Enhancement of membrane damage by saponins isolated from Acacia auriculiformis

Pharmacologic intervention in the management of allergic conjunctivitis was evaluated with different topical ocular agents in man. Their effect can be precisely assessed with the conjunctival provocation test (CPT). A potent specific H1-receptor antagonist, 0.05% mequitazine eye-drops, was tested in a double-blind randomized, placebo-controlled study using CPT with grass pollen allergens. Twenty healthy subjects allergic to grass pollen were included outside the pollen season after a positive CPT screening. They received one drop of 0.05% mequitazine in one eye and the vehicle in the contralateral eye in a random order, four times daily for 5 days. CPT was performed 15 min after the last instillation, and the threshold dose inducing a positive reaction was determined. Results were given by Abelson's composite score including redness, chemosis, tearing, and itching. Topical 0.05% mequitazine significantly reduced the composite score compared to placebo. The allergen threshold concentration which induced the positive conjunctival reaction was higher in mequitazine pretreated eyes. No side-effect was reported. These data clearly suggest that mequitazine has potential to treat allergic conjunctivitis.     

Combined analysis of two studies using the conjunctival allergen challenge model to evaluate olopatadine hydrochloride, a new ophthalmic antiallergic agent with dual activity

PURPOSE: To evaluate the effectiveness and safety of olopatadine hydrochloride and to determine its optimal concentration and the onset and duration of action for treating allergic conjunctivitis. Olopatadine is a new topical ophthalmic antiallergic agent that demonstrates activity as both an antihistamine and a mast cell stabilizer. Two double-masked, randomized, placebo-controlled, contralateral eye comparison studies were conducted using the conjunctival allergen challenge model. METHODS: A total of 169 subjects received 0.05% or 0.1% olopatadine. Study subjects were healthy adult men and women with a history of active allergic conjunctivitis within the previous two seasons but not receiving current treatment. With an allergen dose that produced signs and symptoms of allergic conjunctivitis at visits 1 and 2, the conjunctival allergen challenge was performed 27 minutes after study drug administration at the third visit (onset-of-action challenge) and at 8 hours after study drug administration at the fourth visit (duration-of-action challenge). Olopatadine was administered in one eye and placebo in the opposite eye. Itching and redness were scored for both eyes at 3, 10, and 20 minutes after the conjunctival allergen challenge. RESULTS: Both 0.05% and 0.1% concentrations of olopatadine were significantly (P < .05) more effective than placebo in inhibiting itching and redness at all evaluations when administered 27 minutes or 8 hours before the conjunctival allergen challenge. There were no serious or drug-related ocular or nonocular adverse events in either study. CONCLUSION: These findings demonstrate the rapid and prolonged (at least 8 hours) ocular antiallergic action of olopatadine.     

Lodoxamide versus spaglumic acid: a comparative double-blind trial on patients suffering from seasonal allergic conjunctivitis induced by Parietaria pollen

In order to evaluate the efficacy and tolerability of lodoxamide in the treatment of allergic conjunctivitis, the authors conducted a double-blind trial with intrapatient comparison on 32 patients, using lodoxamide versus spaglumic acid in the course of two conjunctival provocation tests performed with specific allergens. The patients received one drop of lodoxamide in one eye and one drop of spaglumic acid in the other; 15 minutes later, 25 microliters of allergen extract at a pre-established concentration was instilled. After 10 minutes, the signs and symptoms of the allergic response were evaluated and recorded. Six hours later, the instillation of the allergen extract in both eyes was repeated following the same procedure, to establish the duration of the effect of the two drugs. The results, obtained by evaluating the main clinical signs and symptoms (itching, lacrimation, hyperaemia, palpebral oedema and chemosis), demonstrate with statistically significant differences that lodoxamide inhibits the conjunctival response to exposure to the allergen with greater efficacy than spaglumic acid, and for a longer duration. The two drugs provided similar and satisfactory tolerability. In view of these results, lodoxamide can definitely be considered and effective drug in the treatment of allergic conjunctivitis.     

Efficacy of lodoxamide eye drops on mast cells and eosinophils after allergen challenge in allergic conjunctivitis

PURPOSE: The purpose of the study is to evaluate in a double-blind, randomized study the efficacy of lodoxamide tromethamine 0.1% versus placebo. METHODS: Signs and symptoms, tear tryptase, and tear fluid cytology were evaluated in 20 asymptomatic subjects with allergic conjunctivitis. The study included three allergen challenges in skin test-positive patients. At the first visit, a threshold dose of allergen was established. At the second visit, a bilateral ocular challenge was performed without pretreatment. At the third visit, either lodoxamide or placebo eye drops were used for 1 week before ocular challenge. RESULTS: Lodoxamide significantly reduced tryptase levels (P < 0.01), neutrophils (P < 0.04), and eosinophils (P < 0.01) in the tear fluid and significantly inhibited ocular itching (P < 0.02) when compared with that of placebo. CONCLUSIONS: Lodoxamide is effective in reducing tryptase levels and the recruitment of inflammatory cells in the tear fluid after allergen challenge.     

Vernal keratoconjunctivitis in the child. Clinical and complementary study apropos of 22 cases

PURPOSE: Vernal kératoconjunctivitis was studied in a population of 22 children aged 3 to 14 years and followed up in an allergy and ophthalmology outpatient clinic. The role of allergy and the severity of inflammation where assessed by a systematic exploration, which combined a detailed allergy evaluation and blood and lacrimal sampling. MATERIALS AND METHODS: Allergy criteria chosen and recorded in 9 cases are: an increase of total IgE over the higher limit for the age, a positive skin prick test to one allergen, a positive serum specific IgE dosage (> 0.35 IU/mL) of specific IgE. Conjunctival allergy was present in 6 of the 9 children with a positive allergenic provocation test, or with a high local production of total IgE and a lacrimal/serum eosinophilic cationic protein ratio greater than one. RESULTS: Criteria used for supporting the IgE mediated hypersensitivity diagnosis are discussed: they have to be very strict to eliminate false positive results. Allergen involvement can only be evidenced by a specific provocation test. When evidenced as described, limbic or palpebral conjunctivitis had the same frequency. Lacrimal ICAM 1 levels seemed to be higher (p < 0.05) in the severe limbal forms (24.7 +/- 3 pg/mL) than in the palpebral ones (8.1 +/- 6.5 pg/mL). Interpretation of biological parameters evidencing conjunctival inflammation is more difficult. CONCLUSION: Allergic involvement in child vernal keratoconjunctivitis can only be assessed through a detailed evaluation, leading to a specialised ophthalmic and allergic management. A specific treatment can then be established, based on allergen eviction and possibly on specific immunotherapy (5 cases). H1 antihistamin treatments are dedicated only to children with a positive allergic evaluation.     

Variation in toe-web response of turkey poults to phytohemagglutinin-P and their resistance to Escherichia coli challenge

PURPOSE: To evaluate the efficacy and safety of loteprednol etabonate 0.5% as prophylactic treatment for the ocular signs and symptoms of seasonal allergic conjunctivitis. METHODS: In this randomized, double-masked, placebo-controlled, parallel study, 293 adults with history of seasonal allergic conjunctivitis were treated with either loteprednol etabonate or vehicle (placebo) four times daily, beginning before the onset of the allergy season and continuing for 6 weeks. The primary efficacy measure was a primary composite score (sum of itching and bulbar conjunctival injection scores). Supportive efficacy measures were the investigator global assessment and a secondary composite score (sum of tearing, erythema, chemosis, and discomfort scores), all calculated during the 21-day peak pollen season. RESULTS: The proportion of patients who never developed moderate or severe signs and symptoms of allergy during the peak pollen season in the loteprednol etabonate treatment group was greater than that in the placebo group. For the primary composite score, this efficacy criterion was reached by 94% of patients (136/145) in the loteprednol etabonate group and 78% of patients (111/143) in the placebo group (P = .001). The magnitude of effect was similar for the investigator global assessment (86% [118/138] vs 64% [87/137]; P < .001) and, although not statistically significant, the secondary composite score (77% [112/145] vs 68% [97/143]; P = .092). None of the loteprednol etabonate-treated patients had an intraocular pressure increase of 10 mm Hg or more, whereas two placebo patients did. CONCLUSIONS: Loteprednol etabonate is generally effective in prophylaxis of seasonal allergic conjunctivitis and has an acceptable safety profile.     

Evaluation of the enhaled glucocorticosteroid effect on non-specific and specific bronchial reactivity with particular reference to the late inflammatory phase in atopic asthma patients. I. The effect of a single dose of budesonide R on specific and non-specific bronchial reactivity]

The effect of a single dose of 320 micrograms of budesonide R on specific and non-specific bronchial response was evaluated. The study was carried out on a group of 12 patients suffering from mild allergic asthma, sensitive to Dermatophagoides pteronyssinus (D. pteronyssinus). On the first day the bronchial provocation test (BPT) with metacholine was performed, and the next day the effect of a single dose of the drug studied on bronchial response to metacholine was evaluated. On the third day sBPT with D. pteronyssinus allergen was performed. The allergen challenge could induce an early (EAR) and a late asthmatic reaction (LAR). After the BPT with the allergen, a 42 days' run-out period was required to eliminate the effects of the allergen provocation on the results of the next tests. Before the evaluation of the effect of budesonide on the allergen challenge, the non-specific response to metacholine was checked again. The results indicate that a single dose of budesonide R does not affect non-specific and specific bronchial response.     

Elevated levels of substance P in tears of patients with allergic conjunctivitis and vernal keratoconjunctivitis

BACKGROUND: Recent studies have suggested that the nervous system may participate in inflammatory processes. Substance P (SP) acts as a chemical mediator as well as a neurotransmitter. OBJECTIVE: In order to clarify the pathogenesis of ocular allergic diseases, we assessed the concentration of SP in tears. METHODS: Using a highly sensitive and specific double-antibody enzyme immunoassay (EIA), we determined the SP concentration in tears of 10 patients with seasonal allergic conjunctivitis, 10 with atopic dermatitis without keratoconjunctivitis (AD), 13 with vernal keratoconjunctivitis (VKC) and 65 normal controls. Giemsa's staining for brush cytology samples and histocytological study by immunocytochemical staining of giant papillary conjunctival cells from VKC and normal controls was conducted. RESULTS: The mean SP level was low in the normal controls and AD, whereas patients with seasonal allergic conjunctivitis and VKC showed significant elevation of SP (P < 0.01). Brush cytology samples showed conjunctival epithelial cells with lymphocytes, neutrophils and eosinophils that were not seen in normal subjects. Histocytological examination demonstrated SP positive cells in the conjunctiva of patients with VKC, but not in normal controls. CONCLUSION: This study suggests that the increased level of SP in tears may contribute to the pathogenesis and severity of ocular allergic diseases.     

Influence of atipamezole on effects of midsacral subarachnoidally administered detomidine in mares

BACKGROUND: The reliable interpretation of the nasal provocation test in allergy diagnosis requires objective and measurable monitoring parameters for clinical practice. The clinical usefulness of the nasal provocation test has been limited by scanty knowledge of the specificity and sensitivity of the test and a lack of reference values. OBJECTIVE: To test and compare three objective monitoring parameters of a nasal provocation test in occupational allergic rhinitis. To evaluate the magnitude of the nasonasal effects in a unilateral allergen challenge. METHODS: The monitoring parameters of the nasal reaction were derived from the minimum cross-sectional area on acoustic rhinometry, the nasal resistance on active anterior rhinomanometry and the amount of nasal secretion measured at 15 min intervals for 60 min. Twenty-three bovine-allergic dairy and beef cattle farmers and 19 exposed, non-allergic control subjects were challenged first with a control solution and then with the cow allergen. RESULTS: All the three monitoring parameters showed high specificity and sensitivity in finding allergic and non-allergic subjects. The secretion parameter was found to be slightly superior to the acoustic rhinometry and rhinomanometry parameters. The side difference in the nasal response between the allergen-challenged and the contralateral diluent-challenged cavity was significant for all the parameters among the allergic subjects. The contralateral secretion amount was 1/3 of the ipsilateral secretion, indicating the magnitude of the contralateral nasonasal reflex. A nasonasal reflex was also noted in the nasal patency monitoring. The coefficient of variation was significantly lower for the acoustic rhinometry than for the rhinomanometry (P=0.0001). The optimal threshold values for a positive test were a secretion amount of 100 mg, a 15% decrease in the minimum cross-sectional area and a 50% increase in the resistance for the observation period of 30 min and correspondingly 210 mg, 30% and 100% for 60 min. CONCLUSION: The low-pressure aspiration of the nasal secretion from the anterior part of the nasal cavity was found to be a reliable and practical monitoring parameter to be used together with acoustic rhinometry or rhinomanometry in the nasal provocation test for clinical purposes. Although significant nasonasal effects took place in the unilateral allergen challenge, the response was more prominent in the allergen-challenged than in the contralateral diluent-challenged nasal cavity in most allergic subjects.     

Suppression of human melanoma metastasis following introduction of chromosome 6 is independent of NME1 (Nm23)

BACKGROUND: Nasal immunotherapy with single allergen extracts, following premedication with cromolyn, has been reported to be effective in treating seasonal and perennial allergic rhinitis. METHODS: We conducted a double-blind, placebo-controlled study to assess the efficacy, tolerability, and mechanism of action of nasal immunotherapy for allergic rhinitis caused by weed pollens from three unrelated families. Twenty-seven weed-allergic patients underwent baseline nasal provocation and titrated skin test with a mixed weed extract containing ragweed, sage, and Chenopod extracts. Patients were randomized to receive either mixed weed extract or placebo. Nasal immunotherapy was self-administered daily to alternate nostrils preceded by 5.2 mg intranasal cromolyn. Beginning with 1:2500 wt/vol the concentration was increased to 1:10 wt/vol over an average period of 36 days. The maintenance dose (1:10 wt/vol) was administered daily for 12 to 16 weeks through the weed pollen season. Patients recorded nasal and eye symptoms and the use of rescue medications throughout the study. A nasal lavage for cytokine levels and nasal scraping with Rhinoprobe for nasal cytology were performed at the peak of the weed season. Nasal provocation and titrated skin tests with mixed weed extract were repeated after the weed season. Nasal lavage and scraping were also performed before and 24 hours after the final nasal provocation. RESULTS: During the peak weeks of the weed season the group receiving mixed weed extract by nasal instillation, compared with those treated with placebo, had significantly lower total nasal symptom scores, total eye symptom scores, and symptom medication scores. There were no significant differences in the nasal cytology or cytokines levels between the two groups, except for elevated IL-10 in the nasal lavage in the treated group at the peak of the season. Nasal symptoms and medication use were higher preseasonally in the active treatment group. CONCLUSION: Nasal immunotherapy with aqueous mixed weed extract administered with cromolyn sodium pretreatment for 17 to 21 weeks was effective in reducing both nasal and ocular symptoms of weed pollen-induced allergic rhinitis. There were increased nasal symptoms in the treated group preseasonally.     

Why nurse prescribing is good for you...

New drug lodoxamine (alomide) opens new vistas in the treatment of allergic diseases of the eyes highly prevalent both in adults and children. This drug prevents release of mast cell mediators and delays eosinophil migration to conjunctival and corneal tissue, thus exerting a spectrum of antiallergic effects. Clinical studies carried out in 170 patients demonstrated a high efficacy of alomide in the treatment of subacute and chronic pollenosis conjunctivitis, spring keratoconjunctivitis, multiple and toxic allergic keratitis, and other allergic conjunctivities. Alomide can be used as a preventive drug in patients with allergies under high-risk conditions and in patients wearing contact lenses. It is effective in combined therapy of keratitis and keratouveitis. Alomide eye drops are well tolerated.     

Predictors of early- and late-phase reactions to bronchial allergen challenge

The influence of inhaled steroids and predictive factors on the response to bronchial allergen challenge (BCA) was evaluated in 80 asthmatics allergic to Dermatophagoides pteronyssinus (Der p). All underwent BCA with Der p and measurement of early (EAR) and late asthmatic reaction (LAR). The cumulative dose of allergen producing 20% fall in FEV1 in the EAR (PD20) was calculated. Bronchial histamine provocation, conjunctival provocation test (CPT), and skin prick test with Der p extract were performed. Specific IgE to Der p in serum (RAST), blood eosinophil (EOS) count, serum eosinophil cationic protein, and eosinophil protein X were measured. Thirty patients (38%) were treated with inhaled steroids. All patients had at least a 20% fall in FEV1 in EAR. Some 42% of nonsteroid- and 33% of steroid-treated patients had LAR with fall in peak flow of at least 20%. For patients not treated with steroid, 35% of variation in PD20 was explained by RAST and histamine reactivity, and 53% of variation of observed PD20 could be predicted. The baseline FEV1, EOS, and EAR explained 28% of variation in LAR, and 28% of variation in observed LAR could be predicted. For patients treated with steroids, 38% of variation in PD20 was explained by EOS and histamine reactivity, and only 18% of variation of observed PD20 could be predicted. For patients treated with steroids, it was impossible to predict LAR. We conclude that to achieve a quantitative estimation of allergen-specific EAR and LAR, BCA cannot be replaced by the tests used in this study. Treatment with inhaled steroids modifies the response to BCA, making quantitative prediction of EAR less accurate and prediction of the magnitude of LAR impossible.     

Efficacy of nedocromil sodium in perennial allergic conjunctivitis

We have evaluated the efficacy of nedocromil sodium 2% eye drops in 35 patients (18 males and 17 females, mean age 32.8 yrs) suffering from perennial allergic conjunctivitis due to Dermatophagoides pteronyssinus diagnosed on the basis of anamnesis, Skin Prick Test and RAST. Patients were treated for 8 weeks with nedocromil sodium one drop each eye, four times daily and had to report the severity of the symptoms considered (photophobia, lacrimation, hyperaemia and itching) on a daily card. During the study no other medication was allowed. After 4 weeks symptoms were statistically improved and this beneficial effect increased at the end of the treatment. No side effects were reported. Nedocromil sodium eye drops is therefore a useful treatment in perennial allergic conjunctivitis due to Dermatophagoides pteronyssinus.     

Ficus benjamina allergy

We report the case of a 48-year-old patient suffered from asthma and conjunctivitis caused by an immediate type allergy to weeping fig (Ficus benjamina). By RAST inhibition test we could demonstrate that IgE antibodies react with allergens of fig; however our patient tolerated figs in oral provocation test. Sensitization to latex proteins reported to be cross reactive to Ficus species was not found. Ficus benjamina allergens represent relevant indoor allergens. A standardized allergen extract for skin testing is not yet available. Allergen specific IgE is mostly found in patients with strongly positive prick test results using the native sap of the tree. In 12 of 64 latex allergic patients we found simultaneous sensitization to weeping fig, so that cros-sensitization has to been considered in patients with IgE-mediated sensitization to latex.     

Diagnostic problems before specific immunotherapy in patients with late-summer seasonal allergic rhinitis

Skin prick tests were performed on 245 patients with late summer seasonal allergic rhinitis, and of these patients, 135 specific serum IgE test were performed. On the basis of skin prick test results, 94% of the patients were found to be sensitive to Ragweed: 18% of these patients had monosensitisation to Ragweed, and 56% were sensitive not only to Ragweed but also to Mugwort. The correlation between results of skin prick tests and specific serum IgE tests was found to be very good (95%) with Ragweed antigen experiencing no problem in the diagnostic process before immunotherapy. However, in 48% of patients with positive skin prick tests to Mugwort the specific serum IgE was found to be negative. Before immunotherapy, a specific nasal provocation test was performed on 12 of these patients with Mugwort to examine the real sensitivity of the shock-organ. This careful allergen research will demonstrate which components of allergen extract should be used for immunotherapy in late summer seasonal allergic rhinitis patients.     

Demonstration of mast-cell chemotactic activity in nasal lavage fluid: characterization of one chemotaxin as c-kit ligand, stem cell factor

Mast cells are known to accumulate in tissue during allergic inflammation. However, the chemotaxins responsible are undefined. Using a modified Boyden chamber and the human mast-cell line HMC-1, we first identified mast-cell chemotactic activity in nasal lavage fluid collected before the pollen season after allergen provocation of allergic patients (n=29) (mean migratory response compared to medium control was 121%, range 85-198%). Mast-cell chemotactic activity was also detected in lavage fluid collected after allergen provocation at the end of a Swedish birch-pollen season from three different treatment groups: topical steroid treatment with budesonide; the topical antihistamine, levocabastine; and placebo. There was no significant difference in mast-cell chemotactic activity between nasal lavage fluid collected from the placebo group (mean=102%), the budesonide-treated group (mean=114%), or the levocabastine group (mean=125%). Stem cell factor (SCF), a known mast-cell chemotaxin, was present in the nasal lavage fluids from all three groups, and correlated with the mast-cell chemotactic activity (r=0.67, P<0.01). The mast-cell chemotactic activity was inhibited (range 5-100%) in some, but not all, nasal lavage fluids by a polyclonal antibody directed against SCF. This report describes the presence of mast-cell chemotactic activity in nasal lavage fluid during an allergic reaction. These findings show that SCF may play a pivotal role in the recruitment of mast cells in allergic rhinitis.     

Occupational allergy in greenhouse workers: sensitization to Tetranychus urticae

BACKGROUND: Tetranychus urticae (TU) is a macroscopic mite which is found infesting a large number of plants of economic interest. It has rarely been described as a cause of occupational allergic disease in agricultural workers. OBJECTIVE: To describe TU sensitization in greenhouse workers attending the outpatient allergy unit and its clinical associations, and to characterize the allergens involved. MATERIALS AND METHODS: Twenty-four consecutive carnation greenhouse workers with allergy-related symptoms, referred to our outpatient clinic during a 6-month period, were included. We made the diagnostic extract from carnation leaves heavily infested with TU. Skin-prick test, specific IgE measurement and bronchial provocation test with TU extract were carried out in all subjects. Allergen characterization was achieved by SDS-PAGE (sodium dodecylsulfate-polyacrylamide gel electrophoresis) and immunoblotting. RESULTS: Sixteen patients (66%) presented positive skin-prick test and specific IgE and were diagnosed allergic to TU. Fifteen patients suffered from bronchial asthma, 14 rhinitis and five urticaria. Twelve exhibited positive bronchial provocation test to the TU extract. On RAST-inhibition studies, there was no evidence of crossreactivity between TU extract and D. pteronyssinus. An allergen at 19 kDa was determined in the TU extract by SDS-PAGE immunoblotting studies. CONCLUSION: TU could be an important occupational allergen in greenhouse workers showing allergic symptomatology. There is no crossreactivity between this mite and the house dust mite D. pteronyssinus.     

Differential expression of the p27Kip1 mRNA in IFN-sensitive and resistant cell lines

STUDY OBJECTIVES: In a previous study published by our group, six out of nine subjects with mild allergic asthma were shown to have an enhanced response to allergen challenge following a 1-h exposure in an 0.8-m3 exposure chamber (modified from a body plethysmograph) to an average of 120 parts per billion (ppb) ozone at rest. Other studies failed to confirm this effect. In the present study, using a similar design, we reexamined this effect using a larger group of asthmatics and a larger chamber allowing minimal fluctuations in ozone levels during exposures. DESIGN: Prospective, randomized single-blinded crossover study. SETTING: Pulmonary function laboratory equipped with an exposure chamber. SUBJECTS: Fifteen subjects had mild allergic asthma; 9 men and 6 women; the mean (SD) age was 32.5 (10) years; FEV1 was 3.4 (0.8) L; baseline methacholine provocation concentration causing a 20% fall in FEV1 was (PC20) 3.28 (4.1) mg/mL. INTERVENTIONS: Each participant was exposed, at rest, on 1 day to filtered air and on another day to ozone (mean level=120 ppb) in a larger exposure chamber than the one used in our first study with less variability in ozone level (110 to 130 vs 85 to 175 ppb) using a random, single-blinded design. After each exposure, the subject was challenged with allergen (nine with grass pollen extract and six with ragweed extract) and allergen PC15 was measured. RESULTS: Ozone preexposure did not affect allergen PC15 when compared with clean air preexposure (allergen PC15 dilution 1/114 vs 1/119, respectively). Ozone vs air preexposure resulted in an allergen PC15 that was lower in five subjects, higher in six, and unchanged (within one doubling dose) in four. CONCLUSIONS: At this low level with less variability and lower peaks than our previous study, ozone had no significant effect on airway allergen responsiveness.     

Comparison of nested polymerase chain reaction, virus isolation, and fluorescent antibody testing for identifying feline herpesvirus in cats with conjunctivitis

OBJECTIVE: To compare nested polymerase chain reaction (PCR), virus isolation (VI), and fluorescent antibody (FA) testing to detect feline herpesvirus (FHV) in cats with naturally acquired conjunctivitis or respiratory tract disease, or both. SAMPLES: Swab and microbrush specimens from the conjunctiva and throat were taken from 46 cats, allotted to 3 groups (conjunctivitis only, respiratory tract disease and conjunctivitis, and clinically normal). PROCEDURE: Cells from microbrush specimens were digested and herpesvirus DNA was amplified, using a double round of PCR. Products were detected by use of agarose gel electrophoresis. The VI and FA tests were performed in routine manner. RESULTS: Of 16 cats with conjunctivitis only, conjunctival specimens from 8 and throat specimens from 8 were FHV positive by PCR. None had positive results of VI or FA testing. Of 15 cats with respiratory tract disease and conjunctivitis, conjunctival specimens from 13 and throat specimens from 12 were FHV positive by PCR. A conjunctival specimen from 1 cat and throat specimens from 3 cats were FHV positive by VI. A conjunctival specimen from 1 cat was FHV positive by FA testing. Of 15 clinically normal cats, conjunctival and throat specimens from 2 cats were FHV positive by PCR; neither conjunctival nor throat specimens from these cats were FHV positive by VI or FA testing. CONCLUSION: For cats with respiratory tract disease and conjunctivitis, or with conjunctivitis only, nested PCR was more sensitive at detecting FHV than was VI or FA testing. CLINICAL RELEVANCE: Nested PCR is a more sensitive test than the currently available VI and FA tests for identifying FHV in cats with conjunctivitis.     

Neurotrophins are increased in bronchoalveolar lavage fluid after segmental allergen provocation

The mechanisms linking inflammation and airway hyperresponsiveness in allergic bronchial asthma are still not completely defined. Since neurotrophic factors increase nerve excitability and neurotransmitter synthesis and are produced by immunocompetent cells, they are likely candidates as mediators of inflammation and hyperresponsiveness. We tested the hypothesis that neurotrophin concentrations will increase in the bronchoalveolar lavage (BAL) fluid from patients with asthma after segmental allergen provocation. For this purpose an individually standardized dose of allergen or saline was instilled into different segments during bronchoscopy in eight subjects with mild allergic bronchial asthma. Segments were then lavaged 10 min and 18 h after allergen challenge or saline instillation. There was a significant increase in the neurotrophins nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 in BAL fluids 18 h after allergen but not saline challenge. We conclude that neurotrophins are produced endobronchially following allergen provocation, suggesting a contribution to the pathogenesis of asthma.