Skin reactions triggered by the use of cosmetic products in nonspecific lipid transfer protein-sensitive patients

Nonspecific lipid transfer proteins (nsLTPs) are members of the prolamine superfamily and they are found in pollen and food, as well as in latex. Due to the strong stability both against pepsin digestion and thermal denaturation, sensitisation towards these proteins is often associated with severe systemic reactions (angioedema, urticaria, asthma, anaphylaxis, etc.) following the ingestion of both raw or fresh food and cooked or preserved food. Many studies have shown reactivity towards nsLTPs both via inhalation and orally and in this study we present two cases of nsLTPs-sensitive patients who manifested the immediate onset of skin reactions following the use of cosmetic products containing these proteins. Thus, in order to prevent immediate reactions linked to their use, it is necessary to recommend nsLTPssensitive patients to avoid the topical use of products containing these proteins (and obviously the ingestion of foods containing these proteins).

Winter to spring variations of chromophoric dissolved organic matter in a temperate estuary (Po River, northern Adriatic Sea)

The light absorbing fraction of dissolved organic carbon (DOC), known as chromophoric dissolved organic matter (CDOM) showed wide seasonal variations in the temperate estuarine zone in front of the Po River mouth. DOC concentrations increased from winter through spring mainly as a seasonal response to increasing phytoplankton production and thermohaline stratification. The monthly dependence of the CDOM light absorption by salinity and chlorophyll a concentrations was explored. In 2003, neither DOC nor CDOM were linearly correlated with salinity, due to an exceptionally low Po river inflow. Though the CDOM absorbance coefficients showed a higher content of chromophoric dissolved organic matter in 2004 with respect to 2003, the spectroscopic features confirmed that the qualitative nature of CDOM was quite similar in both years. CDOM and DOC underwent a conservative mixing, only after relevant Po river freshets, and a change in optical features with an increase of the specific absorption coefficient was observed, suggesting a prevailing terrestrial origin of dissolved organic matter.

Systemic lupus erythematosus and Wiskott-Aldrich syndrome in an Italian patient

Systemic lupus erythematosus has not yet been associated with mutations in the Wiskott-Aldrich syndrome gene; moreover, the time courses of platelet number and size in patients with Wiskott-Aldrich syndrome are unknown. In this case, we present the time trends of platelet count and volume and the histopathology of the kidney of a patient with systemic lupus erythematosus and a mutation in the Wiskott-Aldrich syndrome gene. The patient suffered from congenital recessive X-linked thrombocytopenia, and he developed systemic lupus erythematosus at the age of 12 years. Thus, his disease was reclassified as Wiskott-Aldrich syndrome, class 5. The g.257G > A mutation in the Wiskott-Aldrich syndrome gene and reduced expression of the specific messenger were revealed by molecular analyses.

Evaluation by double-blind placebo-controlled oral challenge of the clinical relevance of IgE antibodies against plant glycans

BACKGROUND

The clinical relevance of immunoglobulin E (IgE) to plant glycans is a longstanding debate. We sought to evaluate their clinical reactivity using the human glycoprotein lactoferrin expressed in rice.

METHODS

Allergic patients with IgE antibodies against plant glycans were analyzed for the presence of IgE against rice-produced lactoferrin. The potency of IgE to induce mediator release was assessed by basophil histamine release and skin prick tests (SPTs). Clinical relevance was evaluated by double-blind placebo-controlled oral challenge (DBPCOC).

RESULTS

Twenty-four of 29 sera (82.7%) with IgE antibodies against plant glycans demonstrated IgE binding to transgenic lactoferrin. In three of five cases transgenic lactoferrin induced histamine release. Compared to a control major grass pollen allergen lactoferrin concentrations needed for biological activity of IgE were 5-6 orders of magnitude higher. Skin prick test and DBPCOC were negative in five patients with potential clinical reactivity that volunteered to undergo these in vivo challenges.

CONCLUSIONS

Poor or no biological activity and lack of clinical relevance of IgE-binding plant glycans (five out of five) was demonstrated using human lactoferrin expressed in rice as a model.

Organotins (TBT and DBT) in water, sediments, and gastropods of the southern Venice lagoon (Italy)

The release of tributyltin (TBT) from maritime traffic represents one of the main problems of direct, diffuse, and continued contamination of the marine environment. In the present survey, the concentrations of TBT and dibultytin (DBT) in brackish waters, sediments, and the gastropods Nassarius nitidus were evaluated in order to estimate the contamination of the southern part of the Venice lagoon. TBT and DBT were determined by GC-MS/MS. Recent contamination of TBT was found in brackish waters near marinas, whereas the highest concentrations of TBT and DBT were observed in surface sediments at dockyards and harbours. High content of organotin in the gastropods sampled near the dockyards, harbours, and marinas showed a mobilisation from the sediments through the food web. The present study allowed assessment of whether, despite the ban on the use of TBT paints, waters, sediments, and biota were still being contaminated by organotin compounds in the southern Venice lagoon.

Polychlorinated biphenyls in clams Tapes philippinarum cultured in the Venice Lagoon (Italy): Contamination levels and dietary exposure assessment

Total polychlorinated biphenyl (SigmaPCB) concentrations calculated as the sum of 21 and the toxicity equivalent (TEQ) of dioxin-like PCBs calculated on the basis of the toxic equivalent factors were assessed in Manila clams Tapes philippinarum cultured in the Venice Lagoon. The concentrations showed a predominance of hexa-chlorobiphenyls followed by penta-, hepta-, tetra- and tri-chlorobiphenyls. The highest levels of SigmaPCB detected were 4.01 ng/g, 2.71 ng/g and 2.68 ng/g wet weight at a southern lagoon site and two northern lagoon sites, respectively. There was a significant differentiation in toxicity levels between culture sites. The highest value was 0.239 pg TEQ/g at a southern lagoon site; the lowest was 0.004 pg TEQ/g at a central lagoon site.

Mercury in sediments and Nassarius reticulatus (Gastropoda Prosobranchia) in the southern Venice Lagoon

The southern basin of the Venice Lagoon has been the focus of fewer studies concerning contamination from heavy metals than the northern and central basins. A recent increase in urban waste waters from Chioggia town, as well as dockyards, shipping and fishing activities, affect this part of the lagoon. The aim of this study was to investigate the total mercury (THg) incidence in sediments and Nassarius reticulatus gastropods in order to assess its distribution and evaluate the level of contamination. THg concentration measured in bottom sediments ranged between 0.1 and 3.4 mg/kg d. wt. The enrichment factor (EF) showed high values (avg. 30, max 49) near the dockyards of Chioggia; the lowest (avg. 9, max 17) were found in the coastal marine sediments near the port entrance of the southern basin. THg in marine scavenger gastropods accumulated in N. reticulatus with concentrations falling within the range of 0.3-1.3 mg/kg d. wt. A positive correlation was found between THg concentration in sediments and in N. reticulatus in all sites, excluding the dockyards. A first local cause for mercury pollution might be attributed to the antifouling paints used in great quantity in the recent past near the town of Chioggia. Moreover, fine suspended sediments associated with tidal flushing are suggested as possibly being the vehicle for pollutant dispersal from the Marghera industrial area to the whole of Venice's lagoon.

Relationships between organic carbon and microbial components in a Tyrrhenian area (Isola del Giglio) affected by mucilages

The chemical and biological properties of the water column at a Tyrrhenian site (Isola del Giglio) were studied during a 3-year period. The results highlighted the oligotrophic features of the site, characterised by quite low concentrations of organic carbon (on average DOC 102 micromol/L and POC 9 micromol/L). Relevant bacterial biomass (on average 42.1 microg C/L) and a notable activity (in terms of frequency of dividing cells, on average more than 5%) were observed. However, remarkable changes for these parameters were seasonally recorded. The cyclic occurrence, generally during the late spring-summer period, of benthic mucilage indicated that localised distrophic processes may occur. In particular, the benthic mucilage events of 2000 and 2001 were investigated, although some comparative information was available also for 1999 and 2002. The mucilage aggregates generally showed high bacterial colonisation, which have remarkable effects on the organic matter cycle both inside the aggregates and in the surrounding seawater. During the benthic mucilage development, an increase of DOC and POC concentrations was observed (up to 129 and 18 micromol/L, respectively, in June 2000 and up to 145 and 10 micromol/L, respectively, in May and June 2001) in the water column adjacent to the bottom. However, a general decrease of the trophic value of particulate matter (in terms of C/N ratio) was also observed, especially in 2000 after the disappearance of the mucilage. The available energy and organic matter during the mucilage events led to an increased presence of bacteria in the bottom waters of the Isola del Giglio, with maximum biomass values in 2001. Similarly, the replicative activity of bacteria was higher in 2001 (frequency of dividing cells about 5% vs. 3% of 2000). The lower activity of 2000, in addition to the lower trophic value of organic matter and different environmental conditions (namely lower temperature), might be involved in the persistence of mucilage in 2000 with respect to the rapid disappearance observed in 2001.

Exo-enzymatic activities and dissolved organic pools in relation with mucilage development in the Northern Adriatic Sea

We tested the hypothesis that the appearance of mucilage in the Northern Adriatic Sea was related with the accumulation of dissolved organic compounds released by intensive enzymatic activities and not utilized as direct substrate for microbial growth. To do this enzymatic activities and dissolved organic and inorganic pools in periods characterized by the presence of mucilage and in the same seasons but in absence of mucilage were compared. Extracellular enzymatic activities (aminopeptidase, beta-glucosidase and alkaline phosphatase), nutrient pool concentrations (total dissolved nitrogen, dissolved organic nitrogen, total dissolved phosphorus, dissolved organic phosphorus) and the biochemical composition of particulate and dissolved organic matter (in terms of proteins and carbohydrates) were determined on a monthly basis over a period of 3 years. Aminopeptidase and alkaline phosphatase activities displayed higher values in springs preceding the appearance of mucilage than in spring when no mucilage was observed. Beta-Glucosidase activity showed significantly higher values in summer periods characterized by the massive production of mucilage than in summers without mucilage events. The months preceding mucilage events were also characterized by an increase of the alkaline phosphatase to aminopeptidase activity ratio and by a significant accumulation of dissolved proteins. These findings, together with the significant increase of the DON/DOP ratio, suggest that mucilage formation is favoured by the deficiency of organic P. The present study provides compelling evidences that mucilage formation is favoured by the unbalance between organic matter mobilization by enzymatic activities and the accumulation of labile dissolved organic-N compounds.

Conversion from tacrolimus to cyclosporine for a non-dose-dependent tacrolimus-induced toxicity, a pediatric kidney transplant recipient case report

Tacrolimus-induced toxicity is considered a dose-related side effect largely due to a direct action of this potent calcineurin inhibitor on its targets including the kidney and the pancreas. This paper describes a case of tacrolimus systemic toxicity that appeared in a pediatric kidney transplant recipient who received a low drug dose. The kidney biopsy was a crucial aid toward the correct diagnosis, which reversed upon conversion to cyclosporine-based immunosuppression. A review of the literature suggests a chance of systemic toxicity even when the patient is maintained on therapeutic levels of tacrolimus. Because idiosyncratic reactions to the drug have not yet been postulated, we conclude that this suspicion may be addressed by a safe conversion to cyclosporine in pediatric patients.

Distinct delayed T-cell response to beta-methasone and penicillin-G in the same patient

BACKGROUND

Multiple drug allergy syndrome is a clinical condition characterized by reactions against more than one different class of, both pharmacologically and structurally, unrelated drugs. Scanty data are available to date about a multiple drug delayed hypersensitivity syndrome. Our aim was to report the case of a delayed reaction to both beta-methasone (beta-MT) and penicillin-G (pen-G) occurring in the same patient, and analyse beta-MT- and pen-G-specific T-cell Lines (TCLs) with regard to their specificity, phenotype and cytokine profile.

METHODS

We generated two drug-specific TCLs from biopsies at the site of positive intradermal reactions, and analysed their immunophenotype, T-cell receptor Vbeta (TCR-Vbeta) domains expression and cytokine profile.

RESULTS

We demonstrated the specificity of the T cells isolated from positive intradermal test reactions to pen-G and beta-MT through the strict dose-dependent proliferation in response to drug-pulsed autologous antigen presenting cells. Fluorescence activated cell sorter (FACS) analysis revealed a predominance of CD4+ cells in the inflammatory cell infiltrate of intradermal test with beta-MT, while a predominance of CD8+ T cells in the site of delayed reaction to pen-G was found. The drug specific CD4+ and CD8+ T cells were heterogeneous, with regard to TCR-Vbeta usage. CD8+ pen-G-TCL displayed a preferential T helper 2 (Th2) profile, while a substantially heterogeneous pattern of cytokine production characterized specific beta-MT TCL.

CONCLUSION

The study describes the coexistence in the same patient of a delayed hypersensitivity to both penicillin G and beta-MT, driven, respectively, by pen-G-specificTh2-skewed CD8+ and beta-MT specificTh0 CD4+ T cells. This case further support the existence of a multiple drug allergy syndrome also for delayed hypersensitivity.

Occupational asthma due to metoclopramide hydrochloride (MCPH)

Metoclopramide hydrochloride (MCPH) is dopamine antagonist antiemetic drug that binds D2 receptor at the central nervous system and peripheral levels, which stimulates the upper gastrointestinal tract motility. It is often used in the management of some forms of nausea and vomiting (1-3). Occupational allergy to drugs is seldom reported. No case of occupational allergy to MCPH have been reported, to date. We present a case of airborne allergic asthma in a worker employed in the synthesis of Metoclopramide hydrochloride.

Occupational generalised urticaria and allergic airborne asthma due to anisakis simplex

Anisakis simplex (AS), a fish and cephalopodes parasite, may cause allergic reactions in humans on eating and/or handling contaminated fish. We present a case of occupational hypersensitivity to AS in a woman employed in a frozen-fish factory. She showed both generalised urticarial rash and asthmatic symptoms after work place exposure. All these symptoms immediately disappeared after work place exposure was ceased. The presence of a positive skin prick test and high specific IgE values confirmed a hypersensitivity to anisakis. This is the first case reported of both occupational generalised urticaria and allergic airborne asthma due to AS in the same patient. We suggest that AS could be an important cause of occupational asthma and/or urticaria in the fish industry.

Downward fluxes of particulate carbon, nitrogen and phosphorus in the north-western Adriatic sea

Downward fluxes of particles, organic carbon, total nitrogen and total phosphorus and the composition of the settled particulate matter were determined in the north-western Adriatic Sea at two coastal sites influenced by the outflows of the Po and Adige rivers and one offshore site. Vertical fluxes were strongly influenced by resuspension processes in addition to the primary flux and advection. The resuspended material contributed on average 34-43% of the total matter sedimented in the near bottom traps in coastal waters. Net annual vertical fluxes (due to primary flux and advection) of organic carbon, total nitrogen and phosphorus in the coastal stations were: 71-97 g C m(-2) year(-1), 8-14 g N m(-2) year(-1) and 2.1-2.3 g P m(-2) year(-1), with the highest values recorded at the station off the Po river delta. The offshore site was characterised by net annual fluxes of particulates, C, N and P approximately one order of magnitude lower than the above. The carbon export to the bottom was limited in the warm seasons when it constituted only 2-9% of primary production, due to high recycling and utilisation in the upper layer of the water column, increasing up to 8-18% in winter because of the instability of the water column and low biological utilisation.