Allergic Reactions Ebook

Allergy Relief

Allergy Relief

Have you ever wondered how to fight allergies? Here are some useful information on allergies and how to relief its effects. This is the most comprehensive report on allergy relief you will ever read.

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Allergy Relief

This easy-to-read guide contains every piece of information you will EVER need to beat allergy, and get the relief from allergic reactions that you have always needed. Sniffing, itching, and watery eyes are NOT a natural part of life, and they ARE something that you can get rid of! Don't sit around feeling miserable and wishing you were feeling better when there are solutions to your problems! You don't have to pay HUGE amounts of money to a doctor for expensive medicines when this book can give you the tools to get rid of allergy symptoms once and for all. We are so sure that it will help you that we give a 60 day money-back guarantee if it doesn't help you. That's how sure we are that your symptoms will be GONE. Breathe easy; help is on the way! Order now to get the relief of allergy symptoms you deserve.

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Potential allergenicity

The potential allergenicity of the newly introduced protein is one of the major safety concerns in the evaluation of GM foods. Where the candidate crop has acquired allergenic properties by genetic modification, it will, in general, not be approved for market introduction. Food allergy is an adverse reaction of the immune system to food components and manifests itself by symptoms such as dermatitis, oedema, vomiting, diarrhoea and fatal anaphylaxis in the extreme. It is generally accepted that the body is sensitized on initial contact with the allergen and that subsequent exposures elicit an allergic reaction. During the the sensitization process, the allergen stimulates B lymphocytes to synthesize allergen-specific IgE antibodies, probably with the aid of IL-4-producing helper CD4 T cells. The IgE binds to mast cells via the high affinity Fce receptor (FceRI). Upon subsequent exposure, the allergen crosslinks two surface-bound IgE molecules and triggers the mast cell to release...

Common allergenic sources

Where the introduced gene is from a common allergenic source, the first step in the assessment process is a radioallergosorbent test (RAST, ELISA) with the detection of IgE antibodies in the serum from at least 14 individuals confirmed to be allergic to the gene source. When these immunoassays generate negative or equivocal data, the purified protein as well as a protein extract of the GM crop plant should be tested further using skin-prick tests involving at least 14 allergic individuals. A positive result in these latter tests indicates that the protein and or transgenic food extract is able to elicit histamine release from skin mast cells in vivo. Finally, the IFBC ILSI decision tree suggests that the assessment be confirmed using doubleblind, placebo-controlled food challenges (DBPCFC) involving at least 14 allergic individuals. A positive result in either of these in vivo tests would provide sufficient evidence for the allergenicity of the transgenic food.

Infrequent allergenic sources

If the introduced genetic material is from a less common allergenic source, the same type of tests should be performed except that at least five rather than 14 subjects are examined, recognizing that it will be much more difficult to identify individuals with these allergies. Although the degree of assurance that a major allergen from the donor organism has not been introduced in the transgenic crop plant is less than with the proteins obtained from a common allergenic source, the size of the affected population and thus the risk to the consumers is also much less. If less than five allergic individuals are included in the studies, the decision tree approach advocates two additional steps (i) a structural comparison of the protein with known allergens and (ii) an investigation of the stability of the protein (see below).

Unknown allergenic sources

The most difficult assessment involves genetic material obtained from (nonfood) sources of unknown allergenic potential. A merely predictive approach for allerge-nicity testing could be followed. According to the IFBC ILSI, this testing should include at least a comparison of the amino acid sequence of the novel protein with the sequence of known allergens and an analysis of the stability of the protein. Comparison of the amino acid sequence of the novel protein with the amino acid sequences of known allergens may be done using protein structure databases such as GenBank, SWISS-PROT and PIR, and alignment programs such as the FASTA and BLAST algorithms. The amino acid sequences of 198 major allergens including about 30 food allergens from plant origin are known 7 . So far, a relationship, if any, between allergenicity and (putative) biological function and or protein structure has not been established. Although helper T-cell epitopes and B-cell epi-topes of various allergens have been...

Additional evaluations of allergenicity

In addition to the assays mentioned in the IFBC ILSI decision tree, animal experiments should be part of the evaluation in case of insufficient evidence for nonal-lergenicity. An animal model has been developed to test the potential allergenicity of food components in which Brown Norway rats (high IgE responders) are sensitized with or without an adjuvant prior to intraperitoneal and oral exposure to the test compound 8 . In order to avoid the induction of tolerance, these rats are reared for at least two generations on an allergen-free or test protein diet prior to challenge with the test compound. The outcome of such experiments should be carefully evaluated and their deficiencies recognized, e.g. a rat experiment failed to demonstrate the allergenicity of the 2S albumin from Brazil nut transferred into soybean, whereas individuals allergic to Brazil nut reacted positively to the novel product 9 . An additional issue with respect to the evaluation of potential allergenicity of a...


A long history of speculation exists concerning the association of multiple sclerosis (MS) with allergies. This idea was especially popular in the 1940s and 1950s. Many different allergic substances have been proposed over the years. Various food allergies have been implicated in MS. Some studies have found that MS is more common in areas with high intakes of dairy products or gluten-containing grains, such as wheat, rye, oats, and barley. As a result, the consumption of dairy products or gluten has been implicated in MS. Other proposed allergic foods have included yeast, mushrooms and other fungi, fermented products (such as vinegar), sugar, potatoes, red meat, fruits, vegetables, caffeine, and tea and other tannin-containing foods.

Diet Allergies

Food sensitivity can develop at any age but is particularly common in infants and young children. About 7-10 of children exhibit food allergies during their growing years.1 Colic in babies may be caused by sensitivity to a food -a common allergen is the protein in cow's milk. Adults can also develop sensitivity reactions, particularly when the immune system is knocked off-balance by stress, illness, food additives, and poor nutrition. Food allergies are often difficult to identify. Although many diagnostic tests have been tried, none is entirely satisfactory. Elimination of suspected foods from the diet is the most direct and reliable method if one of the eliminated foods was causing the reaction, improvement will occur.1,4,14 Foods must be eliminated for at least 5 days (and often for 2-4 weeks) to allow time for their adverse effects to completely disappear. If improvement occurs, the eliminated foods should be rein- Because a food once caused a sensitivity reaction doesn't mean it...

With Antithrombotic And Antiplatelet Drugs

Replaced ticlopidine in clinical practice owing to a more favorable side effect profile and the fact that it is not associated with neutropenia. At steady state, this drug inhibits platelet aggregation by 40-60 . In patients with recent MI, stroke, or peripheral arterial disease, clopidogrel and aspirin appear to provide similar long-term secondary prevention benefits (31). Thus, clopidogrel is indicated as secondary prevention for patients who have either allergy or intolerance to aspirin. In the Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) trial, the combination of clopidogrel and aspirin was compared with aspirin alone in a population of patients with ACS (32). Compared with aspirin alone, the combination of clopidogrel and aspirin led to a 20 relative reduction in the composite end point of cardiovascular death, MI, and stroke from 11.5 to 9.3 at a mean of 9 mo follow-up (RR 0.80, CI 0.72-0.89, p < 0.00005). The benefit was driven by a reduction in MI (6.7...

Studies in Multiple Sclerosis

A limited number of studies have evaluated the possible role of allergies in MS. No well-designed studies exist to support any specific food or environmental factor as an allergic cause of MS. In addition, no studies have demonstrated that eliminating exposure to a certain presumed allergic agent is beneficial. It is interesting to note that people with MS actually appear to have fewer allergic problems than do those who do not have the disease. Recent information indicates that people with MS have nearly 70 percent fewer allergic symptoms and more than 80 percent fewer positive allergy tests than the general population. This appears to be a result of the underlying immune disorder that occurs in MS. In other studies, it appears that components of the immune system that are involved in allergies may play a role in MS. Specifically, mast cells, allergy-associated immune cells, are present in MS lesions in the central nervous system. In experimental allergic encephalomyelitis (EAE), the...

Additional Readings Journal Articles

Allergy, histamine 1 receptor blockers, and the risk Oro AS, Guarino TJ, Driver R, et al. Regulation of disease susceptibility decreased prevalence of IgE-mediated allergic disease in patients with multiple sclerosis. J Allergy Clin Immunol 1996 97 1402-1408. Robbie-Ryan M, Brown M. The role of mast cells in allergy and autoimmunity. Curr Opin Immunol 2002 14 728-733. Tang L, Benjaponpitak S, DeKruyff RH, et al. Reduced prevalence of allergic disease in patients with multiple sclerosis is associated with enhanced IL-12 production. J Allergy Clin Immunol 1998 102 428-435.

Comprehensive Neurobehavioral Approach

Donna Andrews experienced complex partial seizures (CPS) following acute encephalitis at age 18 years. Medications did not control her seizures and resulted in severe side effects, including the life-threatening allergic reaction Stevens-Johnson syndrome. Through careful observation, she developed techniques that allowed her to completely control her seizures. Donna Andrews met neurologist Joel Reiter in 1979, when she was his student in a course at the Berkeley Biofeedback Institute. After Dr. Reiter discussed his work with epilepsy patients using biofeedback, she challenged him to go further by incorporating the techniques she had developed to control her own CPS. He accepted the challenge and invited her to prove the efficacy of her methods by working in a pilot study directly with six of his patients with uncontrolled CPS (1). This study led to excellent results that have since been repeated with many other patients in the Andrews Reiter Epilepsy Program (2). The Andrews Reiter (A...

Reperfusion Monitoring And Infarct Sizing

Side effects without a high probability of benefit. Furthermore, thromobolytic therapy is not applicable to approx 10-25 STEMI patients, because of contraindications including of age, bleeding diathesis, or drug allergies (34). Guidelines for thrombolytic therapy include ST elevation > 2 mm in contiguous ECG leads, age < 75 yr, bundle branch block with a history suggestive of MI, and presentation < 12 h after the onset of chest pain (34).

New Assignment Vice President of Basic Research

In my new position two Rahway basic research departments in chemistry were to report to me as well as microbiology under Dr Jerome Birnbaum. My immediate assignments were to restore calm among the chemists and to recruit heads of biochemistry and immunology. Dr Eugene H. Cordes, the chair of the chemistry department at Indiana University, Bloomington, IN, and Dr Alan Rosenthal, then a research fellow at the National Institute of Allergy and Infectious Diseases at the NIH, who had clarified the role of the macrophage in immune response, agreed to join Basic Research in Rahway.

UDPglucuronosyltransferases EC 24117

In a few cases, however, UGTs enhance the toxicity of their substrates. This is the case with some nonsteroidal anti-inflammatory drugs (NSAIDs). The resulting ester glucuronides can undergo acyl migration, i.e., the intramolecular transesterification from the C1 hydroxy group of the glucuronic acid to the C2 hydroxy group and further to the C3 and C4 hydroxy groups. This can lead to the formation of a free aldehyde group at C1, which can react with primary amino groups in proteins generating Schiff's bases. Amadori rearrangement can then lead to a stable protein adduct, which may give rise to allergic reactions, a well-known drug toxicity of some NSAIDs. Glucuronic acid conjugation can also result in enhanced genotoxicity. Aromatic amines, including important human carcinogens, are metabolized by CYPs (preferentially CYP1A2) to aromatic hydroxylamines. Glucuronidation of these leads to the formation of a (moderately good) leaving group, which after being cleaved off leaves behind a...

The Two Basic Immunotoxic Action of Chemicals Unwanted Activation

Secondly, chemicals or their metabolites can act by the immune system. This means they interfere with the response mediated by the specific antigen receptors of B and or Tcells. Chemicals may be recognized as antigen and elicit immune responses, or they may directly or indirectly change self antigens and thus break tolerance. It is generally accepted by now that T cells are the major players in xenobiotic-induced autoimmunity and allergy. Chemicals acting by the immune system lead to sensitization and a memory response. Memory lymphocytes can expand and mediate a stronger immune response on second contact with the chemical, even if it occurs long after the first contact. Adverse immune reactions of this type may lead to allergy or autoimmunity.

Targeting Cd52 On Hcl Cells With Alemtuzumab

CD52 is a 12-amino-acid glycoprotein that is present on lymphocytes at up to 450,000 sites cell.48'49 It is also present on monocytes, macrophages, eosinophils, and the male reproductive tract.5051 Quigley et al. at the Scripps Clinic recently reported that in nine cases of classic HCL and one of HCLv, all patients expressed CD52 on 92-100 of the HCL cells.52 Fietz et al. reported recently that a patient with HCL and shortlived or poor responses to cladribine, interferon, splenectomy, and rituximab had hematologic benefit with alemtuzumab.53 The patient tolerated rituximab more poorly than alemtuzumab because of an allergic reaction to the former. With both mAbs, the patient had an improvement in thrombocytopenia, but failed to reverse blood transfusion dependence.

Dental Amalgam Removal

Very small amounts of mercury are released from amalgam in teeth in the form of solid mercury and mercury vapor. It is claimed that the mercury released from amalgam damages the immune system and nervous system and thereby causes MS and other diseases. In addition, it has been proposed that disease is caused by harmful allergic reactions to the mercury or to the electrical currents generated by mercury. The presumed mercury toxicity is termed mercury hypersensitivity, mercury sensitivity, mercury toxicity, and micromercurialism. Electricity generated by mercury is called electrogalvinism or oral galvanism.

Innate Immune Cells

Granulocytes might contribute to tumor destruction through the release of toxic moieties packaged in granules (e.g., cathep-sin G and azurocidin), the generation of reactive oxygen species, and inflammatory cytokine secretion. Experimental tumors engineered to secrete granulocyte-colony stimulating factor were rejected through a pathway requiring neutrophils moreover, this reaction stimulated the generation of adaptive T cell responses that eradicated subsequent tumor challenges (Colombo et al, 1991). Neutrophils were similarly required for the antitumor effects of Her-2 neu-based DNA vaccinations in a transgenic breast cancer model (Curcio et al, 2003). While eosinophils have been intensively studied for their roles in parasite infection and allergy, their local activation through T cell-derived IL-4, IL-5, and IL-13 in the tumor microenvironment may also contribute to tumor destruction through the release of granule components. Whether persistent granulocyte responses in chronic...

Suppressive Effects of CD4CD25 Regulatory T Cells on the Innate Immune Response

Importantly, the regulation of APC function by CD4+CD25+ Tregs might also occur in vivo. It was shown recently that transfer of antigen-pulsed mature DCs into mice that were depleted for CD4+CD25+ Tregs resulted in higher Th1 responses compared to nondepleted mice 88 . A different study by Maloy et al. using a T cell-independent mouse model for intestinal inflammation demonstrated that transfer of CD4+CD25+ Tregs resulted in reduced activation and recruitment of neutrophils, monocytes macrophages, DCs and NK cells, which was partly mediated by IL-10 and TGF-3 89 . Together these data indicate that both the adaptive and the innate immune system are subject to CD4+CD25+ Treg-mediated suppression. The ability of Tregs to inhibit the function of many different cell types helps to explain the observations that CD4+CD25+ Tregs are efficient in suppressing many immune-mediated diseases including autoimmunity 12, 90, 91 , transplant rejection 92 , tumor immunity 93-95 , allergy 96 and...

The Success of Modern Biotechnology

The contribution of biotechnology to medical practice and the pharmaceutical industry can be evaluated by reviewing medical advances and product revenues, as well as looking at pipeline compositions and recent approvals. Biopharmaceuticals are a growing part of research and development pipelines across the pharmaceutical industry, with an ever increasing percentage of discovery stage candidates being described as large molecules. Biologics that have gained regulatory approval over the past 10 years include molecules that offered new approaches to treating a range of diseases, allowing physicians to intervene close to the root cause of the disease rather than alleviating symptoms. Antibodies have been developed for the treatment of infectious disease (Synagis 2004), anemia (Epogen 2005), and allergenic asthma (Xolair 2005), and a number of anticancer antibodies have been added to the options available to oncologists (Walsh 2003a). Additionally,

Immune allergic drug reactions

The same extended DRB1*1501-DQB1*0602 haplotype has been associated with halothane hepatitis in Japan 15 , with liver disease in cystic fibrosis 13 (see below), with primary sclerosing cholangitis, an autoimmune cholestatic liver disease 16 and with a high incidence of allergies, particularly ragweed pollen hypersensitivity 17 . Interestingly, this haplotype may encode resistance to type 1

Differential Diagnosis Drug Induced Bradycardia

High anaphylaxis risk Nonselectives block catechol's ability to reduce mast cell degranulation in patients with atopic allergies. Hypoglycemia All -blockers mask sympathetic response to hypoglycemia and interfere with gluconeogenesis glycogenolysis. Withdrawal Rebound increased heart rate and elevated blood pressure on abrupt withdrawal can precipitate MI and CVA.

CASE 3 Acute Hyperkalemia Case Description

Her past medical history is notable for obesity, recurrent urinary tract infections, and COPD. There was no history of hypertension. Her current medications include albuterol (inhaled), long-acting glipizide, ibuprofen as needed, and trimethaprim sulfamethoxa-zole as prophylaxis for recurrent urinary tract infections. She has no known allergies to any medication. There is a prior history of tobacco use, last noted 20 yr ago. Her family history is notable for diabetes mellitus and hypothyroidism.

Mechanism and Toxicity

Toxicity Gastrointestinal (nausea, vomiting, diarrhea) > allergic manifestations > CNS Allergy 5 manifest penicillin sensitivities local pruritus, asthma 1 develop ana-phylaxis. Treatment O2, epinepherine-nor-epinepherine, P2-agonists, steroids, H1- and H2-blockers, theophylline, fluids. Consider glucagon for severe hypotension. CNS Seizures due to inhibition of GABA-to-receptor binding. Treatment benzodi-azapines > barbiturates.

Inflammation leukocyte activation killing of microbes

In general, CTLs migrate in similar ways as Th1 cells. In contrast, TH2 cells express the chemokine receptors CCR3, CCR4, and CCR8, which recognize che-mokines that are highly expressed at sites of helminth infection or allergic reactions, particularly in mucosal tissues, and so TH2 cells tend to migrate to these tissues. Th17 cells express CCR6, which binds the chemokine CCL20, and migration of TH17 cells into inflammatory sites is dependent on CCR6. CCL20 is produced by various tissue cells and macrophages in many bacterial and fungal infections.

Intestinal mucus secretion and peristalsis

IL-13 works together with IL-4 in producing biologic effects associated with allergic inflammation, discussed in detail in Chapter 19, and in defense against helminths. Some of the actions of IL-13 overlap those of IL-4, and others are distinct. IL-13 functions with IL-4 to induce alternative macrophage activation, which contributes to tissue repair and fibrosis. IL-13 stimulates mucus production by airway epithelial cells, an important component of allergic reactions such as asthma. As mentioned before, both IL-13 and IL-4 can activate B cells to switch to IgE and some IgG isotypes and recruit leukocytes. Unlike IL-4, IL-13 is not involved in TH2 differentiation. Activation of mast cells. Mast cells express high-affinity Fce receptors and may be activated by IgE-coated helminths and other antigens that bind IgE, resulting in degranulation. The granule contents of mast cells include vasoactive amines, and mast cells secrete cytokines such as TNF and chemokines, and lipid mediators,...

Literary Analysis

PHS medical professionals watched the men unnecessarily suffer unbelievable mental and physical pain. For this reason, as the study progressed into the 14th year, lying to her boys became a burden for Evers, especially when their suspicions caused them to demand new doctorin'. In the end, Ben, the oldest, acquiesced to the study's protocol and died, proud that he had earned a government certificate and a proper burial. The superstitious Hodman went mad, drank a magic potion, and died from the poison. Caleb, the most literate, learned about penicillin and was treated in time. Evers took dancing Willie, the youngest, out of a treatment line, convinced by Douglas that penicillin in Willie's late-stage syphilis might set off an allergic reaction or kill off spirochetes, causing his heart to explode. He suffered the crippling effects of the disease. Today, with a known cure available, it would be considered a heinous bioethical injustice not to give study participants the choice to...

Introduction Ocular Anatomy and Diseases

Most information about our surroundings is gathered by the eye, which is literally a 'window' for the brain. With an aging population, the prevalence of sight-threatening ocular diseases continues to increase. Thus, for instance, more than 70 million people suffer from glaucoma worldwide.1-3 Visual impairment caused by diabetes affects up to 90 of diabetics over 10 years of age. Likewise, pathological dry eye and ocular allergic conditions afflict > 100 million patients worldwide, and age-related macular degeneration (AMD) is the leading cause of blindness among the elderly, affecting up to 28 of patients after the seventh decade of life.2 Consequently, the discovery and development of therapeutic products for the treatment of these various ocular diseases is of paramount importance, and is being actively pursued within the pharmaceutical industry.1-3

Physiological Effects Of Glucocortioids

Glucocorticoids inhibit inflammatory and allergic reactions. They do this by stabilizing the lysosomal membranes, inhibiting the release of proteolytic enzymes, and by increasing capillary permeability. This in turn reduces dia-pedesis of leukocytes. Glucocorticoids also reduce the number of circulating lymphocytes, monocytes, eosinophils, and basophils. The decrease in the number of basophils accounts for the fall in blood histamine levels and the reduction of the allergic response. There is also an increase in the number of inflammatory cells (neutrophils) caused by a decrease in the migration from the capillaries and an accelerated release from bone marrow. Glucocorticoids also inhibit the ability of neutrophils to marginate to the vessel wall. In addition, they cause impairment of the lymph nodes, thymus, and spleen that directly leads to decreased antibody formation.

Ocular Surface Diseases

The cornea and conjunctiva are exposed to the environment and are thus susceptible to overexposure to light, radiation, chemicals, and airborne pathogens and allergens. Consequently, ocular surface infections, allergies, dryness, and ulcerations represent the major disorders of the cornea and conjunctiva. While these conditions are not blinding by themselves, they severely limit the quality of life for millions of people.

Treatment of Iron Deficiency

For some patients iron supplements are ineffective. We do not know why some people fail to absorb supplementary iron. These patients may require intravenous iron. The kind of intravenous iron formerly used in the United States, iron dextran, caused death in approximately 0.7 percent of patients due to allergic reactions, making its use very dubious however, iron sucrose, which has been used safely in Europe for decades, is now available here. So is ferric gluconate, another form of intravenous iron.

Regulation of Immunity in the Gastrointestinal Tract by Regulatory T Cells and Cytokines

Oral tolerance is systemic adaptive immune tolerance to antigens that are ingested or otherwise administered orally and is a potential way of treating diseases in which unwanted immune responses occur, such as autoimmunity. Oral tolerance has been most clearly demonstrated in experimental rodent models. Mice fed high doses of a protein antigen may subsequently have impaired humoral and T cell-mediated responses to the same antigen administered by other routes, such as through the skin. A similar phenomenon can be demonstrated when antigens are administered through the nasal passages into the respiratory mucosa, and the more general term mucosal tolerance is used to describe tolerance induced by either oral or nasal antigen administration. The physiologic role of oral tolerance is speculated to be the prevention of potentially harmful immune responses to food proteins and commensal bacteria. The underlying mechanisms of oral tolerance are not well understood but likely include the same...

Side effects of insulin

The most significant adverse effect of insulin therapy is hypoglycemia. This is especially the case for treatment of T1DM, but is also true for T2DM. Insulin allergy and lipoatrophy were commonly seen with the use of animal insulin before 'pure' and biosynthetic preparations became available. Both reactions are now rare, but can be seen, probably because there is some degradation during storage and or with depot injection into tissues that can induce an immune response. Weight gain commonly occurs following improved glycemic control with insulin therapy. In the UKPDS, individuals receiving insulin therapy had an average weight gain of 4.0 kg over the course of the study.81

Studies in MS and Other Conditions

Clinical studies of pets are limited. No large, well-designed studies have been undertaken of pet ownership in people with MS. In other conditions, early studies indicated that pet ownership improved bereavement, lowered the use of medical services, decrease the risk of allergies and asthma in children, decreased the risk of heart disease, and increased survival rates from heart attacks. However, subsequent studies did not support these findings. In children, pet ownership does appear to decrease absenteeism from school.

Chemotherapy Regimens Mopp and MOPP derivatives

Approached 2.5 in the NCI series and 1.5 in smaller studies.47 Hematologic toxicities, although reversible, were sometimes fatal, as hematopoietic growth factor compounds were not available at that time. Vincristine-associated neuropathy was clinically relevant with doses more than 2 mg. Procarbazine was associated with severe emesis, and a type I allergic reaction in rare cases.

Immune Stimulation And Myeloma Chronic infections and eczema

Many medical conditions associated with chronic stimulation of the immune system, such as repeated infections, allergic conditions, or autoimmune disease, have been reported to increase the risk of MM. In a case-control study, past history was abstracted from medical records for leukemia, n 299 non-Hodgkin's lymphoma (NHL), n 100 and MM, n 175 patients, and matched with 787 controls. Prior histories of eczema and musculoskeletal conditions were associated with higher risk for MM with no role identified for chronic antigenic stimulation in the etiology of leukemia or NHL.32 Another case-control study of 100 MM cases in whites showed no associations between MM and history of medical conditions that cause prolonged stimulation of the immune system, like chronic infections, autoimmune disorders, allergy-related disorders, or lymphoid tissue surgery.33

Dietary Treatment of the

The nephrotic syndrome is defined as a very high rate of excretion of protein in the urine (greater than 3.5 g per day), a low level of albumin in the blood (less than 3.5 g per dl), and edema (swelling of soft tissues, such as the ankles, the abdomen, and around the eyes). Most patients with the nephrotic syndrome also show markedly elevated levels of cholesterol and other lipids. This condition is a form of kidney disease distinct from kidney failure. The causes are numerous, including toxic reactions to drugs, allergic reactions to bee stings, various infections, cancer, a huge list of systemic diseases, and various disorders of the heart and blood vessels. For unknown reasons, young children are often affected. Cow's milk protein intolerance is said to cause the nephrotic syndrome. It is hoped that further studies will be done on the effect on the kidney of possible allergy-inducing proteins in food. Sometimes the

Effect of Intestinal Microbiota on the Immune System Preclinical Studies

The same group studied the effects of a specific prebiotic mixture on the effect of allergic reaction in a mouse model using ovalbumin as antigen. The animals were sensitized by 10 g ovalbumin in alum and boosted 7 days later. The allergic reaction was measured before and after inhalation challenge (10 mg ml ovalbumin 20 min duration). The animals were challenged at 21, 24, and 27 days after first sensitization. Parameters used to identify the response to allergen exposure were airway responsiveness, bronchial lavage inflammatory cells, and antibody levels in plasma. Feeding the GOS lcFOS mixture reduced significantly the allergic reaction against ovalbumin as demonstrated by reduction of bronchial constriction after metacholine application, reduction in inflammatory cells in the bronchial lavage fluid, and reduction in the IgE concentration in plasma (72,73).

Other Sedatives and Hypnotics

Despite the continued widespread use of antihistamines to treat insomnia, the Food and Drug Administration (FDA), noting the prominent sedative side effects encountered in the administration of antihistamines (including doxylamine, diphenhydramine, and pyrilamine), concluded that the antihistamines are not consistently effective in the treatment of sleep disorders. Tolerance rapidly develops to the sedating effects of these medicines, and the antihistamines can produce paradoxical stimulation. In addition, the antihistamine doses currently approved for the treatment of allergies are inadequate to induce sleep. Antihistamines used to treat sleep disorders can produce daytime sedation because of their relatively long half-lives (Charney et al., 2001).

Cover Sheet and Problem List

The cover sheet of the online patient chart facilitates quick orientation to a patient by providing a condensed view of relevant clinical information on one screen. Included are active problems, allergies, immunizations, active medications, recent lab results and vital signs, a list of appointments and admissions, crisis notes, warnings, and reminders. Clicking on a cover sheet item provides immediate access to a greater level of detail for that item. For example, clicking on an admission displays the discharge summary for that admission, while clicking on a recent lab test displays the results and reference ranges. Allergies and vital measurements may also be updated from the cover sheet. The components that are displayed on the cover sheet are fully customizable and may be tailored to a specific facility or individual.

Clinical trials targeting the egfr her1

Preliminary safety data have been reported from phase I trials with C225, all in patients with locally advanced or metastatic or recurrent tumors of the upper aerodigestive tract and with detectable EGFR in tumor tissues as measured by immunohistochemistry (35). One published trial investigated the combination of weekly cisplatin in patients with chemorefractory NSCLC or head and neck tumors. In this study, intravenous doses of 200-400 mg m2 wk resulted in steady-state serum concentrations of C225 that would have been predicted to saturate receptors in EGFR-dependent preclinical models and were thus judged to be adequate for phase II efficacy studies. Notably, this optimal biological dose was achieved before any dose-limiting toxicity or before reaching a maximally tolerated dose. C225 clearance did not change with the coadministration of cisplatin. Antibodies against C225 were detected in only 1 of 52 patients, and there was minimal toxicity associated with the antibody alone or the...

Cell Signaling Cascades Soluble And Insoluble Triggers

Bacterial or viral pathogens or abnormal mechanical stress) that have both short- and long-term effects. Furthermore, some signals may initiate a long-term detrimental effect, such as in disease states, cancer pathogenesis, viral or bacterial infection, or genetic disorders that increase the extent of cell death or adherent cell behavior. Other signals may be short term, including synaptic transmission in nerves, transient nitric oxide bursts from endothelial cells, and contractile activation by smooth muscle cells. Such signals may also produce host physiological responses, e.g., eating of a hot pepper causing perspiration due to activation of the vanilloid-1 receptor in peripheral neurons inflammatory responses ranging from activation of eisonophils due to anaphalaxis allergic reaction to antigens such as pollens, pet dander, or other sensitizing chemicals or signals that control cell cycles coinciding with aging and or cell turnover.

Marks Mother Sues Diary Entry July 20 1998

We spent 3 hour with the doctor and nurse today - I thought it would never end My beautiful baby has cancer. I cannot believe it - he has always been so healthy He could die from this disease, he could die from this treatment, and he could lose his leg. His hair will fall out. There is no way he will be playing basketball this fall, and it is all he has ever wanted to do. If only I hadn't kept working when I was pregnant with him - I'll bet it is all the chemicals in the hair color I use every day at the shop. Or maybe it is from the pesticides George uses in his landscaping business. He has always made fun of the organic farmers - how I wish he had paid more attention and tried to do some of that And the drugs they are planning to give him - speaking of poisons One can make him sterile, one will damage his heart, one will ruin his kidneys, one has major allergic reactions, and they all make his hair fall out. And on top of that, they can give him...

Initial Evaluation

RC is a 43-yr-old man who presented without complaints for routine care. His past medical history is notable for seasonal allergic rhinitis and erectile dysfunction but is otherwise unremarkable. He has never smoked and eats a typical Western diet. He has a sedentary job but recently started exercising several days a week. He is concerned that his father died suddenly from an MI at the age of 60 his mother survived a stroke at the age of 68. His medications include fexofenadine as needed for allergies, and sildenafil as needed. He wants to know if he should start taking an aspirin every day.

Current Treatment

The chronic use of immunosuppressants, e.g., azathioprine (3), cyclosporin (4), methotrexate (5), and occasionally mycophenolate mofetil (6) and tacrolimus (7), also requires constant monitoring both for levels of drug and for side effects.40 Thiopurines, such as 6-mercaptopurine and azathioprine, are metabolized to 6-thioguanine, blocking the nucleotide binding site and activity of G-protein Racl and inducing T cell apoptosis. While azathioprine is highly effective at inducing and maintaining disease remission, side effects include allergic reactions, pancreatitis, myelosuppression, nausea, infections, hepatoxicity, and malignancy. Bone marrow suppression is related to levels of 6-thioguanine, and therefore monitoring of complete blood counts at regular intervals is suggested. Of the other most commonly used immunosuppressants, methotrexate also induces myelosuppression and additionally it is associated with hepatoxicity, an increased risk of Epstein-Barr virus (EBV)-lymphoma, and...

Glomerular function Glomerular filtration

The contrast agents iohexol (Krutzen et al. 1984) and isothalamate (Gaspari et al. 1992 Isaka et al. 1992) are eliminated from plasma mainly by glomerular filtration and have an excellent correlation with the plasma clearance of 51Cr-EDTA and inulin (Gaspari et al. 1995). Iohexol is more commonly used as it reportedly has lower allergenic potential. The most accurate estimate of GFR is obtained by sampling up to 600 min after injection, particularly in individuals with GFR < 40 ml min 1.73 m2. However, the disappearance curve is linear after 120 min, so that in individuals with GFR > 40 ml min 1.73 m2, sampling may be limited to only at 120, 150, 180, 210 and 240 min after injection.

Physiologic Environment

At The Institutes, we also recommend a balanced diet consisting of unprocessed food and the elimination of sugar, artificial colors, flavors, and sweeteners. In our experience, many brain-injured children have food allergies, especially to milk and wheat products. Any suspected food allergens are eliminated. In addition, we recommend supplements, including healthy fatty acids, probiotics, multivitamins, and minerals calcium, magnesium, and zinc. Vitamin B6 may also be useful for some children with seizures.

The Nature of Allergens

Antigens that elicit immediate hypersensitivity reactions (allergens) are proteins or chemicals bound to proteins to which the atopic individual is chronically exposed. Typical allergens include proteins in pollen, house dust mites, animal dander, foods, and chemicals like the antibiotic penicillin. It is not known why some antigens induce strong TH2 responses and allergic reactions whereas others do not. Two important characteristics of allergens are that individuals are exposed to them repeatedly and, unlike microbes, they do not generally stimulate the innate immune responses that are associated with macrophage and dendritic cell secretion of TH1- and TH17-inducing cytokines. Chronic or repeated T cell activation in the absence of strong innate immunity may drive CD4+ T cells toward the TH2 pathway, as the T cells themselves make IL-4, the major TH2-inducing cytokine (see Chapter 9). The property of being allergenic may also reside in the chemical nature of the antigen itself....

Properties of Eosinophils

Cytokines produced by TH2 cells promote the activation of eosinophils and their recruitment to late-phase reaction inflammatory sites. IL-5 is a potent eosinophil-activating cytokine, which enhances the ability of eosinophils to release granule contents. IL-5 also increases maturation of eosinophils from bone marrow precursors, and in the absence of this cytokine (e.g., in IL-5 knockout mice), there is a deficiency of eosinophil numbers and functions. Eosinophils are recruited into late-phase reaction sites as well as sites of helminthic infection, and their recruitment is mediated by a combination of adhesion molecule interactions and chemokines. Eosinophils bind to endothelial cells expressing E-selectin and VCAM-1, the ligand for the VLA-4 integrin. IL-4 produced by TH2 cells may enhance expression of adhesion molecules for eosinophils. Eosinophil recruitment and infiltration into tissues also depend on the chemokine eotaxin (CCL11), which is produced by epithelial cells at sites...

The Immediate Reaction

The wheal and flare reaction results from sensitization of dermal mast cells by IgE bound to FceRI, cross-linking of the IgE by the antigen, and activation of mast cells with release of mediators, notably histamine. Histamine binds to histamine receptors on venular endothelial cells the endothelial cells synthesize and release PGI2, nitric oxide, and PAF and these mediators cause vasodilation and vascular leak, as described earlier. Skin mast cells appear to produce only small amounts of long-acting mediators such as leukotrienes, so the wheal and flare response subsides rapidly. Allergists often test patients for allergies to different antigens by examining the ability of these antigens applied in skin patches to elicit wheal and flare reactions.

Allergic Diseases In Humans Pathogenesis And Therapy

Mast cell degranulation is a central component of all allergic diseases, and the clinical and pathologic manifestations of the diseases depend on the tissues in which the mast cell mediators have effects as well as the chronicity of the resulting inflammatory process. Atopic individuals may have one or more manifestations of allergic disease. The most common forms of these diseases are allergic rhinitis (hay fever), bronchial asthma, atopic dermatitis (eczema), and food allergies. The clinical and pathologic features of allergic reactions vary with the anatomic site of the reaction, for several reasons. The point of contact with the allergen determines the organs or tissues that are involved. For example, inhaled antigens cause rhinitis or asthma, ingested antigens often cause vomiting and diarrhea, and injected antigens cause systemic effects on the circulation. The concentration of mast cells in various target organs influences the severity of responses. Mast cells are particularly...

In Silico Prediction of Other Toxicological Endpoints 539341 QT prolongation

Respiratory sensitization is often characterized by episodes of wheezing, coughing, and chest tightness.102 The condition can be severe and sometimes fatal.103 The mechanisms by which chemicals can induce this adverse response are uncertain, but are assumed to be immune mediated with some pharmacological and neurological involvement. Currently there are no accepted, well-validated in vitro or in vivo models for the detection of respiratory sensitizers.85 However, preliminary work by Dearman and co-workers has shown, for a limited number of respiratory sensitizers at least, that these chemicals all elicit a response in the LLNAused for the detection of allergic contact dermatitis.104'105 Therefore, the suggestion can be made that chemicals that do not cause ACD will be unlikely to cause respiratory sensitization. However, there are significant differences between the mechanisms of these adverse effects that mean that not all contact allergens will necessarily be respiratory allergens.85

Immunotherapy for Allergic Diseases

In addition to therapy aimed at the consequences of immediate hypersensitivity, mentioned before, clinical immunologists often try to limit the onset of allergic reactions by treatments aimed at reducing the quantity of IgE produced in the patient. Several empirical protocols have been developed to diminish synthesis of allergen-specific IgE. In one approach, called desensitization, small quantities of antigen are repeatedly administered subcu-taneously. As a result of this treatment, specific IgE levels decrease and IgG titers often rise, perhaps further inhibiting IgE production by neutralizing the antigen and by antibody feedback (see Chapter 11). It is possible that desensitization may work by inducing specific T cell tolerance or by changing the predominant phenotype of antigen-specific T cells from TH2 to TH1 however, there is no clear evidence to support any of these hypotheses. The beneficial effects of desensitization may occur in a matter of hours, much earlier than changes...

Skin Physiology and Textiles Consideration of Basic Interactions

The skin exerts a number of essential protective functions ensuring homeostasis of the whole body. In the present review barrier function of the skin, thermoregulation, antimicrobial defence and the skin-associated immune system are discussed. Barrier function is provided by the dynamic stratum corneum structure composed of lipids and corneocytes. The stratum corneum is a conditio sine qua non for terrestrial life. Impairment of barrier function can be due to injury and inflammatory skin diseases. Textiles, in particular clothing, interact with skin functions in a dynamic pattern. Mechanical properties like roughness of fabric surface are responsible for non-specific skin reactions like wool intolerance or keratosis follicu-laris. Thermoregulation, which is mediated by local blood flow and evaporation of sweat, is an important subject for textile-skin interactions. There are age-, gender- and activity-related differences in thermoregulation of skin that should be considered for the...

Cellular Automata Model of Hypersensitivity

These are the ones which are directly involved in the allergic reactions 52,53 as follows IL-5 is ignored for simplicity, since it is involved in the recruitment and development of eosinophils, which are believed to play a central role during the late-phase allergic reaction 56 but which are not taken into account yet. Indeed, in a further work we will investigate the influence of IL-5 and eosinophils on the problem under study.

Model Validation and Simulation Results

The second set of simulations represents the core of our work. Here we investigate the effect of the allergenic drug dosage and administration schedule on the amount of histamine released by mast cells. Finally, in section 12.5, we briefly discuss the main results and suggest some implications for future drug therapy.

Biodegradables And Biomimetic Coatings 1451 Biodegradable Polymers

Devices obtained from biodegradable materials present great advantages and are the best alternative for the temporary internal fixation of many different kinds of tissue damage for several reasons.139-141 It is widely reported140-142 that during the early stages of tissue healing (bone, tendon, muscle, skin, etc.), the biodegradable implant is capable of holding the healing tissue in place. With the passage of time, the implant decomposes gradually and the stresses are transferred gradually to the healing tissue, avoiding the traditional stress-shielding effects associated with the use of very stiff materials. The other reason is the fact that biodegradable surgical devices do not require a removal operation, which is of substantial benefit, both economically and to the human being involved. In addition, there is the absence of corrosion and fatigue failure and release of metal ions, such as nickel or chromium, which may cause loosening of the implant, patient discomfort, and allergic...

Healthy Subjects Primary and Secondary Immune Response to a Generic Antigen

Immune response in healthy subjects (or IL-4 knockout mice 60 ). Allergenic drug injections are scheduled to be at initiation and in day 40. No histamine is released, because mast cells are not sensitised (not shown) given that no IgEs are secreted (panel (b)). The immune response is of the Th1-type (panel (c)) since IL-4 is absent (panel (a)). Immune response in healthy subjects (or IL-4 knockout mice 60 ). Allergenic drug injections are scheduled to be at initiation and in day 40. No histamine is released, because mast cells are not sensitised (not shown) given that no IgEs are secreted (panel (b)). The immune response is of the Th1-type (panel (c)) since IL-4 is absent (panel (a)).

Parasympathetic Antagonists

Routine mydriasis to allow examination of the fundus is best achieved by tropicamide 0.5 or 1 drops because the effect lasts for only about 3 h. Cyclopentolate 1 (0.5 in babies) can last for 24 h, but because of its cycloplegic effect (blockade of accommodation) is preferable for the examination of children's eyes when refraction is also needed. Dilating the pupil runs the risk of inducing an attack of acute narrow-angle glaucoma in a predisposed individual. Because the vision could remain blurred, driving should be avoided within the first 6-8h after mydriasis. Atropine in drop form is a long-acting mydri-atic, which is used when it is necessary to prevent or break down adhesions between iris and lens in acute iritis (posterior synechiae). It is also used in the treatment of amblyopia in children. Its effect lasts for about seven days. Allergic reactions are quite common and occasionally systemic absorption can cause central nervous system symptoms of atropine toxicity.

Drugs in the Treatment of Openangle Glaucoma

The production of aqueous humour can be reduced by either blockade of the beta-receptors on the ciliary body epithelial cells (i.e., with a beta-blocker) or by agonism of the alpha2-receptors. Brimonidine and apraclonidine are both alpha2-receptor agonists and show good efficacy compared with timolol. A significant number of patients, however, do develop an allergy to these agents and this has limited their widespread use. Acetazolamide was introduced as a diuretic many years ago although not a very good diuretic, it has proved to be a potent ocular hypotensive when given orally. Again because of side effects its use has been restricted to short-term treatment. In 1995, dorzolamide was introduced and more recently, brinzolamide has become available. These are also carbonic anhydrase inhibitors but they are available in drop form and are able to penetrate the cornea. Their ocular hypotensive effects are generally not as great as topical beta-blockers but they are useful as adjuvant...

Hypersensitivity Dependence on Drug Dose

In this section we investigate the relationship between the allergenic drug dose and the amount of histamine released. The parameter setting is the same as in the previous experiments, the only difference being the concentration of allergenic drug in blood and the administration schedule. Panel (a) Histamine release as a function of the sensitising allergenic drug dose for a single administration. Different doses of allergen are administered at time zero. The corresponding histamine release level increases above the allergic threshold of 1 ng mL 61 for an allergenic drug dosing corresponding to the critical concentration of 103ng mL. One hundred independent simulations are averaged standard deviation is shown as error bars. Panel (b) Histamine release following two allergenic drug dosings of different doses. The plot shows the histamine concentration during the secondary immune response as a function of drug dose in the second dosing . Panel (a) Histamine release as a function of the...

Chronic Eosinophilic Leukemia Hypereosinophilic Syndrome

Myeloproliferative hypereosinophilic diseases are defined by a persistent (> 6 months) unexplained eosinophilia greater than 1.5 X 109 L, a hypercellular bone marrow with eosinophilia, and tissue damage. They are discriminated from idiopathic hypere-osinophilic syndrome by the presence of tissue damage, although this may indeed be artificial as tissue damage may be subclinical or occur in the future. While investigating these patients, a reactive cause of eosinophilia such as allergies, parasitic infections, and other malignancies (e.g., on detection of phenotypi-cally abnormal T lymphocytes56) should be assiduously excluded. Eosinophil morphology varies from normal to include abnormalities such as degranulation, cytoplasmic vacuolation, hypolobulation, or hyperlob-ulation. The presence of Chronic eosinophilic leukemia (CEL) is suggested by increased proportion of blasts, hepatosplenomegaly, raised serum tryptase, vitamin B12, and a cytogenetic abnormality. In some patients the...

Scientific Methods in Medical Research

Ideally, the assessment of the safety and efficacy of a CAM for epilepsy should be based on evidence from scientific research. If possible, we want to know the basic as well as the advanced research that has been performed on a CAM that is a natural product, and if possible, we want to know what the active ingredient is and if the active ingredient is always the same. Different batches of the product may not be the same. We also want to know if the product may produce allergic reactions and if any mainstream medication the patient may take will interact with the natural product.

Effect of Intestinal Microbiota on the Immune System Clinical Trials

The study was designed to investigate the possible influence of this prebiotic mixture on the cumulative incidence of atopic dermatitis during the first 6 months of life in formula-fed infants at risk to develop allergy (paternal history of allergy). The study was performed as a prospective, double-blind, randomized, placebo (GOS lcFOS was replaced by maltodextrin in the placebo formula) controlled study. Two hundred fifty nine infants with a family history of atopy were enrolled in the study. Fifty three infants left the trial before completing the study. The main reason for dropping out was the continuation or reestablishment of breastfeeding. One hundred two infants in the prebiotic group and 104 infants in the placebo group completed the study.

Pyrethrum and the Pyrethrins

Pyrethrins poison insects and mammals in a similar manner they interfere with nerve transmission by slowing or preventing the shutting of sodium channels in nerve axons (Bloomquist 1996). The result in insects is hyperactivity and convulsions whole body tremors occur in mammals. The mode of action and resulting symptoms of poisoning are generally similar for pyrethrins and synthetic organochlo-rine insecticides. Although plant-derived pyrethrins are very toxic and fast-acting against insects, they are not very toxic to mammals by oral or dermal routes (Table 4.1), at least in comparison with other insecticides (reviewed by Hayes 1982). When ingested, they are not readily absorbed from the digestive tract, and they are readily hydrolyzed in the acidic conditions of the gut and the liver. As a result, pyrethrins are more toxic to mammals via inhalation than ingestion, because inhalation provides a more direct route to the blood (Hayes 1982). Pyrethrins are highly toxic to mammals when...

Composites In The Biomedical Field

Standard requirements for a polymeric material to be used in the biomedical field include fatigue resistance and resistance to aging in saline aqueous media, biocompatibility, dimensional stability, absence of migrating harmful additives, and the ability to be sterilized by standard methods without significant loss of properties. The biocompatibility requirement includes that the material and its additives should not elicit any toxic, inflammatory, or allergic reaction in the surrounding tissue.27,28 However, when a biodegradable composite is used, new opportunities and challenges need to be faced. It is possible to control the degradation rate, eventually matching the pace of tissue healing. Both the matrix and the reinforcement should be biodegradable and resorbable. Furthermore, it is necessary to ensure that no harmful effect is produced by the degradation residues and metabolites.

Genetic Susceptibility To Immediate Hypersensitivity

The propensity to develop allergies is influenced by the inheritance of several genes. Abnormally high levels of IgE synthesis and associated atopy often run in families. Family studies have shown clear autosomal transmission of atopy, although the full inheritance pattern is multi-genic. Within the same family, the target organ of atopic disease is variable. Thus, hay fever, asthma, and eczema can be present to various degrees in different members of the same kindred. All these individuals, however, will show higher than average plasma IgE levels.

Role Of Mast Cells Basophils And Eosinophils In Immediate Hypersensitivity

Mast cells, basophils, and eosinophils are the effector cells of immediate hypersensitivity reactions and allergic disease. Although each of these cell types has unique characteristics, all three contain cytoplasmic granules whose contents are the major mediators of allergic reactions, and all three cell types produce lipid mediators and cytokines that induce inflammation. TH2 cells also function as effector cells of immediate hypersensitivity their role has been discussed earlier. In this section of the chapter, we discuss the properties and functions of mast cells, basophils, and eosinophils (Table 19-1). Because mast cells are the major cell type responsible for immediate hypersensitivity reactions in tissues, much of our subsequent discussion focuses on mast cells.

Immediate Hypersensitivity Reactions in the Upper Respiratory Tract Gastrointestinal Tract and Skin

Food allergies are immediate hypersensitivity reactions to ingested foods that lead to the release of mediators from intestinal mucosal and submucosal mast cells. Clinical manifestations include enhanced peristalsis, increased fluid secretion from intestinal lining cells, and associated vomiting and diarrhea. Urticaria is often associated with allergic reactions to food, and systemic ana-phylaxis may occasionally ensue. Allergic reactions to many different types of food have been described, but some of the most common are peanuts and shellfish. Individuals may be so sensitive to these allergens that severe systemic reactions can occur in response to minute contaminants of the allergen introduced accidentally during food preparation. Allergic reactions in the skin are manifested as urticaria and eczema. Urticaria, which is essentially an acute wheal and flare reaction induced by mast cell mediators, occurs in response to direct contact with the allergen or after an allergen enters the...

Crotalid Antivenins

Chemistry A polyvalent pit viper IgG antivenin prepared in horses hyperimmunized to venoms of the eastern and western diamondback rattlesnakes (Crotalus spp.) and the tropical fer-de-lance (Bothrops spp.). Mechanism Direct Ag Ab antagonism. Contraindications Horse serum allergy, prior antivenin allergy relative contraindication is a positive skin test. Soon to be replaced by less antigenic polyvalent Crotalid Fab (CroFab ).


At this time, no strong evidence suggests that MS is associated with an allergic response to a specific food or environmental factor. Based on a limited number of studies conducted in this area, there is no reason to believe that allergy-free diets or desensitization procedures are beneficial for patients with MS. Decreasing the activity of specific allergy-related immune processes may be a way to decrease MS disease severity this area is currently being investigated as a novel treatment approach in MS.

Side Effects

Aromatherapy usually is well tolerated, but it is not risk-free. When applied to the skin, some oils may produce a skin rash (this type of allergic reaction may be detected by applying a small amount of oil to the skin and monitoring for a response for 24 hours). Cinnamon or clove oil should not be applied directly to the skin. Basil, fennel, lemon grass, rosemary, and verbena oils may cause skin irritation the use of these oils should be discontinued if skin irritation occurs. Approximately 5 percent of people appear to be allergic to fragrances. Because of possible toxic effects, oil should not be taken internally by mouth or any other method (this is especially true for eucalyptus, hyssop, mugwort, thuja, pennyroyal, sage, and wormwood). Pregnant women probably should avoid aromatherapy because the use of some oils may lead to miscarriage. Odors may provoke headaches in people with migraines and cause breathing difficulties in those with asthma. Some oils (rosemary, fennel, hyssop,...

Muscle Cramps

When cramps occur or as a preventive, for example, at bedtime, often helps. Quinine is far from safe. In substantial dosage, it can cause allergic reactions that deplete elements of the blood, with disastrous consequences. For example, a 64-year-old man recently developed a life-threatening bleeding disorder after taking 2 to 5 large bottles of tonic containing quinine daily for 2 to 3 weeks to ward off muscle cramps.

Other Bee Products

Bee pollen, which is composed of plant pollens, plant nectars, and bee saliva, is sometimes recommended to lessen fatigue, increase strength, and improve many other ailments. It contains a variety of nutrients, but it also may be contaminated with rodent debris, bacteria, insects, and the eggs and feces of insects. Rarely, bee pollen may cause severe allergic reactions, especially in those with pollen allergies. Asthma may worsen after bee pollen use. Isolated reports suggest that liver toxicity may be associated with bee pollen. Pollen could increase the risk of liver toxicity associated with some MS medications, such as interferons and methotrexate. Studies of bee pollen Propolis, a waxlike material also known as bee glue, is collected by bees from buds on poplar and conifer trees and is used to repair cracks in hives. It may be weakly effective in killing a variety of bacteria and viruses. Limited studies have shown both stimulation and suppression of immune system activity....

The Hapten Concept

Low-molecular-weight chemicals (commonly with a molecular mass of less than 1000 Da) are not recognizable by T cells. However, if they are reactive and capable of binding to proteins they may become part of presented peptides (Figure 3) as so-called haptens. In particular electrophilic properties of a chemical will enable it to react with nucleophilic groups of proteins such as the thiol group in cysteins (-SH), amino group of lysine (-NH2) or the hydroxy (-OH) group of tyrosine.22 Known reactive chemicals are isocyanates, quinones, aldehydes, epoxides, beta lactams, and certain nitroaromatics. If a chemical is very reactive, the immune reactions will take place at the site of first contact, e.g., the skin or the lung. Formation of novel antigens recognizable by T cells ('neoantigens') has been shown using the classical hapten trinitrophenol,23 the sensitizing compound of poison ivy, 3-pentadecyl-catechol (urushiol),24 or penicillin.25 Penicillin-induced allergies have been...


The immune system is an organ composed of a large number of very different cell types with very different functions. Cell-cell interactions, mobility, responsiveness to external stimuli, memory, and continuous cell renewal are typical characteristics. Low-molecular-weight chemicals can biochemically interact with proteins produced by immune cells. Covalent or noncovalent binding with proteins can lead to adverse immune reactions affecting the specific, anamnestic responses of B or T cells and lead, depending on the circumstances, to allergy or autoimmunity. On the other hand, low-molecular-weight chemicals can interact with typical immune cell-signaling pathways, resulting in enhanced or repressed immune responses (Figure 4). The underlying mechanisms of both unwanted activation of the adaptive immune response and unwanted shutdown of the immune system in a general way are as diverse as the chemicals and the responsive cells and their targeted proteins. However, increasing knowledge...

Acute toxicity

The major acute toxicity of 2-CdA is myelosuppression. In their long-term follow-up study, investigators at Scripps Clinic noted a 16 incidence of Grade 3 and a 71 incidence of Grade 4 neutropenia in the first 135 consecutive treated patients.5 Ten percent had Grade 3 and 10 had Grade 4 thrombocytopenia. Grade 3 anemia occurred in 20 and Grade 4 in 2 . Forty-two percent developed neutropenic fever, though in only 13 , was an infection documented. Of these, the most common infecting organism was Staphylococcus, usually associated with the indwelling intravenous catheter. Although there were several oral herpetic infections and acute dermatomal herpes reactivations, no fungal infections were found. This high rate of neutropenia with culture negative neutropenic fever was also noted at similar rates in other single-institution series with 2-CdA. Despite the frequency of myelosuppression, additional acute toxicities were uncommon. There were no significant rates of nausea, vomiting,...

Protective Factors

Decreased risks of glioma that have been found in association with past history of allergies 32-34 , autoimmune diseases 32 or certain common viral infections 33, 35 may all indicate a role for immunological factors in the etiology of glioma. These results should be treated with caution, however, as they were based on questionnaires in case-control studies without validation from medical records. Moreover, proxy respondents supplied information on a substantial proportion of cases, usually because the subject was too ill to respond or had died. For allergies, the odds ratios in different studies were inversely correlated with the percentage of proxy respondents, indicating possible bias 36 . Two studies, however, that were not susceptible to recall bias also provide support for an immune-related etiology of glioma. A large cohort study in Sweden, involving record linkage between the population-based Twin Registry, Hospital Discharge Registry, and Cancer Registry, found an inverse...

Yellow fever vaccine

Immediate hypersensitivity reactions with rash, urticaria or asthma occur in less than 1 per million individuals and usually among those with known egg allergy Serious adverse reactions are extremely rare 22 cases of encephalitis have been reported to WHO since 1945, in relation to over 200 million doses of 17D yellow fever vaccine given worldwide. Most of those affected were children under 4 months of age


The relapse rate following IS therapy may be substantial. For ATG CsA, it may be as high as 35 in 7 years.1281 In general, relapse has a good prognosis and survival of relapsed patients is not significantly shortened.81 Patients with falling blood counts can receive a trial of CsA. If unsuccessful in rescuing the counts, a repeated course of ATG should be given. The response rates are likely comparable to those seen in the initial course of ATG. In some instances, rabbit ATG can be used instead of horse ATG, but it is unclear whether this measure helps to avoid more dramatic allergic reactions. High-dose cyclophosphamide (see above) has been suggested to prevent subsequent relapses.


There is no report as of now regarding the expression of CD137 on basophils. CD137 expression on eosinophils could be observed in patients suffering from IgE-mediated allergic responses, but not in normal subjects or those patients suffering from non-IgE-mediated eosinophilic disorders (Heinisch et al., 2001). In both neutrophils and eosinophils, CD137 stimulation promoted apopto-sis in these cells, even in the presence of GM-CSF and or IL-5 survival factors (Heinisch et al., 2000). In this regard, CD137 stimulation may play an important role in regulating granulocyte survival during the initiation and resolution of an inflammatory response. Combined with a report showing CD137 transcript that was frequently found in mast cells, a key type of cells storing and releasing inflammatory mediators for allergy, CD137 may also participate in the control of asthma induced by extrinsic allergens.

GMOs and Health

If the gene being shuffled from one organism to another is not known to be toxic or cause an allergic reaction, the FDA considers it to be substantially equivalent to the foods from which they were derived, that is, GRAS. If a modified crop contains a gene derived from a food that has been shown to cause a toxic or allergic reaction in humans, it must undergo testing prior to being marketed. This method of determining potential hazard worked well in the case of a modified soybean that carried a gene from the Brazil nut. This engineering was done in an effort to increase the protein content of soybeans. Since Brazil nuts were known to cause allergic reactions in some people, the modified beans were tested and did indeed cause an allergic reaction in susceptible people. The product was withdrawn and no one was harmed. Proponents of genetic engineering cite this as an example of the efficacy of the FDA rules. Opponents of genetically modifying foods wonder whether it will always be...

Genes and vaccines

A big advantage of using genetic engineering to produce drugs is that it's possible to mass-produce chemicals that might otherwise be difficult and costly to extract, or simply unavailable by conventional means. Another important advantage is that drugs produced in this way are pure and, if made using human genes, fully compatible with use in people. For example, before engineered bacteria were cloned to manufacture human insulin, the main source of this hormone (used to treat diabetes) was the pancreas of cattle or pigs. Although similar to human insulin, animal insulin is not identical and causes allergic reactions in some patients. The human protein produced by bacteria with recombinant DNA, however, has no such effect. To take another example, vaccines against disease are traditionally prepared from killed or disarmed pathogens (disease-causing microbes). They are effective in the vast majority of people, but a small percentage of the population have allergic reactions to...


Several formulations are commercially available, including immediate release capsules (containing lactose and starch), slow release capsules (psyllium), slow release (OROS), and transdermal. It is recommended to use synthetic (crystalline white) not beef-derived (yellow brown) , to avoid allergic reactions such as serum sickness. The dosing is unknown. Doses range from 0.1 to 2000 mg per day in anecdotal reports. A usual recommended dose is generally in the range of 2 to 5 mg, but no evidence supports this other than common usage. The oral bioavailability of melatonin is 10 to 15 absorption, and metabolism is via the cytochrome P450 (1A2 enzyme) system of the liver. Melatonin enters the brain rapidly the elimination half-life is 30 to 50 minutes. Interactions with AEDs can occur. An acute oral dose of valproic acid suppressed nocturnal melatonin (25). Carbamazepine may decrease melatonin levels (26).


Remarkable in other tissues and cells, as could be exemplified by measuring 5-10 ig mg-1 total protein in kidney tubules and endothelial cells 27-29 . These high cytosolic concentrations enable Cyp18-binding drugs, notably high-affinity cyclosporins, to accumulate in the cell at high intracellular levels where they could translate into potent physiological signals. This is an important determinant of cyclosporin efficacy because cells lacking high levels of cyclophilins, as could be achieved in gene deletion experiments, might become resistant to the drug 30 . Despite the fact that the Cyp18 gene is regarded as a housekeeping gene, the regulated expression of Cyp18 mRNA in rat brain points to stress control 31 . Many larger cyclophilins are subject to stress regulation as well 32-34 . Similarly, pro-teome analyses detected upregulation of Cyp18 in the higher passages of fetal skin cells and downregulation in the fibroblasts of higher aged adults 35,36 . Autoantibodies against...

Using Herbs Wisely

Most herbs are used to treat minor health problems, as opposed to major diseases, such as epilepsy. Therefore, they should not be considered a substitute for prescribed AEDs. Patients using herbs should notify their physician, due to the risk of interactions with medications. Likewise, herbal practitioners should be advised as to the medical history of those who consult them, including allergies and medications being taken. Notably, 40 of patients using CAMs did not report their use to their physicians (20). Patients should also be aware that it is wise to discontinue herbs at least 2 weeks prior to any surgery, because some herbs may cause bleeding irregularities or may interfere with anaesthesia.

Lumbar Puncture

Additionally the injection of local anesthetic initially stretches the skin where all the cutaneous pain receptors are located which again is painful until the anesthetic takes effect. And then there are of course the rare but potentially serious side effects of local anesthetics from wound infection to allergic reactions. If it looks like an easy procedure and the patient has no objections I will use the recommended atraumatic 22 gauge Sprotte needle (this is a pencil-point needle) 17 straight away without local anesthesia. Being a right handed person I now place my left thumb firmly over the superior aspect of the L5 spinous process with the back of the thumb so that it is in continuation with the angle of the spinous process (dependent on the patient in the range of about 30 -60 ).


The mite causes intense itching, which is often worse at night and is aggravated by heat and moisture. The irritation spreads outside the original point of infection resulting from an allergic reaction to mite feces. This irritation may persist for approx 2 weeks after treatment but can be alleviated by antihistamines.

Diet Ulcer

Dietary factors play a central role in ulcer frequency and severity.3,4 High intakes of sugar and refined carbohydrate can contribute to ul-cers.5 Milk, traditionally recommended to reduce acidity, actually produces only a transient rise in pH. This is often followed by a large rebound increase in acid secretion, which can worsen ulcers. Heavy alcohol consumption can cause erosions and ulceration of the stomach lining. Both decaffeinated and regular coffee can aggravate heartburn and ulcers. Food sensitivities (such as allergy to cow's milk) may contribute to ulcer formation identifying and avoiding the offending foods often improves healing and may prevent recurrence.6 Raw cabbage juice contains large amounts of S-methylmethionine and glutamine, two amino acids that can accelerate healing of ulcers.


Side effects in temporal association to the infusion were generally mild reactions like fever, nausea or allergic reactions and could be controlled with premedication. In terms of haematological toxicity, grade 4 neutropenia and thrombopenia occurred but resolved spontaneously during or after the end of treatment.


In patients with stage II III breast cancer with no previous chemotherapy, Glaspy et al.32 showed that the leukapheresis yield was 70 higher for those receiving SCF 10 g kg perday concomitantly with G-CSF than those receiving G-CSF alone. The combination of SCF+G-CSF has also been shown to be effective in patients with breast cancer with previous chemotherapy and those with heavily pretreated lymphoma. Moskowitz et al.33 conducted a phase I II randomized trial of SCF (5, 10, 15, or 20 g kg per day) plus G-CSF 10 g kg per day, or G-CSF 10 g kg per day alone to mobilize PBSC in NHL patients. The combination of SCF+G-CSF was better than G-CSF alone for patients who had received extensive prior therapy. Similar results were reported by Stiff et al.34 in another randomized study using SCF 20 g kg per day plus G-CSF 10 g kg per day versus G-CSF 10 g kg per day in 102 heavily pretreated patients with Hodgkin's disease and NHL. Compared with the G-CSF alone group, the SCF+G-CSF group showed...

And Allergic Disease

A variety of human diseases are caused by immune responses to nonmicrobial environmental antigens that involve Th2 cells, immunoglobulin E (IgE), mast cells, and eosinophils. In these responses, the antigens induce CD4+ Th2 cells, which then help B cells to produce IgE antibodies that are specific for the antigens and bind to Fc receptors on mast cells and basophils. When these cell-associated IgE antibodies are cross-linked by antigen, the cells are activated to rapidly release a variety of mediators. These mediators collectively cause increased vascular permeability, vasodilation, and bronchial and visceral smooth muscle contraction. This reaction is called immediate hypersensitivity because it begins rapidly, within minutes of antigen challenge (immediate), and has major pathologic consequences (hypersensitivity). Following the immediate response, there is a more slowly developing inflammatory component called the late-phase reaction characterized by the accumulation of...

Lipid Mediators

Mast cell activation results in the rapid de novo synthesis and release of lipid-derived mediators that have a variety of effects on blood vessels, bronchial smooth muscle, and leukocytes. The most important of these mediators are derived from arachidonic acid, which is generated by PLA2-mediated hydrolysis of membrane phospholipids, as discussed earlier. Arachidonic acid is then metabolized by either the cyclooxygenase or lipoxygenase pathways to produce mediators of allergic reactions.


Mast cells (and basophils) produce many different cytokines that contribute to allergic inflammation (the late-phase reaction). These cytokines include TNF, IL-1, IL-4, IL-5, IL-6, IL-13, CCL3, CCL4, and various colony-stimulating factors such as IL-3 and granulocyte-monocyte colony-stimulating factor (GM-CSF). As mentioned before, mast cell activation induces transcription and synthesis of these cytokines, but preformed TNF may also be stored in granules and rapidly released on FceRI cross-linking. TH2 cells that are recruited into the sites of allergic reactions also produce some of these cytokines. The cytokines that are released from activated mast cells, basophils, and TH2 cells are mainly responsible for the inflammation associated with late-phase reaction. TNF activates endothelial expression of adhesion molecules and together with chemokines accounts for neutrophil and monocyte infiltrates (see Chapter 3). In addition to allergic inflammation, mast cell cytokines also...

Protecting consumers

People with food allergies are particularly concerned over transgenic foods, since a chemical to which they react badly may be transferred by genetic engineering to a food in which it was previously absent. For example, some people have an inherited metabolic deficiency named favism, which causes them to react adversely to the seed protein lectin, found in legumes such as beans. These people avoid eating beans. Lectin, however, deters aphids from feeding on legumes, and the gene for making lectin has recently been engineered into potatoes as a pest defense strategy. The risk is that individuals with favism may unknowingly eat these transgenic potatoes and suffer as a result. Accurate labeling is their only defense against such a possibility.


Most chemotherapeutic agents have proven to induce hypersensitivity. All four types of allergic reactions have been reported in literature, but type I, or IgE-mediated (see below) is the most common one 1 . In the clinical practice these complications are usually overcome by means of either suitable premedication with antiallergic agents, or by postponing drug administration. Nevertheless, the risk of a severe anaphylactic reaction is a major concern, severity strongly depending on the drug dose and the dosing interval between successive injections 2 . There are many reasons why modelling allergies is an intricate task. The first and most important of these is that allergic diseases, whose origins have yet to be fully uncovered 13 , arise because of a malfunctioning of the immune system, which is known to be among the most complicated natural systems. Moreover, modelling allergies has to embrace different levels of biological organisation, going from the gene level (allergies are...


The term atopic refers to people suffering certain form of allergy. For reasons that are not yet understood, these people have a predisposition to respond to some environmental antigens (e.g., pollen, mold spores) by producing antibodies of the IgE class (immunoglobulin of class E). Since this trait tends to run in families, it probably has a genetic component. It is estimated that over 30 of the world population is atopic. Moreover, the number of people suffering from atopic diseases is increasing in the industrialised countries, revealing a link between modern life and atopy 2 . In the case of allergy induced during the administration of anti-cancer drugs, the patient develops the same type of hypersensitivity to one or more components of the anti-cancer agents, usually during the first or the second cycle of chemotherapy. Among the known cytotoxic anti-cancer drugs inducing an IgE-mediated reactions we recall cyclophosphamide 17 , peplomycin 18 , hyaluronidase 19 , and pacli-taxel...

Vinca Alkaloids

Toxicity Toxicities of the two agents are similar. The dose-limiting toxicity for both is myelosuppres-sion, which mainly manifests as leukopenia. Thrombocytopenia occurs less often and is usually not as severe.5 Reversible alopecia, mild nausea and vomiting, and stomatitis are common. Allergic reactions including anaphylaxis have been observed. These are more common with tenioposide, which is less-water soluble than etoposide. Hepatotoxicity has been reported in up to 3 of patients receiving etoposide, consisting of hyperbilirubinemia, ascites, and transaminase elevations. Secondary leukemias, including AML and APL, have been reported. Toxicity in general is enhanced in patients with low serum albumin levels because of the decreased binding of the drug and increased free levels.19 Toxicity While toxicity to the bone marrow is minimal, L-asparaginase and related compounds are associated with a variety of adverse effects. Hypersensitivity reactions, including anaphylaxis, can occur...


Although it is clear that naturally occurring CD4+CD25+ Tr cells arise in the thymus, the cells, signals, and Ags that stimulate their development are poorly characterized. In humans, CD4+ CD25+ Tr cells are present in the thymus, particularly in the perivascular areas of fibrous septa 5 , and these cells share many phenotypic and functional similarities with their peripheral counterparts. Moreover, patients with thymic hypoplasia (DiGeorge syndrome) have low numbers of peripheral CD4+CD25+ Tr cells, supporting the concept that they are thymically derived 94 . Whether or not CD4+CD25+ Tr cells exclusively recognize self-Ags, or posses a repertoire broad enough to include foreign Ags, remains unclear. Analysis of V gene region diversity in human cell populations does not reveal any significant differences between that CD4+CD25+ Tr cells and nonsuppressive controls 51, 96 , suggesting the Tr cells do not recognize a specialized subset of Ags. A definitive answer to this question is...

Protein Antagonists

In many cases, we have been able to engineer antagonists out of cytokines with relatively small changes to the primary sequence. The chemokine RANTES, for example, can be turned into an antagonist by the addition of an amino acid at the amino terminus (Proudfoot et al. 1996). Chemical modification of the amino terminus led to a molecule that was highly potent in blocking HIV infection (AOP)-RANTES (Simmons et al. 1997). Amongst the four helix bundle cytokines, early work on IL-4 produced an antagonist R121D, Y124D (Pitra-kinra) - which was taken into clinical development for allergy by Bayer (Tony et al. 1994). Work on another four helix bundle, IL-5, cytokine showed that potent antagonism is achieved by a single amino acid change E12 K (McKinnon et al. 1997). We can expect that examples of such antagonists based on other four helix bundle cytokines may enter clinical trials in the near future.