1/6. Immunologic and clinical responses to parenteral immunotherapy in peanut anaphylaxis--a study using IgE and IgG4 immunoblot monitoring.BACKGROUND: Specific desensitisation to food allergens, which produce anaphylaxis after ingestion, has not been considered as a treatment for food allergy until recently. The purpose of this study was to assess if a parenteral immunotherapy program, using a partially characterised crude peanut extract, could induce a state of immunological tolerance in a patient who exhibited anaphylaxis, asthma and urticaria on exposure to peanut and other legumes. A further aim was to measure the serum antibody responses to the immunotherapy. methods AND RESULTS: We report the successful desensitisation towards all of the legumes tested of a male patient on parenteral immunotherapy using a partially characterised peanut extract. The immunologic parameters measured during treatment included specific IgE and IgG4 for peanut, soybean, pea and lentil extracts. Immunoblots of specific IgE and IgG4 were made before and after therapy. The antibody response followed the same pattern seen in successful desensitisation of patients with bee venom anaphylaxis. The IgG4 levels increased strongly from a low pre-treatment level in proportion to the antigen dose received. The antigen-specific IgE levels gradually fell from a high pretreatment level, but remained significantly elevated. immunoblotting for specific IgE and IgG4 demonstrated that acquisition of clinical tolerance after therapy was associated with declines in the number and intensity of bands in IgE blots and the development of more bands of increasing density in the IgG4 blots. CONCLUSIONS: Parenteral immunotherapy may offer an alternative treatment to lifelong dietary restriction and epinephrine injections in patients who exhibit life-threatening IgE-mediated anaphylaxis to peanut. Cross desensitisation to other legumes appears to have occurred in this study. The quality and potency of the extract used is an important factor in achieving the desired acquisition of clinical tolerance. In our patient this tolerance correlated with his ability to maintain high levels of specific IgG4, which acted as a marker of protection against anaphylaxis. The use of IgG4 immunoblotting may provide an improved level of discrimination in the assessment of correlation of clinical efficacy with the immunologic response.- - - - - - - - - - ranking = 1keywords = bean (Clic here for more details about this article) |
2/6. Buckwheat anaphylaxis: an unusual allergen in taiwan.IgE-mediated hypersensitivity to buckwheat is common in korea, japan, and some other Asian countries. However, buckwheat is not a common allergen in taiwan. We report a woman with asthma who had anaphylactic shock, generalized urticaria, and an acute exacerbation of asthma five minutes after ingesting buckwheat. The patient underwent skin prick and Pharmacia CAP testing (Uppsala, sweden) for specific IgE to buckwheat, white sesame and soybean as well as other common allergens in taiwan including dermatophagoides pteronyssinus (Dp), D. farinae (Df), cat and dog dander, cockroach, egg white, cow milk and codfish. The patient had a strongly positive skin prick test response to buckwheat and positive reactions to Dp and latex. Specific IgE results were class 6 for buckwheat, class 4 for Dp and Df, and class 2 for dog dander, wheat, sesame and soybean. Results of an open food challenge with white sesame and soybean were negative. Although buckwheat is a rare allergen in taiwan, it can cause extremely serious reactions and should be considered in patients presenting with anaphylaxis after exposure to buckwheat.- - - - - - - - - - ranking = 3keywords = bean (Clic here for more details about this article) |
3/6. Long-lasting contact urticaria from castor bean.Type I (immediate) and type IV (delayed) allergic reactions to castor bean developed in a stockroom worker in a coffee roasting plant. The exceptionally strong contact urticarial patch rest reaction persisted for more than 48 hours and was therefore called "long-lasting contact urticaria." light and electron microscopic observations indicated that eosinophils and mast cells were activated and participated in patch test reactions, which include both type I and type IV allergic reactions. Although patch testing is an absolute prerequisite for an accurate diagnosis of delayed allergy, it should be stressed that skin tests should not be performed with castor bean because of its toxicity and potential danger.- - - - - - - - - - ranking = 6keywords = bean (Clic here for more details about this article) |
4/6. Long-lasting contact urticaria. Type I and type IV allergy from castor bean and a hypothesis of systemic IgE-mediated allergic dermatitis.A unique urticarial type I patch-test reaction to castor bean that persisted for more than 48 hours and was followed by a delayed type IV reaction is described. Immunohistochemical and electron microscopic observations indicated involvement of eosinophils and IgE receptors on Langerhans' cells. The authors present a scheme for the role of Langerhans' cells in skin allergy.- - - - - - - - - - ranking = 5keywords = bean (Clic here for more details about this article) |
5/6. IgE-mediated occupational allergy to a spider mite.Two patients who suffered from allergic rhinitis, conjunctivitis and contact urticaria caused by the two-spotted spider mite (Tetranychus urticae, Koch) are described. Both patients worked in a greenhouse where they came in contact with both spider mites and predator mites living on bean leaves. Prick, Prausnitz-Kustner and RAST tests indicated type I allergy to spider mite but not to predator mite. Both patients had a high level (RAST score 4) of spider-mite-specific IgE in their sera. radioallergosorbent test (RAST) inhibition studies revealed no cross-reactivity between spider mite and house dust mite allergens. These results show that spider mites, which are herbivorous mites found in nature, in greenhouses and even in homes, can cause IgE-mediated allergy in man.- - - - - - - - - - ranking = 1keywords = bean (Clic here for more details about this article) |
6/6. Green bean hypersensitivity: an occupational allergy in a homemaker.As a member of the legume family, the green bean is frequently associated with food allergy. However, allergic reactions caused by skin contact or by inhalation of vapors from boiling legumes are rare. This article presents a case of occupational asthma in a homemaker; symptoms occurred during preparation and cooking of raw green beans. Skin prick, rub, and bronchial provocation tests were performed on the patient. in vitro tests were done with the serum samples of the patient and 10 control subjects (5 atopic and 5 nonatopic). Test results indicate that the patient has type I hypersensitivity to raw green bean antigen(s). This case is of interest because it demonstrates that a food allergen, when inhaled, can induce respiratory symptoms in sensitized patients and may even be the source of primary sensitization.- - - - - - - - - - ranking = 7keywords = bean (Clic here for more details about this article) |