Food allergy with monovalent sensitivity to poultry meat

BACKGROUND

Allergy to poultry meat is only rarely covered in science. The few reports are usually related to patients allergic to eggs or bird feathers.

OBJECTIVE

Two patients with a clear history of monovalent, ingestive allergy to chicken and turkey meat, without other food allergies, were analysed. The relevant allergens were to be identified by immunoblotting.

METHODS

Both patients were evaluated with skin tests and specific IgE determination (CAP). Allergens were identified by SDS-PAGE and immunoblotting. Cross-reactivity of chicken and turkey meat was examined by IgE inhibition experiments.

RESULTS

Skin tests and specific IgE were positive for chicken and turkey in both patients. Cross-reactivities to other poultry meats were documented for duck and goose meat. No sensitization to egg components or poultry feathers could be found. Allergenic proteins of poultry meat were detected at molecular weights of 21, 23 and 50 kDa (distinct bands) and 13, 27 and 33kDa (faint bands). An additional band at 91 kDa for turkey, can probably not be considered a distinct allergenic epitope. Immunoblot inhibition confirmed cross-reactivity of chicken and turkey meat allergens.

CONCLUSION

Food allergy to poultry meat is a distinct disorder with crossreactivity among chicken, turkey and other poultries. The relevant allergens were identified by immunoblotting. Associated food allergy to egg-components is unlikely as the patients were able to tolerate egg and eggs products.

Effects of adjuvants on the immune response to allergens in a murine model of allergen inhalation: cholera toxin induces a Th1-like response to Bet v 1, the major birch pollen allergen

Based on the fact that type I allergies are frequently elicited by inhalant allergens, we have established a model of aerosol inhalation leading to allergic sensitization in BALB/c mice. Using this model we studied the effects of aluminium hydroxide (Al(OH)3), known to enhance IgE antibody responses, compared with cholera toxin (CT), a potent mucosal adjuvant, on the immune response to birch pollen (BP) and its major allergen Bet v 1. Two groups of BALB/c mice were either systemically immunized with recombinant Bet v 1 in Al(OH)3 and subsequently aerosol exposed to BP allergen, or aerosolized with BP and CT. IgE-mediated skin reactions were only elicited in the mice which had received Bet v 1/Al(OH)3. Allergen-specific serum IgE and IgG1 antibodies dominated in the Al(OH)3 group, IgG2a antibody levels to BP and rBet v 1 were markedly higher in the sera of mice exposed to CT with the allergen. IgA antibodies were only detected in the bronchial lavage of the CT-treated group. Moreover, the latter group displayed consistently higher T cell proliferative responses to BP and interferon-gamma production in vitro. Thus, the systemic immunization with rBet v 1 in Al(OH)3 before inhalation of the BP extract promoted a Th2-like immune response, while CT mixed with the aerosolized BP extract rather induced a Th1-like immune response. In an attempt to reverse these ongoing immune responses we could achieve a shift towards a Th0 response. Immunization with BP extract without adjuvant treatment led to undetectable antibody or cellular immune responses. We conclude from the present study that the induction of an immune response to BP allergen after aerosol inhalation can be directed towards a Th1- or a Th2-like response. Once established, the immune response can be modulated.

Food allergy to pumpkinseed--characterization of allergens

In recent years, pumpkinseed has become increasingly popular as a foodstuff. Here we report the occurrence of allergic reactions (itching and swelling of oral mucosa, and asthma) to this member of the Cucurbitaceae family. We investigated three patients suffering from symptoms after ingestion of roasted pumpkinseed. All the patients fished for sport and used pressed pumpkinseed flour as bait. Sera were tested by the immunoblot technique for IgE reactivity with proteins of pumpkinseed extract. The immunoblot revealed pumpkinseed allergens of 13, 14, 36, 48, 77, and 87 kDa. Inhibition experiments with recombinant birch profilin were performed: IgE binding to the 14-kDa allergen was completely blocked by preincubation of the sera with recombinant birch profilin. In conclusion, type I allergy to pumpkinseed is rare, and the patients' histories suggest inhalation of pumpkinseed flour during fishing to be the relevant route of sensitization, leading to food allergy to pumpkinseed.

Forebrain patterning defects in Small eye mutant mice

Pax6 is a member of the Pax gene family of transcriptional regulators that exhibits a restricted spatiotemporal expression in the developing central nervous system, eye and nose. Mutations in Pax6 are responsible for inherited malformations in man, rat and mouse. To evaluate the role of Pax6 in forebrain development, we studied in detail mouse Small eye/Pax6 mutant brains. This analysis revealed severe defects in forebrain regions where Pax6 is specifically expressed. The establishment of some expression boundaries along the dorsoventral axis of the secondary prosencephalon is distorted and the specification of several ventral structures and nuclei is abolished. Specifically, the development of the hypothalamo-telencephalic transition zone and the ventral thalamus is distorted. Our detailed analysis included a comparison of the expression of Pax6, Dlx1 and several other genes during embryonic mouse brain development in wild-type and in the mutant Small eye (Sey) brain. The results from the analysis of normal brain development show that the restricted expression of Pax6 and Dlx1 at E12.5 dpc respect domains within the forebrain, consistent with the implications of the prosomeric model for the organisation of the forebrain (L. Puelles and J. L. R. Rubenstein (1993) Trends Neurosci. 16, 472–479). Furthermore, we found an early restriction of Pax6 and Dlx1 expression into presumptive histogenetic fields that correlate with the formation of distinct forebrain structures and nuclei. Our results are discussed in light of changes in adhesive properties in the Sey brain that might control segregation, assembly and cell migration of progenitors of specific forebrain regions.

IgE cross-reactivity between birch pollen, mugwort pollen and celery is due to at least three distinct cross-reacting allergens: immunoblot investigation of the birch-mugwort-celery syndrome

BACKGROUND

Allergy to celery is often associated with sensitization to birch and/or mugwort pollen.

OBJECTIVE AND METHODS

In a multi-centre study, sera from 23 patients suffering from type 1 allergy to celery and 15 patients with positive celery RAST but no clinical sensitization were compared. To examine whether cross-reactivity between celery and mugwort pollen includes cross-sensitization to birch pollen allergens, we determined cross-reacting structures in birch pollen, mugwort pollen and celery by means of immunoblotting. Inhibition studies were performed by preincubation of sera with extracts of birch pollen, mugwort pollen, and celery.

RESULTS

We identified three groups of proteins--homologues of Bet v 1 and birch profilin (Bet v 2) as well as a group of proteins with a molecular range of 46 to 60 kD--displaying IgE-cross-reactivity, which were shared by birch pollen and celery. Two of these groups of allergens (profilin and the 46 to 60 kD proteins) were also present in mugwort pollen. In this paper we demonstrate that most cross-reacting allergens present in mugwort pollen and celery can also be detected in birch pollen extract.

CONCLUSION

Therefore we propose, from a serological point of view, to extend the mugwort-celery syndrome to the birch-mugwort-celery syndrome.

Checklist: vertebrate homeobox genes

Up to now around 170 different homeobox genes have been cloned from vertebrate genomes. A compilation of the various isolates from mouse, chick, frog, fish and man is presented in the form of a concise checklist, including the designations from the original publications. Putative homologs from different species are aligned, and key characteristics of embryonic or adult expression domains, as well as mutant phenotypes are briefly indicated.

The role of Pax-1 in axial skeleton development

Previous studies have identified a single amino-acid substitution in the transcriptional regulator Pax-1 as the cause of the mouse skeletal mutant undulated (un). To evaluate the role of Pax-1 in the formation of the axial skeleton we have studied Pax-1 protein expression in early sclerotome cells and during subsequent embryonic development, and we have characterized the phenotype of three different Pax-1 mouse mutants, un, undulated-extensive (unex) and Undulated short-tail (Uns). In the Uns mutation the whole Pax-1 locus is deleted, resulting in the complete absence of Pax-1 protein in these mice. The other two genotypes are interpreted as hypomorphs. We conclude that Pax-1 is necessary for normal vertebral column formation along the entire axis, although the severity of the phenotype is strongest in the lumbar region and the tail. Pax-1-deficient mice lack vertebral bodies and intervertebral discs. The proximal part of the ribs and the rib homologues are also missing or severely malformed, whereas neural arches are nearly normal. Pax-1 is thus required for the development of the ventral parts of vertebrae. Embryonic analyses reveal that although sclerotomes are formed in mutant embryos, abnormalities can be detected from day 10.5 p.c. onwards. The phenotypic analyses also suggest that the notochord still influences vertebral body formation some days after the sclerotomes are formed. Furthermore, the notochord diameter is larger in mutant embryos from day 12 p.c., due to increased cell proliferation. In the strongly affected genotypes the notochord persists as a rod-like structure and the nucleus pulposus is never properly formed. Since the notochord is Pax-1-negative these findings suggest a bidirectional interaction between notochord and paraxial mesoderm. The availability of these Pax-1 mutant alleles permitted us to define an early role for Pax-1 in sclerotome patterning as well as a late role in intervertebral disc development. Our observations suggest that Pax-1 function is required for essential steps in ventral sclerotome differentiation, i.e. for the transition from the mesenchymal stage to the onset of chondrogenesis.

[Ulna growth retardation syndrome in the dog]

Premature closure of the distal ulnar physis leads to medial bowing of the radius, later to lateral deviation of the carpus, and ventral subluxation of the elbow. Diagnosis of this growth disturbance depends on accurate radiographical examination. There are different surgical treatments to allow the radius to grow without impediment. The prognosis depends on early treatment.

The molecular basis of the undulated/Pax-1 mutation

The murine paired box gene Pax-1 has been associated with the mouse developmental mutant undulated (un), which exhibits malformations in the vertebral column. In un mice, a point mutation leading to a Gly-Ser exchange in a conserved part of the paired domain of Pax-1 is present. Here we show that Pax-1 encodes a DNA-binding protein with transcriptional activating properties. The DNA-binding specificity of the Pax-1 protein has been extensively analyzed in gel shift assays, and in conjunction with binding interference experiments, a DNA-binding core motif was defined. Comparison of the DNA-binding properties of wild-type and un Pax-1 proteins demonstrates that the Gly-Ser replacement at position 15 within the paired domain dramatically decreases the DNA-binding affinity of the un Pax-1 protein and alters its DNA-binding specificity. These results decipher the molecular basis of the un mutation.

Does trampolining and anaerobic physical fitness affect sleep?

The structure of nocturnal sleep of 16 volunteers, participating in the anaerobic sports of trampolining, dancing, and soccer, was monitored by means of polygraphic recordings. Since trampolining requires the acquisition of unfamiliar patterns of motor coordination, it can be considered as a special form of motor learning, whereas the acquisition of motor skills specific for dancing and soccer can be linked with motor patterns of normal biped locomotion. According to this view, an experimental group of 8 volunteers was formed; they participated in a training course of trampolining. In addition, a control group of 8 subjects was recruited, who engaged in one of the other two anaerobic sports. Subjects who had acquired new motor skills during a 13-wk. program in trampolining showed a statistically significant increase in REM-sleep. By contrast, the 8 subjects of the control group showed no considerable changes in REM-sleep. This suggests that efforts in acquiring new and complex motor patterns activate processes specifically involved in the generation of REM stage during nocturnal sleep.

Rapid detection of IDDM susceptibility with HLA-DQ beta-alleles as markers

The allelic forms of the human leukocyte antigen (HLA)-DQ beta-chain (DQB1) have been recognized as the best markers of insulin-dependent diabetes mellitus (IDDM) susceptibility. We describe a method that allows the recognition of these DQB1 alleles without the use of either allele-specific oligonucleotide probes or radioactive material. This method determines these alleles by electrophoretically separating restriction enzyme-generated fragments from the polymerase chain-reaction-amplified second exon of the HLA-DQB1 gene, which encodes the first domain of the protein chain. This digestion method, which is simpler and more rapid than the previously adopted hybridization method, is described in detail to enable individuals at any clinical laboratory to quickly ascertain IDDM susceptibility.

First domain encoding sequence mediates human class II beta-chain gene cross-hybridization

HLA class II molecules are surface heterodimers which are essential in the initiation of immune responses. The amount of polymorphism expressed by the different class II molecules is largely dependent on the polymorphic structure of their beta chains. Cross-hybridization between class II beta genes frequently hampered restriction fragment length polymorphism analysis of donor genomic DNA. In this report we show that the cross-hybridization between human class II beta genes is mediated by a region of high homology, rich in C and G residues, between the first domain encoding sequences of DP, DQ, and DR genes. The removal of the DNA segment containing this region from the fragments used as labeled probes against the corresponding fragments of the genes at other loci or against endonuclease digested genomic DNA completely eliminated or drastically reduced the cross-hybridization. Also, the RFLP patterns generated with the shortened probes were more informative and much simpler to interpret than were these generated with probes made from the original genes.

A three-year prospective study of systemic manifestation in rheumatoid arthritis

Rheumatoid arthritis (RA) as a systemic disease can attack many other organs in addition to the joints. A variety of pathological lesions of the blood vessels are responsible for the extra-articular features (EAF). In the present study, we investigated firstly whether the presence of blood vessel changes in one organ--namely the skin--may indicate blood vessel pathology and, consequently, EAF in other organs. Secondly, we investigated the number of EAF in individual patients with RA, and observed whether this changed during the course of the disease. Fifty-one RA-patients (40 female, 11 male; ages had a mean of 49.5, minimum 19, maximum 73 years; mean duration of RA was 7.3, minimum 0.25, maximum 41 years) were included in the study. Punch biopsies from the posterior calf were examined immunohistologically for vessel wall immune deposits. Further, EAF were determined by means of instrumental clinical methods such as pulmonary function test, echocardiography, electromyography, and nerve conduction velocity measurement. At the first investigation 21/51 patients had skin vessel wall immune deposits (SVWID). Five patients--all showed SVWID at first investigation--died during the three-year investigation period, 10 patients could not be followed-up for unknown reasons; the skin biopsy of one patient could not be assessed. At the final investigation, we found SVWID in 11/35 patients. SVWID-positive patients had more EAF compared to SVWID-negative patients; this was true both, at the first investigation (1.85 EAF/patient vs 1.05 EAF/patient) and at the final investigation (1.91 EAF/patient vs 0.67 EAF/patient).(ABSTRACT TRUNCATED AT 250 WORDS)

The importance of skin vessel wall immune deposits in the course of the systemic and articular features of rheumatoid arthritis. A prospective study

Fifty-one rheumatoid arthritis patients were examined prospectively during a 3-year investigation period by means of immunohistological, histological, and instrumental clinical methods. Skin vessel wall immune deposits (SVWID) were found in 21/51 patients at the first and in 11/35 patients at the concluding investigation. Patients with SVWID showed more extra-articular features, more rapid progress of joint damage, higher mortality frequency, higher inflammatory activity, and higher levels of circulating immune complexes, compared with patients without SVWID.

[Value of hilus tomography in tuberculin positive, non BCG vaccinated children]

X-ray films of the thorax in two levels were prepared of 15 children of 3-14 years of age who had not been BCG-inoculated, after the tuberculin test had shown a positive reaction. Besides bacteriology and bronchoscopy, tomography of the hilus and of the anterior mediastinum was performed to exclude hilar lymph node enlargements. In this manner, it became possible to disclose an enlargement of lymphatic nodes in four children in whom plain radiography of the thorax had not yielded any abnormal findings.

[Vascular changes in the kidney after blunt abdominal trauma in a child]

A genuine trauma, which had been overlooked at first, resulted in macrohaematuria. Infusion urography showed an enlarged left kidney with delayed and incomplete visualisation of the renal pelvis. Angiography showed swelling of the left kidney and small arterial ruptures with pseudoaneurysmatic contrast medium deposits in the parenchyma. Three months later, the angiogram showed largely normalised vessels.

HLA-B27 in possible ankylosing spondylitis with peripheral arthritis

Among 86 patients selected as possibly having ankylosing spondylitis because of clinical symptoms and radiologically normal sacroiliac joints. HLA-B27 was positive in 41%. Four years later a representative sample of 38 individuals were re-examined and radiographed. HLA-B27 positive patients developed sacroiliitis as defined by radiological criteria twice as often (P less than 0.05). They also showed increased uptake of technetium 99 m upon quantitative scintigraphy with a region of interest method and more often probable or definite ankylosing spondylitis as defined by the New York criteria. Further differences between the HLA-B27 positive and negative follow-up groups concerned the frequency of clinical symptoms and peripheral arthritis. It is suggested that HLA-B27 typing may be helpful both in diagnosis and in judging the prognosis of possible or abortive ankylosing spondylitis.

[Diagnostic accuracy of pulmonary vessel blood flow assessed by roentgenography--a comparison with haemodynamic data (author's transl)]

The article reports on an examination of the diagnostic accuracy in assessing the pulmonary vessel blood flow via x-ray films of the thorax in 323 children by means of a comparison with the haemodynamic data of four examiners, on the basis of a Yes/No (True/False) decision. Overall accuracy in the total group of examined children--depending on the experience of the examiners--was 60 to 66%; in children below 2 years of age, it was 63-69%, and in children over 2 years old it was 59-65%. In a Left-Right Shunt smaller than 35%, accuracy was between 33 and 63%; if the Left-Right Shunt was greater than 57%, it was 81-97%. Diagnosis of reduced pulmonary blood flow proved more difficult than of an enhanced flow. Sensitivity of the examination method was 53-71%, whereas its specificity was 57-70%.

[Thoracic fistulas of the pancreas and their complications in childhood (author's transl)]

The article reports on two thoracic fistulas of the pancreas in infants. Anamnesis revealed that recurring abdominal pain had occurred in those children for years; at the time of their admission to hospital there was considerable dyspnoea with thoracic pain depending on the respiration. Fistulas of the pancreas with thoracic connection were identified as the cause. The article goes into the details of genesis, differential diagnosis and courses of the disease.

[Radiological changes in systemic lupus erythematosis (author's transl)]

In a study of 50 patients with systemic lupus erythematosis, radiologically demonstrable lung changes and pleural effusions were found in 50%. Changes in the peripheral skeleton, such as osteoporosis, erosions or mutilations, were seen in only two patients. Our radiological analysis has shown that systemic lupus erythematosis does not produce changes in the joints, but is responsible for abnormalities in the lungs, as well as for pericardial and pleural effusions.

[Results of retrobulbar irradiation in case of benign endocrinous ophthalmopathy (author's transl)]

83 patients with a benign endocrinous ophthalmopathy were submitted to radio-iodine and thyreostatic therapy and to high voltage therapy of the retrobulbar region. The ophthalmologic controls showed that 30% of the treated patients had improved data and 70% had unchanged data. These results were independent from the individual radiation qualities used and the field sizes.

[Radiological changes in the skeleton due to anticonvulsant therapy in childhood (author's transl)]

Anticonvulsant therapy can lead to severe rachitic changes in the skeleton which closely resemble renal osteopathy. In addition to apparent widening of the epiphyseal plate, there are changes in the cortex of the long bones. Within four to six weeks of the commencement of vitamin D therapy, recalcification of the poorly recognised. Since the changes are best seen in the hand, further examinations of the skeleton are only indicated if there are positive findings in the hand.

[Roentgenologic aspects after (total) gastrectomy for malignant tumours (author's transl)]

Pre-operatively, radiological examination is important for the diagnosis of malignant tumours in the stomach. Postoperatively, it can be used to demonstrate the state of the anastomosis and possible defects of the suture, for the early recognition of recurrences or other abnormalities, and for the diagnosis of reflux oesophagitis and the dumping syndrome. Changes in the oesophagus following various types of reconstruction were examined, both clinically and radiologically, in 40 patients who had had gastrectomies. Following jejunal interposition with a proximal end-to-side anastomosis and a long blind segment, there may be reflex into the oesophagus, but symptoms of reflux oesophagitis only occur if there is also duodeno-jejunal reflux. Patients with a Roux loop show few symptoms, while the worst radiological and clinical results were achieved with a double-barrelled jejunal loop, despite a low anastomosis.

[The child's skeleton following renal transplant. A correlation of the radiographic findings to the amount of parathormone (author's transl)]

The skeletal X-rays (magnification radiography of hand, pelvis, knee and shoulder joint) of 20 children before and after successful kidney transplantation were compared with the parathormone concentrations measured in the interval closest to the roentgenological examination. In 19 children, renal osteodystrophy existed before kidney transplantation, which was diagnosed based on the following radiographic findings of varying frequency: rarefaction and fuzziness of the spongiosa, fraying of metaphysical ends, widening of the growth plates, subperiosteal resorption and acroosteolysis. The parathormone concentrations were definitely increased before kidney transplantation. After kidney transplantation the abnormal radiographic findings receded corresponding to normalisation of the parathormone concentrations. Nevertheless, in 14 out of 19 children a rarefaction of the spongiosa remained, the cause of which is presumed to be steroid therapy.

A new highly potent and short-acting analgesic, carfentanyl (R 33799), in combination with the hypnotic agent, etomidat (R 26490), as a method of anaesthesia in guinea pigs

Anaesthesia in guinea pigs with a new highly potent and short-acting analgesic, carfentanyl (R 33799), combined with the hypnotic, etomidat (R 26490), is reported. Clinical observations as well as respiratory and circulatory variables have revealed this combination to be safe. Profound surgical anaesthesia has been obtained with good sedation, analgesia, and immobilisation. This method has been evaluated clinically and can be recommended with confidence in this species.

[On the clinical value of roentgenological observation of the clinical course of renal osteopathy (author's transl)]

Basing on radiological observation of the course of renal osteopathy confirmed both clinically and by bone biopsy in 96 patients -- the x-ray examination comprising primarily the entire axial skeleton including the proximal extremities and hands -- 60% of the patients showed mineralisation in their hands. The rest of the skeleton was affected only if there were identifiable alterations at the hands, although the affection of the axial skeleton was definitely lower in terms of percentage. Hence, radiological observation of renal osteopathy based on x-ray films of both hands with additional magnification technique appears both possible and meaningful.

[Problems in differential diagnosis in pharmacoangiography with angiotensin of the kidney (author's transl)]

The article reports on a case material of 225 patients with reference to the effect of angiotensin in angiographic examinations of malignant and benign tumours, as well as of inflammatory processes and non-typical parenchyma patterns, pseudotumours and columns of Bertin, and goes into the details of problems of differential diagnosis.

[Mesenteric lipomas in children: a report on one case (author's transl)]

A case of mesenteric lipoma presenting as an isolated abdominal masse in a boy of 20 months is reported. Diagnosis was made from the appearance of the fatty mass in a straight abdominal film. Radiological examination was completed by urography and echotomography. The analysis of 11 identical cases found in the literature enabled the principal clinical and radiological characterists of this affection to be defined and evoked the problems of differential diagnosis from other lipomatous abdominal masses and cystic lymphangioma.

[New aspects concerning exposure factors during direct geometrical X-ray magnification (author's transl)]

The paper is concerned with the use of rare-earth intensifying screens in order to overcome some of the exposure problems during magnification techniques using very small focal spots. Theoretical experiments and tests with biological objects indicate that the use of high intensifying screens under these circumstances is acceptable and useful. A comparison has been carried out between the results of conventional techniques without magnification and magnification techniques using very small focal spots and rare-earth intensifying screens.