[The main hygienic aspects of biotechnological processes]

It was shown that the present technologies and implementation at the majority of biotechnological plants do not completely meet the hygienic requirements. Under such conditions, there is a complex of unfavourable factors which can have a negative effect on the production areas and environment and consequently on the workers and nearby population. The biological and, at some plants, chemical factors are the leading in the complex. The main aspects of the studies aimed at increasing the safety of biotechnological production, improving the labor conditions and decreasing the disease incidence in the personnel are described in general.

Allergic reaction to latex: a risk factor for unsuspected anaphylaxis

Allergic reactions to latex, including anaphylaxis may be a problem in certain individuals exposed to latex. Four atopic patients with symptoms of rhinitis, asthma, anaphylaxis, and/or urticaria upon contact with latex products were studied. The patients showed IgE binding to latex RAST disks ranging from 1.0 to 27.3 times the negative control. Latex products (gloves, balloons, and condoms) directly bound IgE from all four patients. Eluted proteins from the latex products inhibited IgE binding to commercial latex RAST disks. SDS-PAGE demonstrated multiple latex protein bands by Coomassie Blue staining between 14 and 66 kD. Immunoblotting showed specific IgE binding to latex proteins at 30 and 66 kD. These results indicate that latex-allergic patients have IgE directed against specific latex proteins. Allergy to latex can pose a substantial health risk to susceptible individuals.

Delivery of prevention and care to asthmatic children

Asthma-induced mortality increases especially among children; asthma induced morbidity impairs their day-to-day life as well as both their physical and psychological development. The treatment of asthma in children should reduce their symptoms. Although asthma medication appears to be efficient in clinical trials such is not the case in clinical practice and public health. The use of drugs and services depends upon the severity of the disease as well as upon cultural, personal and familial factors. These factors are crucial in the spontaneously inconsistent evolution of this disease. The management of asthmatic children should thus aim: 1) to alter behaviors--of both the patients and their parents who are often in charge of the treatment on a day-to-day basis and of the physician in order to organize a comprehensive therapeutic project for the sick children; 2) to enhance the collaboration between the different paramedical people involved in the treatment; 3) to improve the efficiency of the health system to allow it to achieve its goal of providing high-standard, accessible health care.

Nonpharmacologic means of preventing asthma

Cessation of smoking in the home is one of the most important nonpharmacologic actions to be recommended. There is a highly significant increase in wheezing, coughing, and respiratory infections in children with smoking mothers, and this increase is directly proportional to the number of cigarettes smoked. Cord blood IgE levels are increased in babies whose mothers smoke during pregnancy. Other agents, such as sulpur dioxide and chemical pollutants from industrial processes may play a role in the development or exacerbation, of asthma symptoms and should be avoided. One of the most interesting areas in food allergy is whether breast feeding causes sensitization or induces tolerance in infants to foods ingested by the mother. There is an increase in asthma in second-generation immigrant populations who are exposed, from birth, to the Western style of living which increases their exposure to house dust mite. Several studies have shown that month of birth is important in the development of specific allergies, for example, in the incidence of birch pollen allergy in Scandinavia. The presence of a pet in the home at birth is associated with a greater incidence of allergy to that animal. Our study in asthmatic children has shown a strong association (p less than 0.001) between the presence of allergens in the air in their homes (sampled retrospectively in the month of birth) with a positive skin test to those allergens.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevention of bronchial hyperreactivity in children

Hyperresponsiveness of the bronchi is defined as an excessive reaction of bronchial mucosa to irritants that do no harm to a healthy mucosa. Measures to prevent bronchial hyperreactivity in children with asthma and other diseases remain rather ineffective at present. Though progress has been made in some areas.

[Epidemiology and prevention of respiratory allergies in children]

There appears to be a belief that asthma in children is increasing. Given the fact that the morbidity of asthma has not decreased despite many advances in pharmacologic treatment, it is clear that attempting at reduce exposure should come at an early stage of life. This is best accomplished through preventive measures such as dietary prophylaxis and sufficiently aggressive measures to reduce exposure to mites.

Protection by nedocromil sodium of active immunization-induced bronchopulmonary alterations in the guinea pig

The effect of nedocromil sodium on PAF-acether- and antigen-induced bronchoconstriction (BC) and mediator release in lungs from actively sensitized guinea pigs and on the eosinophil content of bronchoalveolar lavage (BAL) was investigated. Guinea pigs were actively sensitized by two subcutaneous injections of 10 micrograms ovalbumin in 1 mg AI(OH)3 at 2-wk intervals. One week after the second (booster) injection, the lungs were removed, perfused in the absence or presence of indomethacin, and challenged at 10-min intervals with PAF-acether (1 and 100 ng) and with ovalbumin (1 micrograms). No inhibition of PAF-acether- and antigen-induced BC or mediator release from sensitized lungs was observed when nedocromil sodium (10 microM) was added directly to the buffer solution. By contrast, when guinea pigs were treated for 1 wk before the experiment with nedocromil sodium (30 mg/kg per day), BC and the release of leukotrienelike material (but not of thromboxane B2) to 1 ng PAF-acether were reduced by around 50% (p less than 0.05) and 62% (p less than 0.05), respectively. No inhibition was observed for 100 ng PAF-acether and 1 micrograms ovalbumin. Furthermore, nedocromil sodium markedly impaired histamine secretion induced by both PAF-acether and antigen administration. Nedocromil sodium did not affect the titers of circulating ovalbumin-specific immunoglobulin G, as detected by an enzyme-linked immunosorbent assay. The 1-wk treatment with nedocromil sodium also reduced markedly the proportion of eosinophils in the BAL of sensitized guinea pigs, whereas it was ineffective when injected once subcutaneously at the dose of 30 mg/kg 2 h before the experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of inhaled frusemide on the early response to antigen and subsequent change in airway reactivity in atopic patients

The purpose of this study was to investigate whether inhaled frusemide was able to inhibit the increase in nonspecific bronchial reactivity that occurs after the early response to allergen exposure in subjects with allergic rhinitis or asthma (or both). Ten symptom free patients initially underwent a challenge with methacholine, to determine the dose of methacholine that caused a 15% fall in FEV1 (PD15 FEV1 meth) and a challenge with a specific allergen, to determine the concentration of allergen that caused a fall in FEV1 of at least 15%. On two further occasions they inhaled allergen concentration that had caused the greater than or equal to 15% fall in FEV1 preceded by inhaled frusemide (40 mg frusemide in 4 ml buffered saline) or placebo (4 ml of diluent solution), according to a randomised, double blind, crossover design. All allergen studies were separated by at least seven days. A methacholine challenge was performed two hours after the allergen challenge, a time when the early response to allergen had completely resolved. Frusemide inhibited the early response to antigen, causing mean (95% confidence interval) protection of 87.6% (96-80%) for the maximum fall in FEV1. The increase in non-specific airway reactivity that occurred after antigen when this was preceded by placebo was reduced by frusemide. The mean (95% CI) difference in PD15 values between the placebo and the frusemide days was 1.73 (2.30-1.16) doubling doses of methacholine. These results confirm that frusemide is highly effective in preventing the early response to allergen, and show that it inhibits the increase in reactivity to methacholine that follows the early response.

A new test for specific IgE to inhalant allergens (Phadiatop) in the screening of immediate respiratory hypersensitivity states

Three hundred recruits were classified as either allergic or nonallergic to inhalant allergens on the basis of history, physical examination, skin testing, and RAST. Forty-nine (16.3%) were classified as allergic as they were affected by oculorhinitis and/or asthma. This diagnosis was compared with results obtained with PRIST and with a new commercially available multi-RAST test for inhalant allergy, Phadiatop (Pharmacia). Sixty subjects (20%), including all 49 allergic subjects, scored positive in the Phadiatop assay (100% sensitivity) while PRIST (cut-off 220 IU/mL) identified only 20/49 allergics (40.8% sensitivity). The correlation between RAST and Phadiatop was excellent. Phadiatop is much more sensitive than PRIST; furthermore, Phadiatop is easier, less expensive, and as reliable as RAST for use in mass screening programs.

Dust from carpeted and smooth floors. II. Antigenic and allergenic content of dust vacuumed from carpeted and smooth floors in schools under routine cleaning schedules

Dust samples were collected twice from smooth and carpeted floors in 10 Norwegian schools. The content of antigens and allergens of alder (Alnus incana), birch (Betula verrucosa), timothy (Phleum pratense), cat and dog dander, house dust mite (Dermatophagoides farinae), mould (Cladosporium herbarum), hen egg white and codfish (DIII) were investigated by crossed immunoelectrophoresis (CIE), crossed radio immunoelectrophoresis (CRIE), radio allergosorbent test (RAST) inhibition and quantitative precipitation inhibition analysis by laser nephelometry. Antigens and allergens of cat and dog dander and hen egg white were most prevalent in the dust samples investigated. With the exception of hen egg white and codfish allergens, no statistically significant differences in mean allergen content were shown in identical quantities of freeze-dried dust extracts from carpeted and smooth floors. RAST-inhibition analyses of identical amounts of dust from either floors showed higher content of allergens of cat, dog, hen egg white, codfish, mould and timothy pollen in classrooms with carpets.

[The effect of a selective 5-lipoxygenase inhibitor, AA-861 on airway hyperresponsiveness induced by ozone exposure in dogs]

To determine whether 5-lipoxygenase products are involved in hyperresponsiveness induced by ozone exposure, we studied the effect of a selective 5-lipoxygenase inhibitor, AA-861 on ozone-induced airway hyperresponsiveness in six dogs. Airway responsiveness to methacholine was measured by modified Astograph (7 Hz oscillation method) before and after ozone exposure, and TxB2 in plasma and in BALF, 6-keto-PGF1 alpha in BALF, numbers of neutrophils in the peripheral blood and differential cell counts in BALF were measured before and after ozone exposure. Ozone exposure was carried out for 2 hr at an ozone level of 3.04 +/- 0.01 ppm (mean +/- SE). There was a significant increase in airway responsiveness to methacholine after ozone exposure in the six dogs (p less than 0.01), and the numbers of neutrophils in the peripheral blood and the neutrophil counts in BALF increased significantly after ozone exposure (P less than 0.01). A selective 5-lipoxygenase inhibitor, AA-861 significantly inhibited the increase of airway responsiveness to methacholine induced by ozone exposure (p less than 0.05), and furthermore, the increase in the numbers of neutrophils in the peripheral blood and the neutrophil counts in BALF after ozone exposure were significantly inhibited by pretreatment with AA-861 (p less than 0.05). There was no significant change in the levels of TxB2 in plasma or in BALF, and also no apparent change in the levels of histamine was observed in BALF after ozone exposure. The levels of 6-keto-PGF1 alpha in BALF decreased after ozone exposure, but the decrease was not significant. These results suggest that 5-lipoxygenase products play an important role in the development of airway hyperresponsiveness and in the infiltration of neutrophils into the airway after ozone exposure in dogs.

[In vitro study as a screening test for inhalation allergy (Phadiatop)]

To investigate the question as to a possible allergic cause of disease of the airways, a new laboratory method has now become available (Phadiatop, Pharmacia Freiburg im Breisgau), which enables the physician who is not a specialist in allergology, to obtain initial orientation on the presence of an IgE-mediated allergic condition affecting the airways. The procedure is capable of identifying allergen-specific antibodies against ten different inhalation allergens, simultaneously and undifferentiated. It is available either as a radioimmunoassay or an enzyme immunoassay.

Inhibition of allergic and nonallergic leukotriene C4 formation and histamine secretion by azelastine: implication for its mechanism of action

Azelastine, an orally effective antiasthmatic agent, has been reported to inhibit antihistamine-resistant, leukotriene-mediated allergic bronchoconstriction in guinea pigs. This suggests that azelastine might act through inhibition of leukotriene (LT) C4/D4 synthesis. We have examined the effect of azelastine on allergic and nonallergic histamine secretion and LTC4 formation. Azelastine and the known 5-lipoxygenase inhibitors, nordihydroguaiaretic acid and AA-861, exerted concentration-dependent inhibition of allergic LTC4 formation in chopped lung tissue from actively sensitized guinea pigs and calcium ionophore A23187-stimulated LTC4 synthesis in mixed peritoneal cells from rats. Azelastine also produced concentration-dependent inhibition of allergic and nonallergic histamine secretion from rat peritoneal mast cells. The ability of azelastine to inhibit allergic and nonallergic histamine secretion and LTC4 generation may contribute to its mode of action and its therapeutic efficacy.

Efforts by the United States to coordinate the prevention of occupational allergic diseases in the workplace

The investigator who studies OADs must realize that results may impact social, ethical, and moral issues and create economic dilemmas. This is different from most research endeavors, which create warm appreciation for research findings. Finally, the researcher may be asked to support, defend, or deny a position that argues or extrapolates beyond the scientific findings--a situation that does not usually occur in "pure" research. Many investigators are poorly equipped to deal with these broader issues, and thus confusion and distrust occasionally result. Working on OAD requires enormous understanding from the interested parties. Task force recommendations that fail to consider nonmedical and nonscientific needs for industry and labor are not likely to be welcomed or implemented.