Læknablaðið : fylgirit - 01.08.2002, Blaðsíða 16

ABSTRACTS / 21 ST NORDIC CONGRESS OF ALLERGOLOGY
Subjects and methods: Swimmers and runners with increased
airway responsiveness (AR) as defined by a PC20 methacholine
<16 mg/ml (mean PC20 2.27 (n:12) and 3.2 (n:10) respectively) or
normal AR (> 16 mg/ml, mean PC20: 32.2, (n=10) and 41.5 (n=13)
were studied. All subjects had in random order, two methacholine
tests and induced sputum (IS) analyses, after 3 days without
training and 24 h after training. Two subjects agreed to have
bronchial biopsies (BB).
Results: PC20 methacholine was unchanged after training (p> 0.05,
all groups). The median % inflammatory cells on IS were within the
normal range on baseline. After training, neutrophils increased
similarly in all groups (p>0.05), although it reached statistical signi-
ficance (pre-post training) only in the group of swimmers with
increased AR (p = 0.039). There were no changes in other inflam-
matory cells on IS after training. Histological staining of BB ob-
tained from an atopic swimmer with normal AR and a non-atopic
swimmer with increased AR, showed the presence of subepithelial
fibrosis, proeminent blood vessels and, in the atopic subject only, a
slight inflammatory infiltrate.
Condusion: There are evidences of airway remodeling in elite
athletes although minimal airway inflammation. Intense training
induced an increase in airway neutrophils but AR remained
unchanged. We need to evaluate if increased AR and changes in
airway structure in athletes could be related to mechanisms other
than inflammatory.
0 8- Specific Allergen Immunotherapy attenuates early
and late phase reactions in lower airways of birch
pollen asthmatic patients. A double blind placebo
controlled study.
Arvidsson MB, Löwhagen O, Rak S
Asthma and Allergy Research group, Department of Respiratory Medicine and
Allergology, Sahlgrenska University Hospital, Göteborg, Sweden
Objectives: Few studies have examined the effect of specific
allergen immunotherapy on early and late phase asthmatic
reactions and placebo-controlled pollen studies are lacking. We
have therefore undertaken a placebo-controlled study investigating
the effect of one-year specific allergen immunotherapy with birch
pollen extract (Alutard® SQ, ALK-Abelló, Denmark) on early and
late phase asthmatic reactions in adult asthmatic patients.
Mcthods: Nineteen patients with a history of birch-pollen-induced
symptoms from upper and lower airways, positive skin prick test
and in vitro specific IgE to birch pollen (Betula verrucosa) extract
were included. Allergen and metacholine bronchial challenges
were performed and blood samples obtained for analyses of total
eosinophil count and ECP, before and after one year of immuno-
therapy.
Results: All patients developed early and sixteen both early and
late phase asthmatic reactions. Following allergen challenge a
significant increase in allergen dose required to evoke early
asthmatic reaction was found in the immunolherapy, but not in the
placebo group after one year of treatment. The difference between
the groups was significant, p<0.01. The size of late asthmatic
reaction was significantly reduced in the immunotherapy group
compared with placebo treated patients, p<0.01. Methacholine
sensitivity following late asthmatic reaction, number of total
eosinophils and ECP increased significantly in the placebo, but not
in the immunotherapy group after allergen challenge.
Condusions: Specific allergen immunotherapy with standardised
birch pollen extract decreases sensitivity to allergen as reflected by
early asthmatic reaction and development of inflammatory
response as assessed by late asthmatic reaction in birch pollen
allergic patients.
0 9 - Specific immunotherapy for latex allergy
Pereira C, Pedro E2, Tavares B', Ferreira MB2, Carrapatoso I', Rico
P\ Santos MC2, Palma-Carlos AG2, Chieira C1
'Immunoallergology Unit: Coimbra University Hospital, Coimbra; 2Santa Maria
Hospital, Lisbon, Portugal; ’ALK-Abelló, Madrid , Spain
We describe 4 patients (3 adult females + 13y old boy) with latex
allergy. They all had symptoms with increasing severity. The 3
females had severe symptoms in the workplace. The boy had spina
bifida with 9 previous surgeries and needed further surgical
interventions. All of them developed anaphylaxis related with latex
and oral-latex-fruit syndrome. Positive skin prick tests, the presence
of serum latex specific IgE (CAP-RAST, Pharmacia-Upjohn,
Sweden- class 3 in the 3 females and class 4 in the boy) and clinical
symptoms demonstrated the sensitisation.
All 3 patients were treated with specific immunotherapy (SIT)
with aqueous extract (ALK-Abelló, Spain) administered subcuta-
neously at the hospital, by rush modified method. A maintenance
dose (MD) of 0.35p.g protein was established according to the
magnitude of local reactions. In one patient a higher dose induced
the appearance of a systemic reaction 40 min after administration,
which promptly remitted with treatment. After establishing MD, all
3 females remained assymptomatic at workplace. A challenge test
with latex gloves was performed 2 months after MD was reached (2
females are negative and another one had slight symptoms of rino-
conjuntivitis). The boy was subjected to surgical intervention with
no allergic reaction.
We also observed a reduction on skin reactivity prick tests to
latex in all patients. We consider SIT with latex to be highly effec-
tive, and the allergenic extract used to be safe and well tolerated at
this dose.
0 10 - Presence of IgE, Activated Eosinophils and T-
cells in Duodenal Biopsies from Adults with Birch
Pollen Allergy
Magnusson J1-2, Ping Lin X2, Dahlman-Höglund A3, Hanson LÁ2,
Magnusson O4, Telemo E2, Bengtsson U', Ahlstedt S5
'Asthma and Allergy Research Group, Department of Respiratory Medicine and
Allergy, 2Clinical Immunology and ’Occupational and Environmental Medicine,
4Sahlgrenska University Hospital, Surgical department, Frölunda Specialist
Hospital, Göteborg. Present address: Slnst Environmental Medicine, KI,
Stockholm, Sweden
The pathophysiological connection between the upper, lower
respiratory and gastrointestinal (GI) tract are still not understood
in the allergic desease. The aim of this study was to determine
presence of IgE, eosinophils and T-cells in Gl-mucosa in patients
16 Læknablaðið/Fylgirit 46 2002/88