| 1. |
- Arvidsson, Monica, 1955, et al.
(författare)
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Allergen specific immunotherapy attenuates early and late phase reactions in lower airways of birch pollen asthmatic patients: a double blind placebo-controlled study
- 2004
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Ingår i: Allergy. ; 59:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Few placebo-controlled studies have examined the effect of allergen specific immunotherapy (SIT) on early and late phase asthmatic reactions. In this placebo-controlled study we have investigated the effect of 1 year of SIT with standardized birch pollen extract on early and late phase asthmatic reactions in adult asthmatic patients. METHODS: Nineteen patients with a history of birch-pollen-induced seasonal symptoms from upper and lower airways, positive skin prick test and in vitro specific immunoglobulin E to birch pollen extract were included. Allergen and methacholine bronchial challenges were performed and blood samples obtained for analyses of total eosinophil count and eosinophil cationic protein (ECP) in serum, before and after 1 year of immunotherapy treatment. RESULTS: All patients developed early and 16 of 19 both early and late phase asthmatic reactions. A significant increase in allergen dose was required to evoke early asthmatic reaction in the immunotherapy group (P < 0.01) after 1 year of treatment. The difference between the groups was significant (P < 0.01). Also the size of late asthmatic reaction was significantly reduced in the SIT group compared with placebo treated patients (P < 0.01). Twenty-four hours after allergen challenge methacholine sensitivity, number of total eosinophils and ECP increased significantly in the placebo (P < 0.02, P < 0.05 and P < 0.05 respectively), but not in the SIT group. CONCLUSION: Allergen SIT with standardized birch pollen extract decreased early and late asthmatic responses following bronchial challenge in pollen allergic patients, thus confirming anti-inflammatory effect of the treatment.
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| 2. |
- Arvidsson, Monica, 1955, et al.
(författare)
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Effect of 2-year placebo-controlled immunotherapy on airway symptoms and medication in patients with birch pollen allergy
- 2002
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Ingår i: J Allergy Clin Immunol. ; 109:5 Pt 1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Birch pollen is a common allergen in northern, central, and eastern Europe. Earlier studies of specific immunotherapy using birch pollen extract were not placebo-controlled or were only preseasonal. Long-term, placebo-controlled studies with subcutaneously administered standardized birch pollen extract are lacking. OBJECTIVE: The aim of this study was to evaluate the effect of immunotherapy with birch pollen extract on airway symptoms and use of medication in adult birch pollen-allergic patients in a double-blind, placebo-controlled trial. METHODS: Forty-nine patients with histories of birch pollen allergy from the upper and lower airways, positive skin prick test and conjunctival provocation test results, and in vitro specific IgE to birch pollen (Betula verrucosa ) extract were included. Immunotherapy with birch pollen extract was given during 2 consecutive years in a double-blind, randomized, placebo-controlled study. Clinical symptom scores from the upper and lower airways and use of rescue medication were registered throughout the pollen season. RESULTS: Forty-six patients reached the maintenance dose and were maintained on that dose during the 2-year study. The median symptom scores during the 1997 and 1998 seasons were 1.3 and 2.6, respectively, in the specific immunotherapy group and 2.1 and 4.3, respectively, in the placebo group. The differences between the groups were significant (P =.05 in 1997 and P =.005 in 1998). The placebo group used significantly more rescue medication during both seasons than the specific immunotherapy group (P =.004 for 1997 and P =.004 for 1998). CONCLUSION: Specific immunotherapy with birch pollen extract is an effective and safe treatment for reducing clinical allergy symptoms and medication use in birch pollen-allergic patients during the pollen season.
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| 3. |
- Hansson Scherman, Marianne, 1944, et al.
(författare)
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Drug compliance and identity: reasons for non-compliance. Experiences of medication from persons with asthma/allergy.
- 2004
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Ingår i: Patient education and counseling. - : Elsevier BV. - 0738-3991. ; 54:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe patient experiences of medication. Patients with asthma/allergy were interviewed in depth twice with 8 years between. The interviews were analysed according to the phenomenographic approach and three categories, one with four sub-categories, were identified: 'access to medicine is important to relieve discomfort and to avoid fear', 'medicine damages your body and your identity without curing the illness' (because 'you can become immune or addicted', 'the ability of your body to heal itself is weakened', 'your body's own signals are camouflaged' and 'you become stigmatised') and 'production and distribution of medicine is a profit-seeking commercial undertaking which is not primarily aimed at curing the patient'. Medication experiences were stable over time. Sociological and biological survival must be compared in an open discussion along with the patient's and health professional's different reasons for how they take or prescribe medication.
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| 4. |
- Hansson Scherman, Marianne, 1944, et al.
(författare)
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Refusing to be ill: a longitudinal study of patients' experiences of asthma/allergy.
- 2002
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Ingår i: Disability and rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 24:6, s. 297-307
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to search for a deeper understanding of the ways patients with asthma/allergy experience their illness situation. METHOD: Thirty patients with a history of airway symptoms on allergen exposure and a positive skin prick test were included in the study. They took part in open-ended interviews in their homes twice at an interval of eight years, according to the phenomenographic approach. RESULTS: Fourteen different categories of experience were identified: 'knowing for oneself, 'body related', 'environment related', 'psychosomatic', 'magic', 'fatalism', 'compliance with medication', 'alternative medicine', 'health care', 'provocation', 'avoidance', 'normalization', 'normification' and 'pursuing life'. The analysis also showed that these categories, to varying degrees, were an expression of a desire to retain an ordinary healthy identity and its value. The longitudinal results showed that with time the patients distanced themselves from the medical perspective and found their own ways of thinking and acting in relation to their ill health, which is seen as strengthening for the identity. CONCLUSIONS: The different, individual ways patients with asthma/allergy developed in relation to the illness situation have a preserving effect on the identity, which ought to be considered in patient education and rehabilitation.
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| 5. |
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| 6. |
- Hellgren, Johan, 1965, et al.
(författare)
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Quality of life in non-infectious rhinitis and asthma
- 2004
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Ingår i: Rhinology. ; 42:4
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Tidskriftsartikel (refereegranskat)abstract
- In this study we evaluated how the quality of life in subjects with asthma was affected by a history of non-infectious rhinitis. The study comprised 180 persons with asthma and 156 controls, who answered the Short Form 36 quality of life questionnaire. Both the asthma subjects and the controls were stratified according to a history of non-infectious rhinitis (NIR). The global physical quality of life score (PCS) was significantly lower for all the asthma subjects regardless of their previous history of NIR compared to controls (NIR positive asthma, -8, p=O,001, NIR negative asthma, -9, p=0, 001). The subjects with asthma and a positive history of NIR obtained significantly lower scores for their global mental quality of life (MCS) than the controls (46 vs 51, p=0.004). The subjects with asthma and a negative history of NIR obtained MCS scores that were similar to those of the controls (50 and 51, p=0.9). In this population based study, the physical Qol of the subjects with asthma was lower regardless of a previous history of NIR compared to controls. A positive history of NIR in asthma was however associated with a poorer mental Qol.
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| 7. |
- Hytönen, Ann-Marie, et al.
(författare)
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Haplotypes of the interleukin-4 receptor alpha chain gene associate with susceptibility to and severity of atopic asthma
- 2004
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Ingår i: Clin Exp Allergy. ; 34:10
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Tidskriftsartikel (refereegranskat)abstract
- Summary Background Development of asthma is likely to depend on a complex interaction between environmental and genetic factors. Several groups have suggested the gene of the IL-4 receptor alpha chain (IL4R) as a candidate gene for the development of asthma, although association with single polymorphisms has shown contradicting results. Objective We chose to analyse IL4R gene haplotypes and assess their possible relevance in susceptibility to asthma and to certain clinical phenotypes. Methods IL4R gene haplotypes were analysed, based on the three markers C-3223T, Q551R and I50V, using the expectation-maximization algorithm, in 170 atopic asthma patients and 350 controls, all adult Swedish Caucasians. Results Our data showed significantly higher levels of soluble IL-4R (sIL-4R) in asthma patients compared with controls (P<0.0001). Furthermore, we showed a significant association between the IL4R haplotype containing the alleles T-3223, V50 and R551 (TVR) of the IL4R gene, and susceptibility to atopic asthma, with a frequency of 6.5% in the patients compared with 1% in the controls (P<0.0005). A subgroup of patients with heterozygous or homozygous state for the T-3223, V50 and R551 alleles, also had lower levels of sIL-4R in their circulation compared with patients with homozygous state in the C-3223, I50 and Q551 alleles (P<0.05) and showed less severe asthma according to lung function test (P<0.05). Analysis of single markers showed the T-3223 IL4R allele to associate with lower serum levels of sIL-4 receptor (P<0.0001) and patients carrying the T allele also had more symptoms of active asthma (wheezing, P<0.01; coughing, P<0.05 and breathing difficulties, P<0.01). Conclusion Our data suggest that asthmatic patients with low levels of sIL-4 receptor may represent a genetically distinct subgroup of atopic asthma. TVR haplotype analyses confirm the importance of IL4R as a candidate gene for susceptibility to asthma. This finding may have implications for the understanding of the pathogenesis of asthma and possibly for the development of more specific therapies.
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| 8. |
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| 9. |
- Millqvist, Eva, 1949, et al.
(författare)
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Combining a beta2-agonist with a face mask to prevent exercise-induced bronchoconstriction
- 2000
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Ingår i: Allergy. ; 55:7, s. 672-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In this study, we aimed to test the effect of combining a P2-agonist with a heat- and moisture-exchanging cellulose face mask in patients with bronchoconstriction induced by exercise in cold air. METHODS: Nine allergic, asthmatic patients with a history of adverse reaction to exercise were tested on an ergometric bicycle at a temperature of approximately -10 degrees C. They were in turn given no treatment, given premedication with a beta2-agonist, allowed to breathe through a heat- and moisture-exchanging cellulose face mask, and given both premedication and the face mask. After each treatment regimen, they were subjected to provocation with exercise and cold air. RESULTS: The decrease in FEV, was greatest with no therapy (mean maximal change: 27%), and this diminished when the face mask was used (mean maximal change: 12%,) or premedication with a 32-agonist was given (mean maximal change: 7%); no decrease in FEV1 occurred with the combination of agonist and face mask. CONCLUSIONS: The results suggest that different mechanisms are involved in the pathophysiology of exercise- induced bronchoconstriction (EIB). This finding may be of importance for asthmatic athletes who train and compete in a cold climate and are affected by small changes in their lung function.
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| 10. |
- Nordin, S., et al.
(författare)
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A short chemical sensitivity scale for assessment of airway sensory hyperreactivity
- 2004
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Ingår i: Int Arch Occup Environ Health. ; 77:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES. A short version of the 21-item Chemical Sensitivity Scale (CSS), called the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), was developed and evaluated for the quantifying of self-reported affective reactions to and behavioral disruptions in daily activities by odorous/pungent substances among patients with sensory hyperreactivity (SHR) for clinical and epidemiological studies. METHODS. Twenty-two patients with clinically diagnosed SHR and 124 control participants responded to the CSS and to additional questions about chemical sensitivity for the evaluation of the CSS-SHR. RESULTS. Eleven of the 21 items of the CSS were selected, on statistical grounds, to constitute the CSS-SHR, which was found to generate approximately normal distributions, have good test-retest reliability (r(xy)=0.87), satisfying internal consistency (r(alpha)=0.76-0.84) and predictive and concurrent validity, and to be uni-dimensional. The metric properties of the CSS-SHR were, despite its few items, comparable with those of the CSS. A proposed diagnostic cut-off score for SHR demonstrated a high correct classification rate (92%) for the CSS-SHR. CONCLUSIONS. The favorable metric properties of the CSS-SHR and its sensitivity/specificity suggests that it is useful for clinical diagnosis and epidemiological study of sensory hyperreactivity in combination with other diagnostic tools.
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