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  • Ahlgrim, C., et al. (author)
  • Comparison of Molecular Multiplex and Singleplex Analysis of IgE to Grass Pollen Allergens in Untreated German Grass Pollen-Allergic Patients
  • 2015
  • In: Journal of investigational allergology & clinical immunology. - 1018-9068 .- 1698-0808. ; 25:3, s. 190-195
  • Journal article (peer-reviewed)abstract
    • Background: The ImmunoCAP ISAC 112 platform is the only commercially available molecular allergy IgE multiplex test. Data on the comparison of this rather novel test with the molecular singleplex ImmunoCAP IgE platform are lacking. Objective:To compare the multiplex ISAC 112 platform and the singleplex ImmunoCAP platform in regard to IgE to grass pollen allergens in untreated grass pollen allergic patients in Germany. Methods: Serum samples from 101 adults with grass pollen allergy were analyzed for specific IgE (sIgE) to 8 allergenic molecules from timothy grass pollen and to the 112 allergenic molecules included in the ISAC panel. The results for the multiplex and singleplex tests were subsequently analyzed statistically. Results: Comparison of sIgE to grass pollen allergens detected by ISAC 112 and the singleplex ImmunoCAP assay revealed the following correlation coefficients: 0.88 (rPhl p1), 0.96 (rPhl p2), 0.70 (nPhl p4), 0.94 (rPhl p5b), 0.92 (rPhl p6), 0.85 (rPhl p11), and 0.78 (rPhl p12). Conclusion: Molecular testing with ISAC 112 correlates well with the ImmunoCAP platform for respective molecular timothy grass pollen allergens.
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  • Gellerstedt, Martin, 1966-, et al. (author)
  • Methodological issues in the diagnostic work-up of food allergy : a real challenge.
  • 2007
  • In: Journal of investigational allergology & clinical immunology. - Barcelona : J.R. Prous, S.A. - 1018-9068 .- 1698-0808. ; 17:6, s. 350-356
  • Journal article (peer-reviewed)abstract
    • The standard of reporting in diagnostic studies has generally been low. Fortunately, this issue has begun to be addressed in recent years through the discussion of important methodological issues in educational series, textbooks, and checklists. Double-blind, placebo-controlled, oral food challenges (DBPCFC) are considered to be the gold standard for diagnosis of food allergy. However, there is no consensus regarding how to interpret the outcome and how to define positive and negative provocations in DBPCFC. Furthermore, since most theories on the diagnosis of food allergy rely on the assumption that the DBPCFC has a high accuracy, this accuracy must be formally statistically evaluated. In this review, we discuss essential methodological issues for diagnostic accuracy studies in general and for oral food challenges in particular and discuss the importance of methodological issues as a guide for forthcoming studies of diagnostic procedures.
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  • Hjalmarsson, E, et al. (author)
  • A 5-Year Open-Label Follow-up of a Randomized Double-Blind Placebo-Controlled Trial of Intralymphatic Immunotherapy for Birch and Grass Allergy Reveals Long-term Beneficial Effects
  • 2023
  • In: Journal of investigational allergology & clinical immunology. - : Esmon Publicidad, SA. - 1018-9068. ; 33:5, s. 362-372
  • Journal article (peer-reviewed)abstract
    • Background: Intralymphatic immunotherapy (ILIT) has been proposed as a novel, less time-consuming alternative to conventional allergy immunotherapy (AIT). Few previous studies have evaluated its long-term effects. The objective of the study was to complete a 5-year follow-up of a previously performed randomized, double-blind placebo-controlled trial of ILIT for a combination of birch and grass allergens. Methods: Fifty-eight patients with allergic rhinitis were treated with either placebo or a combination of ALK Alutard Birch and Grass 1000 SQ-U, three intralymphatic injections with one-month intervals. A year after the vaccination, symptoms induced by nasal provocation were significantly reduced. 5-6 years later, 20 out of 26 actively treated patients were followed up with a nasal provocation test (NPT), seasonal registration of the combined symptoms and medications score (CSMS), IgE and IgG4 levels in the blood and immunological markers in blood and lymph nodes and compared with 13 unvaccinated controls Results: The ILIT induced reduction in the NPT response seen in year one could not be convincingly reproduced in year five. The new CSMS scores were markedly lower among the previously treated patients than for the control group. Further, grass-specific IgG4 was increased, grass-specific IgE decreased, FcεR1 on basophils reduced, and the amount of memory T-cells in the lymph nodes increased. Conclusion: The combination of seasonal derived clinical data and immunological parameters supports the notion of a long-lasting effect of ILIT. These data support the concept of ILIT as a good alternative to traditional AIT in pollen-induced allergic rhinitis.
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  • Hjalmarsson, E, et al. (author)
  • A 5-Year Open-Label Follow-up of a Randomized Double-Blind Placebo-Controlled Trial of Intralymphatic Immunotherapy for Birch and Grass Allergy Reveals Long-term Beneficial Effects
  • 2023
  • In: Journal of investigational allergology & clinical immunology. - : Esmon Publicidad, SA. - 1018-9068. ; 33:5, s. 363-372
  • Journal article (peer-reviewed)abstract
    • Background: Intralymphatic immunotherapy (ILIT) has been proposed as a novel, less time-consuming alternative to conventional allergy immunotherapy (AIT). Few previous studies have evaluated its long-term effects. The objective of the study was to complete a 5-year follow-up of a previously performed randomized, double-blind placebo-controlled trial of ILIT for a combination of birch and grass allergens. Methods: Fifty-eight patients with allergic rhinitis were treated with either placebo or a combination of ALK Alutard Birch and Grass 1000 SQ-U, three intralymphatic injections with one-month intervals. A year after the vaccination, symptoms induced by nasal provocation were significantly reduced. 5-6 years later, 20 out of 26 actively treated patients were followed up with a nasal provocation test (NPT), seasonal registration of the combined symptoms and medications score (CSMS), IgE and IgG4 levels in the blood and immunological markers in blood and lymph nodes and compared with 13 unvaccinated controls Results: The ILIT induced reduction in the NPT response seen in year one could not be convincingly reproduced in year five. The new CSMS scores were markedly lower among the previously treated patients than for the control group. Further, grass-specific IgG4 was increased, grass-specific IgE decreased, FcεR1 on basophils reduced, and the amount of memory T-cells in the lymph nodes increased. Conclusion: The combination of seasonal derived clinical data and immunological parameters supports the notion of a long-lasting effect of ILIT. These data support the concept of ILIT as a good alternative to traditional AIT in pollen-induced allergic rhinitis.
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  • Hjalmarsson, E, et al. (author)
  • A five-year open follow up of a randomized, double-blind placebo-controlled trial of intralymphatic immunotherapy for birch and grass reveals remaining beneficial effects
  • 2022
  • In: Journal of investigational allergology & clinical immunology. - : Esmon Publicidad, SA. - 1018-9068. ; , s. 0-
  • Journal article (peer-reviewed)abstract
    • Background: Intralymphatic immunotherapy (ILIT) has been proposed as a novel, less time-consuming alternative to conventional allergy immunotherapy (AIT). Few previous studies have evaluated its long-term effects. The objective of the study was to complete a 5-year follow-up of a previously performed randomized, double-blind placebo-controlled trial of ILIT for a combination of birch and grass allergens. Methods: Fifty-eight patients with allergic rhinitis were treated with either placebo or a combination of ALK Alutard Birch and Grass 1000 SQ-U, three intralymphatic injections with one-month intervals. A year after the vaccination, symptoms induced by nasal provocation were significantly reduced. 5-6 years later, 20 out of 26 actively treated patients were followed up with a nasal provocation test (NPT), seasonal registration of the combined symptoms and medications score (CSMS), IgE and IgG4 levels in the blood and immunological markers in blood and lymph nodes and compared with 13 unvaccinated controls Results: The ILIT induced reduction in the NPT response seen in year one could not be convincingly reproduced in year five. The new CSMS scores were markedly lower among the previously treated patients than for the control group. Further, grass-specific IgG4 was increased, grass-specific IgE decreased, FcεR1 on basophils reduced, and the amount of memory T-cells in the lymph nodes increased. Conclusion: The combination of seasonal derived clinical data and immunological parameters supports the notion of a long-lasting effect of ILIT. These data support the concept of ILIT as a good alternative to traditional AIT in pollen-induced allergic rhinitis.
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  • Kalm-Stephens, Pia, et al. (author)
  • Elevated exhaled nitric oxide in adolescents is associated with incident allergic symptoms : a prospective cohort study
  • 2019
  • In: Journal of investigational allergology & clinical immunology. - : ESMON Publicidad. - 1018-9068 .- 1698-0808. ; 29:3, s. 231-238
  • Journal article (peer-reviewed)abstract
    • Background: The fraction of exhaled nitric oxide (FeNO) is a marker of type-2 inflammation in the airways and elevated FeNO may precede development of allergic disease. The aim of the present study was to investigate the association between elevated FeNO and the development of allergic symptoms.Methods: A total of 959 adolescents from a general population answered, together with their parents, a standardized questionnaire, performed lung function and FeNO measurements at a baseline visit. Four years later, 921 of these subjects (96%) completed a to a great extent same version of the baseline questionnaire.Results: Adolescents with self-reported incident allergic symptoms to cat (n = 50) or dog (n = 33) had higher baseline FeNO (p < 0.001) than subjects without allergic symptoms to cat and dog at either time point (n = 776 and n = 838, respectively). Adolescents with incident allergic symptoms to pollen did not have elevated baseline FeNO. The adjusted odds ratio [aOR (95% confidence interval)] for incident allergic symptoms to cat was 4.2 (2.2, 8.0) times higher if FeNO was > 75th percentile (vs. < 75th percentile) at baseline. This was consistent after exclusion of subjects with reported asthma, wheeze or rhinitis at baseline [aOR (95% CI) 8.6 (3.0, 24.1)].Conclusion: Elevated FeNO in adolescents related to an increased risk of developing allergic symptoms to cat and dog, but not pollen allergens, within four years.
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  • Kalm-Stephens, Pia, 1959-, et al. (author)
  • Sex differences in baseline risk factors for the incidence of asthma between early adolescence and young adulthood
  • 2021
  • In: Journal of investigational allergology & clinical immunology. - : Esmon Publicidad, SA. - 1018-9068 .- 1698-0808. ; 33:1, s. 21-29
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Several studies have shown sex differences in the prevalence of asthma and a relationship to age. The aim of the present study was to prospectively investigate the development of asthma, wheeze, rhinitis and allergic symptoms, between adolescence and adulthood. Furthermore, to determine if sex modifies the associations between baseline risk factors and incidence of asthma in early adulthood.METHODS: In the study Screening Project Asthma in Schools(SPAIS), adolescents aged 12-15 years answered a standardised respiratory questionnaire (ISAAC) and underwent measurements of fractional exhaled nitric oxide (FeNO) and lung function (FEV1) at baseline. Two follow-ups with similar questionnaires were performed after four and 16 years, with 491 subjects participating in all three examinations.RESULTS: The prevalence of asthma and wheeze were unchanged after four years, but had increased after 16 years. However, the increase was significant only for females. A more continuous increasein rhinitis and allergic symptoms showed no difference between the sexes. Sex interaction analysis showed that higher FeNO (p = 0.01) and family asthma (p = 0.02) increased the risk of incident asthma for males but not for females.CONCLUSION: An increased prevalence of respiratory symptoms was seen primarily between late adolescence and young adulthood, and was significant for females but not males. Allergic risk factors in early adolescence for incident asthma in early adulthood were confirmed in males but not in females. Awareness of these sex differences in the development of symptoms, and the associated risk factors, are important in clinical practice.
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  • Movérare, Robert, et al. (author)
  • Change in the pattern of IgE reactivity to timothy grass and birch pollen allergens over a 20-year period
  • 2006
  • In: Journal of investigational allergology & clinical immunology. - 1018-9068 .- 1698-0808. ; 16:5, s. 274-278
  • Journal article (peer-reviewed)abstract
    • Background: Several studies have shown that the prevalence of allergy and allergen sensitization has increased in recent years. However, the changes in the pattern of IgE reactivity to individual allergens are mostly unknown. Objective: The aim of this preliminary study was. to assess the change in IgE reactivity profile to individual timothy grass and/or birch pollen allergens in sera from sensitized individuals randomly collected 20 years apart. Methods: Serum samples from 51 sensitized individuals were obtained from 2 cross-sectional surveys performed in 1973 and 1994 using random samples from Vammala, Finland. The sera were analyzed for IgE reactivity to timothy grass and/or birch pollen extracts, recombinant (r)Phl p 1, 2, 5, 6, 7, 11, 12, native (n)Phl p 4, and rBet v 1, 2 and 4 by immunoassay (ImmunoCAP). Results: The median (range) concentrations of IgE antibodies to timothy grass and birch pollen were higher in 1994 than in 1973 (6.47 [0.35 to > 100] kU(A)/L vs 1.53 [0.40-25.3] kU(A)[L; P=.0035). The prevalence of IgE reactivity to some allergens was higher in 1994 than in 1973, particularly rPhl p 5 (52% vs 19%), rPhl p 6 (43% vs 12%), and rBet v 1 (100% vs 29%). There was a correlation between timothy grass pollen-specific serum IgE levels and the numbers of IgE reactivities to individual allergens (p=0.76, P <.001). Conclusions: The increase in specific IgE levels together with a possible increase in the prevalence of IgE reactivity to the major allergens Phl p 5 and Bet v 1 between 1973 and 1994 may have contributed to the increase in atopic conditions in Finland.
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  • Peterson, Christer, et al. (author)
  • Detection of Local Mast-Cell Activity in Patients With Food Hypersensitivity
  • 2007
  • In: Journal of investigational allergology & clinical immunology. - 1018-9068 .- 1698-0808. ; 17:5, s. 314-320
  • Journal article (peer-reviewed)abstract
    • Background: Mast cells play a central role in many inflammatory diseases and assessment of their activation may be of use to provide objective confirmation of the outcome of food challenge in the diagnosis of food hypersensitivity. However, to date, assessment of mastcell activation using serum markers has been unsuccessful. Objective: The aim of this study was to explore whether locally released tryptase could be detected in stool samples from patients with food hypersensitivity. Methods: Nine patients (median age, 55 years; range, 26 - 68 years) with food hypersensitivity confirmed by double-blind placebo-controlled food challenge were included in the study. Tryptase concentration was assessed in stool samples collected before and after an open food challenge at home and symptoms were recorded throughout the study. Tryptase concentration was also assessed in stool samples from 16 apparently healthy individuals (median age, 44 years; range, 27 - 72 years). Results: Measurement of fecal tryptase levels in 16 healthy control subjects revealed an upper limit of the normal range (mean + 2 SD of log transformed data) of 10 ng/g. Fecal tryptase levels exceeded 10 ng/g in 7 out of 9 patients in one or more samples obtained during the study. The tryptase levels varied between patients in response to the food challenge and the individual mean levels of tryptase correlated with the corresponding levels of the inflammatory marker eosinophil protein X (ρ = 0.7500, P = .02). Conclusion: Measurement of tryptase levels in stool samples is feasible using the method described here. Our results revealed elevated concentrations of fecal tryptase in patients with food hypersensitivity. However, several factors, including food exposure, may account for the increase in fecal tryptase and further studies are necessary to elucidate the role of mast cells in food hypersensitivity.
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  • Suutari, T. J., et al. (author)
  • IgE cross reactivity between reindeer and bovine milk beta-lactoglobulins in cow's milk allergic patients
  • 2006
  • In: J Investig Allergol Clin Immunol. - 1018-9068. ; 16:5, s. 296-302
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Allergic reactions to cow's milk are common in small children. One of the main protein allergens found in cow's milk is beta-lactoglobulin (beta-Lg). Reindeer and bovine milk both contain related beta-Lg proteins, but the allergenicity of reindeer beta-Lg has not previously been studied. The purpose of this study was to analyze the immunological cross-reactivity of IgE antibodies from children with cow's milk allergy to reindeer and bovine beta-Lg. METHODS: Sera from 17 children and a serum pool of 4 patients with elevated cow's milk-specific IgE were investigated. Beta-Lg from bovine and reindeer milk was isolated in native form and an enzyme-linked immunosorbent inhibition assay was developed. Bovine beta-Lg was used as a capturing antigen and the inhibiting effects of reindeer and bovine beta-Lg on the IgE binding were measured. RESULTS: Cross-reactivity patterns of bovine milk beta-Lg specific IgE to reindeer beta-Lg varied among patients. In general, reindeer beta-Lg showed significantly lower inhibition (mean 43%) of IgE binding to the capturing antigen than did bovine beta-Lg (mean 89%). In some patients, even high concentrations of reindeer beta-Lg only partly eliminated the IgE binding to bovine beta-Lg. CONCLUSIONS: The partial cross-reactivity of human anti-bovine IgE with reindeer beta-Lg suggests that it lacks important bovine epitopes and those that are recognized are only weakly bound.
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  • Suutari, T.J., et al. (author)
  • IgE cross reactivity between reindeer and bovine milk ?-lactoglobulins in cow's milk allergic patients
  • 2006
  • In: Journal of investigational allergology & clinical immunology. - 1018-9068 .- 1698-0808. ; 16:5, s. 296-302
  • Journal article (peer-reviewed)abstract
    • Background: Allergic reactions to cow's milk are common in small children. One of the main protein allergens found in cow's milk is ?-lactoglobulin (?-Lg). Reindeer and bovine milk both contain related ?-Lg proteins, but the allergenicity of reindeer ?-Lg has not previously been studied. The purpose of this study was to analyze the immunological cross-reactivity of IgE antibodies from children with cow's milk allergy to reindeer and bovine ?-Lg. Methods: Sera from 17 children and a serum pool of 4 patients with elevated cow's milk-specific IgE were investigated. ?-Lg from bovine and reindeer milk was isolated in native form and an enzyme-linked immunosorbent inhibition assay was developed. Bovine ?-Lg was used as a capturing antigen and the inhibiting effects of reindeer and bovine ?-Lg on the IgE binding were measured. Results: Cross-reactivity patterns of bovine milk ?-Lg specific IgE to reindeer ?-Lg varied among patients. In general, reindeer ?-Lg showed significantly lower inhibition (mean 43%) of IgE binding to the capturing antigen than did bovine ?-Lg (mean 89%). In some patients, even high concentrations of reindeer ?-Lg only partly eliminated the IgE binding to bovine ?-Lg. Conclusions: The partial cross-reactivity of human anti-bovine IgE with reindeer ?-Lg suggests that it lacks important bovine epitopes and those that are recognized are only weakly bound. © 2006 Esmon Publicidad.
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  • Uriarte, SA, et al. (author)
  • Clinical and Immunologic Changes due to Subcutaneous Immunotherapy With Cat and Dog Extracts Using an Ultrarush Up-Dosing Phase: A Real-Life Study
  • 2022
  • In: Journal of investigational allergology & clinical immunology. - : Esmon Publicidad, SA. - 1018-9068. ; 32:2, s. 133-
  • Journal article (peer-reviewed)abstract
    • Objective: We aimed to evaluate the efficacy of and immunologic changes caused by subcutaneous immunotherapy (SCIT) in patients with allergy to cat and dog. Methods: The study population comprised patients with rhinitis and/or asthma and allergy to cat or dog from a previous safety study. All patients had specific IgE to cat and/or dog. The SCIT maintenance dose was administered using an infusion pump over a single 4-hour session, followed by monthly administration over 6 months. Data were gathered on clinical outcomes, pulmonary function, FeNO, rhinitis and asthma symptoms, quality of life (QOL), and scores for the Asthma Control Test and symptom visual analog scale were recorded at baseline and then at 1, 3, and 6 months. Specific IgE and IgG antibody responses to cat and dog allergens were determined. Results: The study population comprised 61 patients with a mean age of 35.6 (9.7) years, of whom 40 underwent SCIT for at allergy. A significant improvement was observed in rhinitis and asthma symptoms and in QOL, use of medication, visual analog scale score, and Asthma Control Test score at 1 month; these improvements persisted at month 6. The clinical improvement with cat extract was significantly more marked than with dog extract. Nearly half of the patients (49.09%) had an increase of >0.9 in the ESPRINT-15 QOL in allergic rhinitis questionnaire, and 58.18% had an increase of >0.5 in the Asthma Quality of Life Questionnaire score at month 6. Both differences represent the minimal clinical important difference. A significant increase was observed in specific IgG and IgE to different allergens at 3 and/or 6 months. Conclusions: Ultrarush SCIT with cat and dog extracts has substantial clinical value for many patients.
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