[Immunoglobulin E. Biochemical, immunological properties and clinical significance (author's transl)]

Associations between atopic diseases and the polymorphic systems ABO, Kidd, Inv and red cell acid phosphatase

In 239 German patients with atopic conditions (atopic dermatitis, hay fever, allergic rhinitis, bronchial asthma, and acute urticaria) the phenotype and gene distribution of 15 genetic blood polymorphisms (ABO, MNSs, rhesus, P, Kell, Duffy, Kidd, Hp, Gc, Gm, Inv, aP, PGM1, EsD, and 6-PGD) were analyzed and compared with those in 151 selected controls (individuals clinically free of allergic conditions and without allergy in the family history). The incidence of blood group antigens A and B was somewhat higher in patients than in controls. These observations are in accordance with the results of previous studies in other populations. In addition, our observations favor the hypothesis that there are also associations between the phenotypes Jk (a-b+), Inv(1) and red cell acid phosphatase aP A and aP AP on the one hand and atopic disposition on the other. The possible reasons for these associations are discussed.

Predictive value of high IgE levels in children

A group of 207 healthy non-atopic children 0-14 years of age without any known family history of atopic disease was selected for a study of the relation between serum IgE levels and the occurrence of atopic manifestations during an observation period of 18 months; 206 fullfilled the study. Serum IgE was measured by a direct radioimmunological sandwich technique (PRIST). At the follow-up 28 of 32 with an initial IgE level greater than one standard deviation above the mean for the age continued to show a high level (87.5%). The total concordance was 81.1%. Atopic or probable atopic diseases had developed in 75.0% of children 0-1 year of age with an initial IgE above +1 S.D., but in only 6.4% of those from the same age group with a lower initial IgE. Even among children 2-14 years old, it was noticement of atopic disease. Otitis media was more frequent among children with an initially elevated IgE level than among the rest of the children. Determination of serum IgE with the PRIST-technique has been shown to provide a valuable means for predicting future atopic manifestations and may be used as a screening procedure especially in children of atopic parents.

[Electrocardiogramme in anaphylactic shock in humans (author's transl)]

Twenty clinical cases described in the literature were gathered, in which electrocardiographic tracings had been recorded. Electrocardiographic changes were found in all cases, such as sinus tachycardia (12 times), impaired electrical conduction (5 times), ventricular overexcitability (7 times), high P-wave (6 times), changes of the ST (10 times), and of the T-wave (18 times). The reason for these changes might be of a complex nature. Based on experimental investiagations mentioned in the discussion, it may be assumed that beside a direct effect on the myocardial cells, the following mechanisms could have influenced the electrical heart potentials: 1. a constriction of the coronary vessels, 2. a pulmonary vascular constriction, 3. an aggregation of thrombocytes, 4. a peripheral vascular dilatation, 5. a bronchiolar constriction.

Serum IgE-concentrations in patients with contact sensitization

In 123 patients with contact sensitization (cs), of whom 23 had positive histories of atopy and/or positive prick tests (csa), the serum IgE-concentrations were determined and the following results were obtained: 1. A remarkable dispersal of IgE-concentrations was noted in cs--patients (1-3080 U/ml); 12% of them displayed IgE-concentrations of more than 1000 U/ml, even though they had no histories of clinical manifestations of atopy, liver of kidney diseases, or parasitic infestations. Their mean IgE-value of 396 U/ml +/- 60 differed considerably from the one of a comparable control group of healthy individuals. No statistically significant differences were noted between the IgE-levels, the age of our patients, the type and number of contact allergens, and the duration of skin lesions. 2. On an average, there were higher IgE-levels noted in cases of acute and extensive skin lesions than in cases of subacute to chronic, localised skin lesions. Controls of the serum IgE-concentrations and histologic examinations by means of immunofluorescence suggested that, depending on the individual patient, skin lesions might lead to an (unspecific?)activation of IgE-synthesising round cells. 3. In csa-patients with sensitization to metal, the skin lesions were of localised subacute to chronic character, while skin lesions of acute and extensive character were exceptional (5.9%).