| 1. |
- Lin, Xiao Ping, et al.
(författare)
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Local allergic reaction in food-hypersensitive adults despite a lack of systemic food-specific IgE
- 2002
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Ingår i: J Allergy Clin Immunol. ; 109:5 Pt 1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Objective tools are lacking for the diagnosis of local gastrointestinal inflammatory reactions in skin prick test (SPT)-negative and serum IgE antibody (s-IgE Ab)-negative patients with suspected food allergy. OBJECTIVE: The purpose of this investigation was to evaluate the presence of eosinophils, T cells, local IgE-bearing cells, IL-4, and IFN-gamma in small intestinal biopsy specimens from adult SPT-negative/s-IgE Ab-negative patients with food allergy during symptomatic and nonsymptomatic periods. METHODS: Fourteen patients with food allergy-related gastrointestinal symptoms confirmed by double-blinded, placebo-controlled food challenge (DBPCFC) were investigated. Eleven of the patients were SPT-negative and s-IgE Ab-negative. Sex- and age-matched healthy volunteers were used as controls. Duodenal biopsies were studied with immunostaining through use of a panel of mouse monoclonal antibodies specific for eosinophils, CD3, CD4, CD8, IgE, IL-4, and IFN-gamma. RESULTS: Significant increases in numbers of MBP(+) eosinophils, IgE-bearing cells, and T cells were found in the duodenal mucosa of the patients when they were symptomatic in comparison with when they were asymptomatic and in comparison with healthy controls. Numbers of IL-4(+) cells were increased and numbers of IFN-gamma(+) cells were reduced in the patients when they were symptomatic in comparison with when they were asymptomatic and in comparison with the controls. There were no differences in total s-IgE levels between any of the groups. CONCLUSION: A significant correlation was found between the appearance of symptoms of food hypersensitivity and the duodenal presence of IgE-bearing cells, activated eosinophils, and T cells in patients with negative SPT results and negative s-IgE Ab to the offending food. We suggest that a localized IgE-mediated response caused the gastrointestinal symptoms seen in these patients.
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| 2. |
- Magnusson, Jenny, 1970, et al.
(författare)
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Seasonal intestinal inflammation in patients with birch pollen allergy
- 2003
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Ingår i: J Allergy Clin Immunol. ; 112:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The pathophysiologic interactions of inflammatory reactions between the mucosa of the respiratory tract and that of the gastrointestinal tract in individuals with allergy are poorly studied, despite the fact that allergic symptoms in the airways and the gastrointestinal tract might arise in the same patient. OBJECTIVE: The objective of this study was to examine the inflammatory response histologically by enumerating eosinophils, IgE+ cells, and T cells in duodenal biopsy specimens in adult patients with IgE-mediated birch pollen allergy during the birch pollen season and off-season. METHODS: Nine patients with birch pollen allergy verified by skin prick test and serum IgE antibodies were investigated toward the end of the birch pollen season and again 6 months later (off-season). Duodenal biopsy specimens were obtained and studied by immunostaining for the eosinophil major basic protein (MBP), IgE, and CD3+ T cells. RESULTS: Oral allergy syndrome to birch-associated foods was present in all patients as indicated by questionnaire. Duodenal increases of MBP+ eosinophils and IgE-bearing cells were found in the patients during the birch pollen season as compared with off-season. No seasonal differences in the T-cell numbers in these patients were seen. Off-season, there was no significant difference between the patients and the control subjects regarding the intestinal frequencies of MBP+ eosinophils, mucosal IgE+ cells, and T cells. CONCLUSION: Birch pollen exposure triggered a local inflammation with an increase in duodenal eosinophils and IgE-carrying mast cells in patients with allergy. Our study gives evidence for the interplay between immunologically active cells in the airways and the gut.
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| 3. |
- Van Odijk, Jenny, 1969, et al.
(författare)
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Measurements of eosinophil activation before and after food challenges in adults with food hypersensitivity
- 2006
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Ingår i: Int Arch Allergy Immunol. - : S. Karger AG. - 1018-2438 .- 1423-0097. ; 140:4, s. 334-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Objective assessment of inflammatory reactions in the gastrointestinal tract could be useful in the diagnosis of food hypersensitivity. The aim of the present study was to investigate the involvement of eosinophils and mast cells in the inflammatory response of patients with food hypersensitivity before and after food challenges. METHODS: Eleven patients (4 with IgE-mediated allergy and 7 without) with food hypersensitivity and positive double-blind, placebo-controlled food challenge were subjected to food challenge in a single-blinded fashion. Four subjects with no known food hypersensitivity were recruited as controls. Placebo was given after a 1-week washout period followed by an active dose. Stool, urinary and serum samples were collected and symptoms were recorded in a diary. Fecal samples were analyzed for eosinophil protein X (F-EPX) and tryptase; urinary samples for EPX (U-EPX) and leukotriene E4 (U-LTE4) and serum samples were analyzed for eotaxin and food-specific IgE antibodies. RESULTS: Patients with IgE-mediated food allergy had increased levels of F-EPX compared to controls and tended to have lower serum levels of eotaxin compared to non-allergic patients and controls. U-LTE4 was significantly higher in allergic patients compared to non-allergic patients after challenge. Moreover, F-EPX correlated to U-LTE4 (p = 0.011). Reported symptoms, abdominal pain, distension, flatulence and nausea were similar in the allergic and non-allergic patients. CONCLUSION: The results strongly indicate that eosinophils are activated in the gastrointestinal tract of food-allergic patients but not in patients with non-allergic food hypersensitivity. Due to the inconsistent pattern of symptoms after placebo and active food challenge, it was not possible to relate the levels of inflammation markers to the recorded symptoms.
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| 4. |
- Ekerhult, Teresa, et al.
(författare)
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Ectopic Germinal Centres with B and T Cells and Follicular Dendritic Cell Networks in Urethral Stricture Tissue: Possible Avenue for Immunological Treatments
- 2021
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Ingår i: European Urology Open Science. - : Elsevier BV. - 2666-1691 .- 2666-1683. ; 27, s. 88-93
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Tidskriftsartikel (refereegranskat)abstract
- Background: The underlying cause of a urethral stricture can sometimes be obscure. It is possible that an injury to the urethra induces an immunological cascade that generates scar tissue and fibrosis, eventually resulting in a stricture. If such immuno-logical reactions could be better elucidated, immunological therapies could possibly emerge. Objective: To evaluate if ectopic germinal centres exist in urethral stricture disease. Design, setting, and participants: Resected stricture specimens from 45 patients undergoing open bulbar urethroplasty with excision and anastomosis were assessed. Histopathological characteristics, such as fibrosis (grade I & ndash;III), inflammation, and scle-rosis, were evaluated using immunostaining for CD3 (T cells), CD20 (B cells), and CD21 (follicular dendritic cells). Outcome measurements and statistical analysis: The primary outcome measure was the presence or absence of a germinal centre. The secondary outcome was evaluation of any correlation between the degree of fibrosis and germinal centres. Fisher & rsquo;s exact test was used for univariate analysis. Results and limitations: In six patients, ectopic germinal centres were found. In ten patients, there was no inflammation at all. There was no correlation found between the degree of fibrosis and the abundance of immunohistochemically detected immune cells. Conclusions: Ectopic germinal centres, with B and T cells as well as follicular dendritic cell networks, do exist in urethral stricture disease. This finding may open up for novel research avenues on the possibility of adopting immunological treatments for urethral stricture disease. Patient summary: In patients with a narrowing of the urethra due to any kind of trauma, we looked for the presence of centres of immunological reaction in urethral tissue. We identified these immunological centres (also called germinal centres) in some patients. This intriguing finding suggests that immunological treatments may have potential for men with scar tissue in a narrowed urethra. (c) 2021 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creati-vecommons.org/licenses/by-nc-nd/4.0/).
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| 5. |
- Magnusson, Jenny, 1970
(författare)
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Pathogenesis and Diagnosis of Food Hypersensitivity in Adults
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective tools to diagnose local gastrointestinal (GI) inflammatory reactions in patients with food hypersensitivity are lacking. To fully appreciate the mechanisms mediating allergy-like reactions in the GI tract and for improvement of diagnostic techniques more knowledge is required.The aims of this investigation were to (I) compare retrospectively a new approach for a more objective estimation of symptoms in double-blind placebo-controlled food challenge (DBPCFC) with the previous routine me... merthod of obtaining a diagnosis in adults; (II) to analyse the GI inflammation in adults with negative and positive skin prick test (SPT) and serum-IgE antibody with food hypersensitivity during symptomatic and asymptomatic periods and (III) in birch pollen allergic patients during and out off the birch pollen season; (IV) to assess markers of inflammation in duodenal biopsies, serum and faeces from these patients.I: Three independent observers re-evaluated DBPCFC protocols with a new strategy for interpreting symptoms; inter-observer agreement was 100% and 97%. All patients previously diagnosed as positive were re-evaluated as positive. The new approach resulted in 34% and 38% being positive, compared with 22% by the previous method. II and III: The investigation of inflammatory features in the duodenal mucosa of the food hypersensitive patients during exposure to offending food allergens showed significant increases of MBP+ eosinophils, IgE-bearing cells and T cells. Similar features were seen in birch pollen allergic patients during the birch pollen season, but not off-season. Healthy controls did not show such inflammatory signs. IL-4+ cells were increased in number, while IFN-g+ cells were reduced in the food hypersensitive patients when symptomatic compared to when asymptomatic, or to controls. The inflammatory pattern in the duodenal mucosa was similar in patients with negative and positive SPT/ serum-IgE antibodies whether challenged with foods or birch pollen allergens. IV: During food challenge DBPCFC-positive adults with significant increase of abdominal pain, distension and flatulence, exhibited EPX levels in faeces. Such levels were more obvious for EPX compared with those of the markers of ECP and MPO. Individuals with a short duration of symptoms had significantly higher mean levels of EPX and MPO in faeces than those with a longer duration of symptoms.Conclusions:Subjective symptoms could be managed by using the pre-defined strategy allowing improved interpretations, i.e. independent of the observer. Patients with proven food hypersensitivity and birch pollen allergic individuals during season showed increased numbers of inflammatory markers in the duodenal mucosa. The lack of serum-IgE and SPT positivity suggested a local reaction in the food hypersensitive patients. Local reactions to food components should be considered to enable a correct diagnosis. Our results give evidence for the presence and interplay between immunologically active cells in the airways and the GI tract in birch pollen allergic patients. Increased levels of eosinophil markers, in particular EPX, were observed in faeces from patients with food related GI-symptoms.
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| 6. |
- Wising, Jenny, et al.
(författare)
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‘Life with a device’ : the octogenarians’ experiences with an implantable cardioverter-defibrillator—a qualitative study
- 2021
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 21:2, s. 161-168
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Tidskriftsartikel (refereegranskat)abstract
- AimsImplantable cardioverter-defibrillator (ICD) treatment has expanded due to its effectiveness. However, there are concerns about complications, and use in the most elderly has been questioned. There is scarce data on qualitative aspects regarding experiences of living with an ICD among patients above the age of 80 years. The aim of this study was to explore octogenarians’ experience, knowledge, and attitude of living with an ICD.Method and resultsWe used semi-structured interviews to collect data from 20 patients, aged 80–89 years (90% men). The data were then structured and analysed through deductive thematic analysis network approach using the ATLAS.ti v.8.4 software. The framework of the analysis was based on the Successful Aging Theory. Three main themes emerged regarding the patients’ experiences: Life goes on; Their Health, The Janus-Faced Device; Their attitudes, and Mind the gap; Their knowledge. None of the octogenarians regretted receiving their ICD, instead, they presented with feelings such as gratitude towards the device. However, a lack of knowledge about the devices was expressed, which can be a risk for potential complications, in turn causing suffering and unnecessary concerns.ConclusionOverall, the ICD did not pose a threat towards successful ageing. It was mainly considered a life-saving device. However, the lack of knowledge might hinder informed choices close to death and contribute to ethical dilemmas when deactivation of the ICD is a reasonable option.
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