisms involving cholinergic pathways and airway mediators such as histamine and the products of the arachadonic acid cascade. This effect is not dependent on the presensitization of guinea pigs. [ABSTRACT FROM AUTHOR]

BackgroundMost patients with birch pollen allergy report oral allergy symptoms after eating fresh apples and other vegetable foods. Major birch pollen and apple allergens, Bet v 1 and Mal d 1, are highly homologous; as a consequence, pollen-specific immunotherapy (SIT) might be expected to improve apple hypersensitivity. ObjectiveTo evaluate the clinical and immunological effects of birch pollen SIT on oral allergy syndrome (OAS) induced by apples. MethodsA prospective study carried out in 49 birch pollen-sensitive patients with apple-induced OAS who received injection immunotherapy for 12, 24, or 36 months. Twenty-six patients not submitted to SIT and followed up for 12–48 months were used as controls. Both SPT and open oral challenges with fresh golden delicious apple were performed, as well as specific IgE measurements, before and after SIT. ResultsForty-one patients (84%) vs no control (0%) reported a significant reduction (50–95%) or a total disappearance (100%) of OAS symptoms after SIT (P < 0.001). Similar responses were observed in patients treated for 12, 24, or 36 months. SIT also induced a marked reduction in skin reactivity against fresh apple in 43 patients (88%). The effect of SIT was inversely related with baseline skin reactivity: 50% and 8% patients with a weakly or strongly positive baseline apple skin prick tests (SPT), respectively, did not report changes in OAS severity after SIT (P < 0.01). In contrast, baseline birch pollen-specific or apple-specific IgE antibodies levels did not influence SIT effectiveness on OAS. SIT induced a marked decrease in birch pollen-specific IgE levels (P < 0.001), whereas apple-specific IgE showed an unexpected variability (reduction in 21%, no change in 43%, increase in 38%). No control subject reported a reduction in OAS severity or showed a decrease in skin reactivity at follow-up (P < 0.001). ConclusionsSIT with birch pollen extracts effectively reduces clinical apple sensitivity and skin... [ABSTRACT FROM AUTHOR]

Numerous published studies have reported that the prevalence rates of asthma and allergic rhinitis have increased over the last two to three decades. When interpreting prevalence data, it is important to consider that reported figures may be biased by differences in classification and diagnostic methods, and increased awareness of the conditions. Studies indicate that asthma and allergic conditions are most prevalent in the UK, Australia and New Zealand. High rates have also been reported for Chile. In Europe, intermediate prevalence rates are seen in southern Europe, and the lowest rates occur in central Europe. Despite factors that may affect the figures, worldwide data provide compelling evidence that the prevalences of both asthma and allergic rhinitis have increased. Prevalence rates and increases in prevalence appear to be greatest in children and young adults. It is estimated that, worldwide, between 1% and 20% of children and young adults have asthma, and around 20% of individuals (all age groups) have allergic rhinitis. In Northern Sweden, data from recent studies indicate that major risk factors for the development of asthma are family history (all age groups), own smoking (adults) or the mother smoking (children), and factors related to house dampness (children). Several studies provide evidence that sensitization to allergens in early life are important risk factors for both asthma and allergic rhinitis. Outdoor air pollution, climatic and 'life-style' factors may also play a role in the development of these conditions. Finally, data from northern Sweden demonstrate the association between asthma and allergic rhinitis, and the results show that an adult with a family history of asthma or rhinitis has a risk of three- to four-fold for developing asthma and of two to sixfold for developing rhinitis over adults without a family history. [ABSTRACT FROM AUTHOR]

Examines the frequency of atopic diseases which induced by pollen allergens in the European Mediterranean area. Factors enhancing the effects of allergic symptoms; Chances of high atmospheric allergenic pollen concentrations; Causes of pollinosis.

Crossreactivity to Dactylis glomerata, Festuca rubra, Phleum pratense, Anthoxanthum odoratum, Secale cereale, Zea mays, and Phragmites communis of IgE antibodies against Lol p I or Lol p V was investigated by means of RAST-inhibition. Within a group of sent the degree of crossreactivity was demonstrated to be highly variable. Individual sera were not always equally crossreactive to all pollen species. A high degree of crossreactivity for Group I allergens did not necessarily implicate the same for Group V. Group I and Group V representatives were found to be present in all eight species. It was demonstrated that within this group of grass species significant quantitative and qualitative differences exist. with respect to Group I and Group V allergens. Species with a low phylogenetic affinity to LoIium perenne, like Zea mays and Phragmites communis showed a very low degree of reactivity, even when measured with the most crossreactive sera. A higher taxonomic relationship however, did not always implicate a closer antigenic resemblance. Antigenically both allergens from Zea mars are more similar to Lol p I and Lol p V. than the analogues in Secale cereale. [ABSTRACT FROM AUTHOR]

Ninety-one subjects suffering from chronic or recurrent urticaria or recurrent angioedema of 2 months to 17 yr duration were skin-prick and scratch tested with 18 various food additives. Twenty-four of the subjects (26%) had at least one histamine equivalent skin test (ST) reaction. In contrast, only 24 (10%) of 247 non-urticaria control subjects showed comparable results. An oral provocation test with food additives was carried out on 10 of the 24 ST-positive subjects with urticaria or angioedema, but only one positive reaction, caused by benzoic acid, was recorded. All 91 subjects were advised to follow an additive-free diet. The effect of the diet was investigated with a retrospective postal survey. Twenty-three ST-positive subjects returned the questionnaire, 18 had followed the diet, and 16 (89%) of these 18 had experienced marked relief of their symptoms. Correspondingly, 42 of the 47 ST-negative subjects had followed the diet, and 17 (40%) had improved. The difference was significant (P<0.05). Our results suggest that skin tests with food additives can be used to measure skin hyperreactivity and that they may have a predictive value in identifying patients who will respond to an additive-free diet. [ABSTRACT FROM AUTHOR]

The presence of viable mould propagules in indoor air was investigated using the N6-Andersen sampler in combination with DG18-agar, in relation to house damp (characterized with a checklist) and in relation to the presence of moulds in outdoor air. The first part of the study was conducted in 46 houses in the autumn of 1987, the second part in 84 houses in May 1989. Further, in the second part, the results obtained with settlement plates (OPD) were compared with those obtained with the N6-Andersen sampler. The number of CFU/m³ in the indoor and outdoor air varied widely. A large variety of mould genera and species was isolated. Species of Cladosporium, Penicillium and Wallemia predominated. The variability in time was high and the reproducibility of the measurements in terms of CFU/m³ and of species isolated was only moderate. The low predictive value of these measurements limits their use in epidemiological studies of the relationship between exposure to moulds and respiratory symptoms. Overall, the geometric mean concentration was somewhat higher outdoors than indoors. However, the clear differences found between the number of CFU/m³ belonging to different mould species in in- and outdoor air show that the presence of viable mould propagules in indoor air is not simply a reflection of the presence of moulds in outdoor air. The presence of moulds in indoor air was only weakly related to house damp as characterized by the checklist. High, statistically significant correlations were found between the CFU yield obtained with the OPD and the CFU/m³ yield obtained with the N6-Andersen sampler. However, the number of species isolated with the OPD was significantly lower than that obtained with the N6-Andersen sampler. [ABSTRACT FROM AUTHOR]

Provides information about psoriasis. Changes in the serum immunoglobulin of the patients with the disease; Status of lymphocyte transformation in the presence of phythemaglutinin; Possibility of streptococcal infections to trigger psoriasis.

Respiratory symptoms and ventilatory capacity were studied in a group of 288 workers (259 women and 29 men) employed in a confectionery plant. A group of workers (96 women and 31 men) not exposed to confectionery manufacture were also studied as controls. The prevalence of chronic respiratory symptoms was higher in exposed than in control workers, being greatest for confectionery workers exposed to the dust of flour, talc, and starch and the vapours of alcohol. Chronic bronchitis was reported by 7% of the women and 21% of the men, and chest tightness was reported by 27% of women and 66% of men. There was a high prevalence of acute irritative symptoms during the workshift in all groups of confectionery workers, especially for cough, dyspnoea, burning and dryness of the throat, and eye irritation. For all groups of confectionery workers there were statistically significant across shift reductions in ventilatory capacity, being most pronounced for maximum flow rate at 50% of the control vital capacity (FEF50; range 4.6-13.0%) and at 25% of the control vital capacity (FEF25; range 4.7-22.3%). Preshift values of FEF50 and FEF25 were significantly lower than predicted values. The data suggest that some workers employed in confectionery plants may develop acute and chronic respiratory symptoms associated with changes in lung function. [ABSTRACT FROM AUTHOR]

The clinical significance of mould allergens in Phadebas RAST∗ panel was investigated in 121 asthmatic children. They were selected from a total population of 1649 patients. The patients were distributed into four groups, based on the combination of positive or negative skin prick tests (SPT) together with symptoms suggestive or not of mould sensitivity. Mould-specific IgE antibodies were investigated using the original RAST panel (Alternatia, Aspergilius, Candida, Cladosporium. Mucor and Penicillium) and a set of 10 additional mould-allergen discs (Aureobasidium, Botrytis, Currularia, Epicoccum, Fusorium, Helminthosporium, Phoma, Rhizopus, Stemphylium and Trichoderma). The set of additional RAST discs revealed patients with mould-reaginic antibodies not found with the original RAST panel. This occurred in four of 49 (8.2%) RAST positive (class ≥ 2) patients. The allergens most frequently positive were Cladosporium (in 28% of the patients). Candida (28%) and Helminthosporium (26%). A remarkable degree of simultaneous reactivity to almost all moulds tested was observed. Patients with multiple (≥ 7) mould sensitization were effectively pinpointed using any duplicate combination of Aureobasidium, Botrytis, Candida, Cladosporium, Helminthosporium, Pencillium and Stemphylium. [ABSTRACT FROM AUTHOR]

The aim of the study was to determined whether IgG antibodies from patients on specific immunotherapy could inhibit skin test reactivity of allergens when mixed with them prior to testing. In a preliminary double-blind study, mite extracts were incubated with glycero-saline solution or non-specific IgG and used in testing 15 patients. Wheal and flare diameters produced with the two mite extracts did not differ significantly. In a second double-blind study with 15 other patients, skin tests using mite extracts incubated with either non-specific IgG or specific IgG showed significantly decreased diameters when mite extracts were preincubated with specific IgG. This result, in vivo, confirms the antigen neutralizing capacity of specific IgG demonstrated in vitro. [ABSTRACT FROM AUTHOR]

Only seldom have food additives been shown to cause true allergic (immunological) reactions. Adverse effects due to various pharmacological or other mechanisms are much more common. The individual tolerance may be decreased for one reason or another, and may fluctuate from time to time. Many patients suffering from food additive reactions have atopic constitutions and such clinical symptoms as flexural dermatitis, rhinitis and asthma. The most important skin symptoms caused by food additives are urticaria, angioneurotic edema, and contact urticaria. Azo dyes, benzoic acid and several other common food additives may aggravate or, more rarely, even cause urticaria. Spices are one of the most common causes of immunological contact urticaria. Non-immunological contact urticaria is produced by numerous spices, benzoic acid, sorbic acid, cinnamic acid, and many essential oils. Asthma and rhinitis are the main hypersensitivity symptoms in the respiratory tract, and azo dyes, benzoic acid, and sulfitic food additives are the most common causative agents. Systemic and respiratory reactions to food colorants and benzoates have been claimed to occur more frequently in acetylsalicylic acid-(ASA-)sensitive patients than in non-reactors. Hypersensitivity reactions in organs other than the skin and respiratory tract are rare or poorly documented. Psychological factors play an essential role in both food and food additive reactions. [ABSTRACT FROM AUTHOR]

The biological activity of a partly purified, biochemically/immunochemically characterized mugwort pollen allergen preparation and crude pollen extracts of mugwort, goosefoot and English plantain was determined by means of skin prick test (SPT). The patient inclusion criteria with mugwort were a well-defined positive clinical history and a positive SPT. Symptoms related to goosefoot/English plantain pollens are difficult to define, as these weeds flower during the grass pollen season. Thus patients tested with these allergens did not fulfill the most important inclusion criterion for so-called biological standardization. To elicit a wheal of the same size as that produced by histamine 1 mg/ml required 100 to 10,000 times more material from these weeds, than from mugwort and other pollen allergen extracts investigated earlier. One thousand Biological Units/ml (BU/ml) corresponded to 8.3 μg dry weight (dw/ml) of the crude and 1.8 μg dw/ml of the purified mugwort pollen allergen preparation. Only 7/22 goosefoot-and English plantain-tested patients were positive at conjunctival or nasal challenge. All three weeds showed a similar composition with 5-10 allergens by CIE/CRIE analysis and 10-13 by immunoblotting analysis. One dominating allergen (approx. 15,000 d), could be identified for each weed species by protein gel blot after separation by SDS g-PAGE. There was no other explanation for the difference in biological activity than the criteria of selection. If there is no obvious clinical history, which is the main patient inclusion criterion in biological standardization, then additional criteria should be used. [ABSTRACT FROM AUTHOR]

A retrospective study supplemented with follow-up was carried out in 163 children, aged 6 months to 16 years, who were hospitalized because of acute, recurrent or chronic urticaria in 1976-1980. Etiologic agents were identified in 55% of cases. Physical factors were the commonest causes, especially in cases of chronic urticaria, while infections predominated in acute urticaria. 81% of the children participated in the follow-up study. Follow-up for a year or more revealed that 53% of the children had become symptom-free, 36% still had symptoms but less frequently and in 11 % urticaria was unresolved. The results indicate that the etiologic factors in childhood urticaria are similar to those found in adults and that prognosis is favorable, particularly when the etiology is established. [ABSTRACT FROM AUTHOR]

Fourteen boys with a mean age of 1.2.2 years were studied with respect to the protective effect of ketotifen on exercise-induced asthma (EIA) in comparison with disodium cromoglycate (DSCG). All had a positive history of EIA and a post-exercise fall in FEV1 of more than 20%. A double blind cross-over technique was used with a 1 week wash-out period between the two treatment alternatives. Both drugs gave some, but not significant protection for EIA and no differences between the two active substances tested were found. Great individual differences in the response to the two drugs were noted. [ABSTRACT FROM AUTHOR]

A group of 57 female workers employed in the processing of poultry food and 51 nonexposed control workers were studied to determine the possible relation between respiratory and immunological findings in poultry food workers. The prevalences of all chronic respiratory symptoms were significantly higher in exposed than in control workers ( P < 0.01) except for occupational asthma. The highest prevalence of chronic respiratory symptoms in exposed workers was found for chronic cough (49.1 %), followed by dyspnea (43.9%), rhinitis (38.6%), chronic phlegm (31.6%), and chronic bronchitis (26.3%). Occupational asthma was found in 5.3% of exposed workers. Exposed workers with a positive skin prick test to poultry food extract demonstrated higher prevalences of all chronic respiratory symptoms than those with negative skin tests, although the difference was statistically significant only for rhinitis ( P < 0.05). The most frequent skin reactions were found for poultry food extract (exposed: 66.7%; control: 25.5%; P < 0.05). An increased IgE serum level was found in 19 (33.3%) of the exposed and in four (7.8%) of the control workers ( P < 0.01). Three exposed workers with occupational asthma demonstrated an increased serum IgE level. Our data confirm previous results indicating that occupational exposure to poultry food dust may be associated with the development of chronic respiratory symptoms and immunological changes in exposed workers. [ABSTRACT FROM AUTHOR]