Mould-specific immunoglobulin antibodies quantified by flow cytometry reflect mould exposure in Norwegian children

BACKGROUND

Studies from many countries have shown an association between dampness in buildings and airway symptoms. Little is known about the role of mould-specific IgG antibodies in this context. Objective To examine the IgG antibody response to mould applying a new flow cytometric assay, compare the results with the standardized ImmunoCap method, and evaluate the association of IgG to IgE antibodies, dampness in buildings, and airway symptoms like wheeze and asthma.

METHODS

A population of 3713 children 9-11 years of age living in Northern Norway was investigated for airway symptoms and dampness at homes by a parental questionnaire, using protocols of the International study of Asthma and Allergy in Childhood (ISAAC). Among these, a case-control study of 100 wheezers and 100 non-wheezers was established that included home inspection, a parental structured interview, and serum samples analysed for mould-specific IgG and IgE antibodies, total IgE, and specific IgE to an allergen panel (Phadiatop).

RESULTS

Self-reported visible signs of mould or moisture at home during the child's first year of life were a significant risk factor for both wheeze and asthma. The levels of mould-specific IgG antibodies were associated with mould and moisture findings, but only when IgG antibodies were measured by flow cytometry.

CONCLUSIONS

The results support that dampness at home can increase the risk of airway symptoms. IgG antibodies determined by flow cytometry reflect mould exposure better than antibodies measured by the conventional method. IgG antibodies measured by flow cytometry may be used as an indicator of mould exposure.

Diverging prevalence trends of atopic disorders in Norwegian children. Results from three cross-sectional studies

BACKGROUND

During the last decades there has been extensive epidemiological research to explore the increasing prevalence of asthma and allergy in childhood. The worldwide variations in prevalence of these diseases necessitate regional rapports. Furthermore, time-trend analyses with comparable methods are important in order to monitor the rapidly changing prevalence of these diseases.

METHODS

Three cross-sectional questionnaire-based studies of asthma and allergy in schoolchildren were conducted in the counties of Troms and Finnmark, in northern Norway in 1985, 1995 and 2000. The two former studies included children from randomly selected primary schools (n = 1794/1985, n = 1432/1995). The latter study was a part of ISAAC-II Europe study (n = 3853). Identical items of asthma and allergy were employed. The analyses comprised only children 9-11 years of age.

RESULTS

The prevalence of asthma was 9.3, 13.2 and 13.8% in 1985, 1995 and 2000, respectively. However, great gender differences were detected; the prevalence of asthma increased in males from 1995 to 2000, from 14.1 to 17.0%, RR = 1.2 (95% CI 1.0-1.5), but decreased in females 1995 to 2000, from 12.3 to 10.5%, RR = 0.9 (95% CI 0.7-1.1). Furthermore, in children with asthma, a changing trend was found in the external factors that perceived symptoms, from typical allergens towards other, unspecific agents. The prevalence of self-reported atopic eczema/dermatitis syndrome (AEDS) was 13.4, 21.1 and 20.8% in 1985, 1995 and 2000, respectively. The prevalence of self-reported allergic rhinoconjunctivitis was in 16.5, 24.7 and 29.6% 1985, 1995 and 2000, respectively, RR (2000/1995) = 1.2 (95% CI 1.1-1.3).

CONCLUSION

The prevalence of asthma in girls has reached a plateau and even decreased from 1995 to 2000 which is in contrast to the asthma prevalence in boys that tends to continuously increase. The prevalence of AEDS which increased substantially between 1985 and 1995 did not change from 1995 to 2000. However, the prevalence of allergic rhinoconjunctivitis increased steadily from 1985, 1995 to 2000.

Cloning and expression of an endocellulase gene from a novel streptomycete isolated from an East African soda lake

Alkaline cellulase-producing actinomycete strains were isolated from mud samples collected from East African soda lakes. The strains were identified as novel Streptomyces spp. by 16S rDNA sequence analysis. A cellulase gene (cel12A) from Streptomyces sp. strain 11AG8 was cloned by expression screening of a genomic DNA library in Escherichia coli. From the nucleotide sequence of a 1.5-kb DNA fragment, an open reading frame of 1,113 nucleotides was identified encoding a protein of 371 amino acids. From computer analysis of the sequence, it was deduced that the Cel12A mature enzyme is a protein of 340 amino acids. The protein contained a catalytic domain, a glycine-rich linker region, and a cellulose-binding domain of 221, 12, and 107 amino acids, respectively. FASTA analysis of the catalytic domain of Cel12A classified the enzyme as a family 12 endoglucanase and the cellulose-binding domain as a family IIa CBD. Streptomyces rochei EglS was determined as nearest neighbor with a similarity of 75.2% and 61.0% to the catalytic domain and the cellulose-binding domain, respectively. The cell2A gene was subcloned in a Bacillus high-expression vector carrying the Bacillus amyloliquefaciens amylase regulatory sequences, and the construct was transformed to a Bacillus subtilis host strain. Crude enzyme preparations were obtained by ultrafiltration of cultures of the Bacillus subtilis recombinant strain containing the 11AG8 cell2A gene. The enzyme showed carboxymethylcellulase (CMCase) activities over a broad pH range (5-10) with an optimum activity at pH 8 and 50 degrees C. The enzyme retained more than 95% of its activity after incubation for 30 min under these conditions.

Asthma and allergy in Russian and Norwegian schoolchildren: results from two questionnaire-based studies in the Kola Peninsula, Russia, and northern Norway

BACKGROUND

Previous studies have shown that the prevalence of asthma and allergy in children is lower in Eastern than Western Europe.

METHODS

We have compared the prevalence of asthma, respiratory symptoms, allergic rhinoconjunctivitis, and atopic dermatitis in schoolchildren aged 7-13 years in a questionnaire-based study conducted in the city of Nikel on the Kola Peninsula, Russia, in 1994 (n = 1143) and another conducted in northern Norway in 1995 (n = 8676).

RESULTS

The prevalence of diagnosed asthma was 5.1% in Russian children and 8.6% in Norwegian children; RR =0.58 (95% CI: 0.44-0.76). The prevalence of all respiratory symptoms was higher in Russian children. The prevalence of allergic rhinoconjunctivitis was 16.9%, in Russian children and 22.1%, in Norwegian children: RR =0.74 (95% CI: 0.65-0.85). The prevalence of atopic dermatitis was 7.4% in Russian children and 19.7% in Norwegian children; RR=0.38 (95% CI: 0.31-0.46).

CONCLUSIONS

We conclude that the prevalence of diagnosed asthma, allergic rhinoconjunctivitis, and atopic dermatitis was higher in Norwegian than Russian schoolchildren. The higher prevalence of respiratory symptoms in Russian children probably reflects a higher prevalence of undiagnosed, nonallergic asthma.

Atopic diseases in Sami and Norse schoolchildren living in northern Norway

Among children in the western world, atopic diseases are a major cause of morbidity. However, several prevalence studies have indicated that the frequency of these diseases displays both geographic and ethnic variations. In 1995, we conducted a questionnaire-based, cross-sectional survey in northern Norway. Atopic diseases among 8676 schoolchildren, aged 7-13 years, including 491 children with Sami ethnicity, were studied. The role of ethnicity (Sami/white Caucasian) was determined by comparing the reported atopic disease rate in each of the respective groups. In the areas under investigation (the cumulative incidence, the point prevalence of asthma and allergic rhinoconjunctivitis and the cumulative incidence of atopic dermatitis), the Sami children scored higher than the white Caucasian Norwegian children. The relative risks (RR) in Sami children were: current asthma RR = 2.01 [95% confidence interval (CI) 1.48-2.73]; current allergic rhinoconjunctivitis RR = 1.51 (95% CI 1.14-1.99); lifetime atopic dermatitis RR = 1.39 (95% CI 1.18-1.63). We thus conclude that there is an association between Sami ethnicity and asthma and allergy among schoolchildren in northern Norway.

[Latex allergy]

We describe a mother and two children with latex allergy. Their symptoms illustrate the variations in the manifestations of latex allergy. This article reviews currently known aspects of this condition, including diagnosis and treatment. Latex allergy is a hypersensitive response to allergens in natural rubber latex products. It has long been known that latex exposure can cause contact dermatitis. Since 1979 there has been an increasing number of cases of IgE-mediated immediate hypersensitivity reactions, ranging from mild local urticaria to fatal anaphylaxis. The prevalence of latex allergy in the general population is still unknown, but it seems to be less than 1%. Children with spina bifida or urogenital abnormalities, health care workers and workers in the latex industry are known to be high risk groups. Patients belonging to high risk groups or patients with a positive history of latex allergy should be offered testing. High risk patients should be subjected to minimal exposure to latex, and procedures on all patients with a positive history of latex allergy should be performed in a latex-free environment.

Impact of pollution and place of residence on atopic diseases among schoolchildren in Telemark County, Norway

For estimation of the prevalence, degree of severity, and association with outdoor pollution, a questionnaire on asthma and other atopic diseases was distributed to the parents of 4666 7-13-year-olds, comprising all the children in 36 schools in Telemark County, Norway, including 37% of the schoolchildren in the county. The response rate was 94%. In a validity study employing clinical evaluations, the questionnaire-based diagnosis of asthma was found to have a sensitivity of 0.96 and a specificity of 0.88. The lifetime prevalence of asthma in Telemark was 9% (boys 11.3%, girls 6.6%; p < 0.001). There was no significant difference in the lifetime prevalence of asthma by pollution zone; 8.3% in heavily, 9.3% in moderately, and 9.2% in minimally polluted zones. The asthma prevalence was significantly higher (14.2%; p < 0.05) among boys in the coastal area of the county than in the mountainous area (8.9%). Both of these areas were in the minimal pollution zone. Of asthma cases, 67% were categorized as mild, 29% as moderate, and 4% as severe. The lifetime prevalence was 17.8% (boys 21.3%, girls 14.2%; p < 0.001) for allergic rhinitis, 13.2% (boys 11.4%, girls 15.2%; p < 0.001) for atopic eczema, and 29.6% (boys 31.7%, girls 27.4%; p < 0.01) for overall atopic disease (asthma, allergic rhinitis, eczema). These findings are not compatible with the hypothesis that outdoor pollution is associated with the lifetime prevalence of asthma in school-age children. The results also show that less than 0.5% of schoolchildren suffer from severe asthma.

Relation of exposure to airway irritants in infancy to prevalence of bronchial hyper-responsiveness in schoolchildren

To find out whether exposure to sulphur dioxide during infancy is related to the prevalence of bronchial hyper-responsiveness (BHR), we studied schoolchildren (aged 7-13 years) from two areas of Norway--a valley containing a sulphur-dioxide-emitting aluminium smelter and a similar but non-industrialised valley. Bronchial responsiveness was assessed in 529 of the 620 participants. The median exposures to sulphur dioxide and fluoride were 37.1 micrograms/m3 and 4.4 micrograms/m3 at ages 0-12 months and 37.9 micrograms/m3 and 4.4 micrograms/m3 at 13-36 months. The risk of BHR increased with exposure to sulphur dioxide and fluoride at these ages; the odds ratio for a 10 micrograms/m3 increase in sulphur dioxide exposure at 0-12 months was 1.62 (95% CI 1.11-2.35) and that for a 1 microgram/m3 increase in fluoride exposure was 1.35 (1.07-1.70) at 0-12 months and 1.38 (1.05-1.82) at 13-36 months. Exposure to these low concentrations of airway irritants during early childhood is associated with an increased prevalence of BHR in schoolchildren.

A survey of atopic diseases among school children in Sør-Varanger community. Possible effects of subarctic climate and industrial pollution from Russia

The occurrence of atopic diseases in school children in the community of Sør-Varanger was studied on the basis of a questionnaire sent to the parents of all the 575 children aged 7-12 years. 551 children (95.8%), 266 girls and 285 boys, completed the questionnaire. Atopic diseases were reported to be present or to have occurred in 249 (45.2%) of the 551 children, more frequently in girls (50.4%) than in boys (40.4%) (p < 0.02). Asthma occurred in 68 cases (12.3%), with almost the same frequency in girls (13.2%) and boys (11.2%). Allergic rhinoconjunctivitis was detected in 113 children (20.6%); it was slightly more frequent in boys (21.8%) than in girls (18.9%) but did not reach statistical significance. Urticaria occurred in 72 cases (13.1%), more frequently in girls (17.7%) than in boys (8.8%) (p < 0.002), while atopic dermatitis occurred in 130 cases (23.6%), again more frequently in girls (27.6%) than in boys (19.6%) (p < 0.03). Ninety-four (37.8%) of the children experienced more than one atopic symptom. In 75% of the children with dermatitis the age at onset was under 5 and more than 50% of the children with asthma had experienced symptoms before the age of 3. Parental history of atopic diseases was reported by 35.6% of all children, more frequently in mothers (30.2%) than in fathers (20.1%). On the other hand, 30.6% of children with no parental history of atopic diseases appeared to develop some kind of atopic disease; this increased to 48.0% with a single and to 56.1% with a double parental history.(ABSTRACT TRUNCATED AT 250 WORDS)

Frequency of the delta F508 and exon 11 mutations in Norwegian cystic fibrosis patients

We have searched for the delta F508 mutation in 77 Norwegian cystic fibrosis patients. Of the 154 chromosomes tested, 93 (60%) carried the delta F508 mutation. Haplotypes at the D7S23 locus (KM19 and XV2C markers) were determined. Of 81 chromosomes with the F508 mutation, the B haplotype was found on 77. We found three patients with the G551D and one patient with the R553X mutation in exon 11 of the CFTR locus.

[Contrast medium reaction to iohexol (Omnipaque) with monocyte activation demonstrated in vivo]

A contrast reaction to the intravenous injection of the non-ionic contrast medium iohexol (Omnipaque) is reported. The symptoms developed several hours after the injection and at first were not recognised as being due to the contrast. The reaction could be reproduced under controlled conditions and was associated with a significant rise in thromboplastin synthesis in circulating monocytes, a sign of marked cellular activation.

Plasma gastrointestinal regulatory peptides in exercise-induced asthma

To determine the role of gastrointestinal regulatory peptides in exercise-induced asthma (EIA), we studied plasma levels of various gastrointestinal regulatory peptides before and after a 6-min exercise test in seven subjects with EIA and five normal and three asthmatic subjects without EIA. In the EIA group, plasma vasoactive intestinal polypeptide (VIP) rose significantly 5 min and plasma cholecystokinin (CCK) 0 and 20 min after the test compared with the controls. The changes in plasma somatostatin, secretin, pancreatic polypeptide (PP), motilin and insulin showed no significant differences between the two groups. VIP may play an ameliorating role in bronchial asthma, but the relation of CCK to the lung is speculative and awaits further studies.

Immunoglobulin E in extracts of feces from children

Immunoglobulin E (IgE) was demonstrated by a double antibody radioimmunoassay technique (PRIST) in 5 of 17 unconcentrated fecal extracts from children. Four of the PRIST-positive extracts also had measurable levels of IgE determined by an enzyme-linked immunosorbent test (Enzygnost IgE). However, using a competitive antibody radioimmunoassay technique (RIST), IgE was found in all unconcentrated fecal extracts. The RIST-IgE levels of the extracts were higher and did not correlate to IgE measured by the other methods, nor to the IgE in serum from the same children or to the manifestation of allergy. On the other hand, 4 of the 5 children with measurable PRIST-IgE levels, and 3 of the 4 children with detectable Enzygnost IgE concentrations in the extracts, had elevated serum IgE as well as a history of allergy. Gel filtration studies indicated that IgE determined by the PRIST and Enzygnost IgE methods had been degraded to fragments of lower molecular weight than that of albumin. This study also suggests that the IgE in feces measured by the RIST method is overestimated due to the influence from nonspecific substances of high molecular weight.

Antigens Common to Scabies and House dust Mites

Twenty-five antigens were demonstrated in a crude Dermatophagoides farinae (DF) extract by means of crossed immunoelectrophoresis (CIE), using a rabbit anti-DF serum. With the same antiserum, four antigens were demonstrated in a scabies mite preparations, indicating an immunological relationship between these scabies antigens and some of the DF antigens. In tandem CIE experiments the DF antigens were found to be partly identical to three of the scabies antigens. No IgE activity against any of these scabies antigens was evident in pooled sera from patients with house dust mite allergy by crossed radioimmunoelectrophoresis. However, one such patient had IgE antibodies to a DF antigen and a partial identical scabies antigen.

In vitro demonstration of specific immunological hypersensitivity to scabies mite

An extract prepared from 200 adult female scabies mites was used for prick and intracutaneous testing in twelve patients with previous scabies infestation, as well as in six healthy controls and three persons with skin sensitivity to Dermatophagoides pteronyssinus who had never had scabies before. Seven individuals who had had scabies less than a year prior to the testing had positive intracutaneous (immediate type) reactions, whereas all the five who had had scabies more than a year before had negative reactions. The prick tests were negative in all cases. No skin reactions could be evoked in the controls. The passive transfer, or Prausnitz-Küstner, test was positive with the scabies mite extract and serum from three of five patients tested on one healthy individual, and with both of two sera tested on a second healthy individual. These findings indicate that immediate type hypersensitivity reactions may occur with scabies infection.

IgE antibodies to house dust mite in patients with scabies

Of 135 patients with scabies, forty-seven (35%) had a positive (Classes 1--4) radioallergosorbent test (RAST) to Dermatophagoides pteronyssinus (DP). Elevated serum IgE concentrations were found in sixty-one (45%) of the patients. Atopic disease was confirmed in twenty-eight (23%) of the 120 patients who completed a medical questionnaire satisfactorily. In a control group, well-matched for age and sex, of 201 employees at a local bank, only four (2%) had a positive RAST to DP, and eight (4%) had raised serum IgE levels. Atopic disease was confirmed in eighteen (9%) of them. These observations indicate that scabies infection stimulates the production of IgE antibodies, even in non-atopic individuals, and may suggest that IgE antibodies against the human pathogenic mite Sarcoptes scabiei cross-react with DP. Scabies infection in addition often seems to be associated with atopic disease.

Diagnosis of Haemophilus influenzae type b pericarditis by counterimmunoelectrophoresis

A 6-year-old girl developed pericardial tamponade because of pericarditis caused by Haemophilus influenzae type b. Bacteriological cultures of the pericardial exudate were negative. The etiological diagnosis was established by counterimmunoelectrophoresis (CIE).

A new well-characterized, purified allergen preparation from timothy pollen. III. Immunological properties in the human immunoglobulin E system

The following methods were used in vitro to characterize and quantitate the allergenic activity of a purified allergen preparation, Timothy N, from timothy pollen: radioallergosorbent test (RAST), direct-titration RAST and RAST inhibition. Vials containing freeze-dried and standardized quantities of this preparation showed good uniformity and accuracy with regard to the allergenic activity. The stability of the preparation in solution and in the freeze-dried state was tested by RAST inhibition and was found to be acceptable. Using the same method, the allergenic activity of Timothy N was compared to the allergenic activity of a crude extract, Timothy O, indicating a discrepancy which was not observed in vivo.

A new well-characterized, purified allergen preparation from timothy pollen. II. Allergenic in vivo and vitro properties

A purified allergen preparation, Timothy N, from timothy pollen and a crude commercial extract, Timothy O, prepared from the same pollen material, were tested in tenfold dilutions on 59 adults with allergic rhinitis and on 29 children with bronchial asthma. All patients were allergic to grass pollen. Using the prick and intracutaneous methods, dose-response tablets were established for the two preparations showing a good correlation. Nasal provocation tests on the adult patients and bronchial provocation tests on the children gave positive reactions in all cases when using Timothy N. No irritant effect resulting in non specific reactions were elicited. The availability of stable, freeze-dried and purified allergen preparations supplied in different vials with defined allergenic activities fulfils the clinical demands for a modern diagnostic allergen preparation.