allergy
Contact allergy to gold is correlated to dental gold.

Ahlgren C, Ahnlide I, Bjorkner B, Bruze M, Liedholm R, Moller H, Nilner K.

Department of Prosthetic Dentistry, Faculty of Odontology, Malmo University, Sweden. Camilla.Ahlgren od.mah.se

Questionnaire studies have indicated that patients with dental gold will more frequently have contact allergy to gold. This study aimed at investigating the relationship between contact allergy to gold and the presence and amount of dental gold alloys. A total of 102 patients were referred for patch testing because of suspicion of contact allergy. Patch tests were performed with gold sodium thiosulphate 2% and 5%. The patients underwent an oral clinical and radiological examination. Contact allergy to gold was recorded in 30.4% of the patients, and of these 74.2% had dental gold (p=0.009). A significant correlation was found between the amount of gold surfaces and contact allergy to gold (p=0.008), but there was no statistical relationship to oral lesions. It is concluded that there is a positive relationship between contact allergy to gold and presence and amount of dental gold alloys.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12013197&dopt=Abstract allergy medicine



allergy
[Expression of interleukin-4, interferon-gamma and lymphocyte surface markers in small intestinal mucosa of adult patients with cereal allergy]

[Article in Hungarian]

Veres G, Helin T, Kantele A, Farkkila M, Suomalainen H, Savilahti E, Arato A.

Altalanos Orvostudomanyi Kar, I. sz. Gyermekklinika, Semmelweis Egyetem, Budapest.

INTRODUCTION: The mechanism for adverse reactions to foods in the gastrointestinal tract are poorly understood. Previous studies of other atopic diseases and animal models suggest that lymphocytes and cytokines may be implicated in the pathogenesis of food allergy. AIM: The authors investigated the expression of interleukin-4, interferon-gamma and other lymphocyte markers of patients with cereal allergy (wheat, rye, oats) and of controls. PATIENTS/METHOD: Expressions of cytokines and lymphocyte markers on duodenal mucosa of nine patients (mean age 38.3 years, range 18-50 years, 8 women and one man) and nine controls (mean age 36 years, range 24-54 years, 6 women, 3 men) by means of immunohistochemistry were investigated. RESULTS: The mucosal structure on every biopsy specimens was normal. Despite the normal structure the expression of Ki-67 intranuclear proliferation marker was higher in patients with cereal allergy. Expression of interleukin-4 was markedly elevated in the food allergy group, however, interferon-gamma density showed no inter-group difference. The densities of CD4 (1251 vs. 1053 cells/mm2) and HLA-DR positive cells (1227 vs. 1064 cells/mm2) in the lamina propria of cereal allergy group were significantly elevated when compared with controls (P = 0.05 and P = 0.04, respectively). The densities of CD3, CD8, TCR alpha/beta and gamma/delta, HLA-DP, IgA, IgA1, IgA2-containing cells did not differ in the two groups studied. CONCLUSIONS: The authors results suggest that, despite the normal mucosal structure, the increased expression of CD4 and HLA-DR positive cells show a sign of inflammation in duodenal biopsies of patients with cereal allergy. Moreover, increased density of IL-4 may suggest its role in the pathogenesis of cereal hypersensitivity.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12013687&dopt=Abstract allergy medicine



allergy
The epidemiology of food allergy.

Bjorksten B.

Centre for Allergy Research Karolinska Institutet, Stockholm, Sweden. bengt.bjorksten admin.ki.se

In contrast to respiratory allergies, the epidemiology of food allergy has been little studied, and there is no strong evidence for an increasing incidence, either among infants and children or in adults. Neither are there any studies showing regional differences in prevalence. On the contrary, studies in Estonia, Iceland and Sweden indicate a similar prevalence during the first 2 years of life, both in verified food allergy and reported food intolerance. This is despite a low prevalence of respiratory allergies in the two former countries and a high prevalence in Sweden. The major problem with such epidemiological studies lies in the fact that there are no simple diagnostic criteria to verify the diagnosis. So far IgE determinations have been the only available diagnostic test, and their value is limited by poor sensitivity and the fact that at best they would only verify a small proportion of food intolerance, i.e. that caused by IgE-mediated reactions. A diagnosis of food allergy/intolerance must be based on a double-blind placebo-controlled food challenge, and not on the patient's or doctor's impression. More studies are required from different regions in order to identify similarities and differences in the patterns of food allergy. In particular, there is a need for properly conducted epidemiological studies in adults. Such studies should be interdisciplinary, as the cultural and social perceptions of food allergy and food intolerance would be expected to have a major impact on prevalence, perhaps even more than medical factors.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11964693&dopt=Abstract allergy medicine



allergy
Association between allergy and anxiety disorders in youth.

Kovalenko PA, Hoven CW, Wu P, Wicks J, Mandell DJ, Tiet Q.

Virginia Institute for Psychiatric and Behavioural Genetics, Virginia Commonwealth University, Richmond 23298-0126, USA. kovalenp yahoo.com

OBJECTIVE: Studies have documented associations between anxiety disorders and allergy in adults, but these associations have not been studied extensively in children. The objective of this study is to examine the associations between allergy and six anxiety disorders (AD) in youth. METHOD: This is a data analysis of two epidemiologic-services studies: (i) alternative service use patterns of youth with serious emotional disturbance (n = 936), and (ii) methods for the epidemiology of child and adolescent mental disorders (n = 1285). Child psychiatric diagnoses were measured by the diagnostic interview schedule for children. Allergy was assessed by the service utilization and risk factors interview. RESULTS: Among ADs, the strongest association found was between allergy and panic disorder (adjusted odds ratio 5.0; p < or = 0.001). Associations of allergy and the other ADs do not seem to be clinically significant. CONCLUSIONS: Findings suggest that in some patients panic disorder may be associated with hypersensitivity of immune system. Panic disorder should be considered in anxious children reporting allergy when no organic cause of allergy is found, and likewise allergy should considered in children with panic disorder.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11990892&dopt=Abstract allergy medicine



allergy
NHS allergy services in the UK: proposals to improve allergy care.

Ewan PW, Durham SR.

Immunology Clinic, Addenbrooke's Hospital, Cambridge. pamela.ewan addenbrookes.nhs.uk

Allergy is common and its prevalence has increased substantially in the last 2-3 decades. There has been a particular increase in severe allergic disease, including anaphylaxis and food, drug and latex rubber allergy. Provision of allergy services in the NHS is poor and there is a huge unmet need. Allergy is a full specialty, but there are few consultants and few trainees: only six centres in the UK offer a full-time specialist service. Most allergy services are provided by doctors--general practitioners and consultants in other specialties--with little or no training in allergy. Whilst specialists in other areas of medicine have a role in the management of allergy, it is no longer adequate to devolve most allergy care to them. The lack of special care leads to morbidity, mortality and substantial cost to the NHS, much of it avoidable. To ensure that adequate standards of care are satisfactory, allergy care must be led by allergy specialists. More consultant posts and training posts in allergy are urgently needed; this requires recognition by trust managers, regional commissioners and the Department of Health. As a first step, we propose the setting up of appropriately staffed regional allergy centres. This could be achieved with a central directive and (relatively minor) pump-priming of funding.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11991093&dopt=Abstract allergy medicine



allergy
Nut allergy in schoolchildren: a survey of schools in the Severn NHS Trust.

Watura JC.

Community Child Health, Severn NHS Trust, Rikenel, Montpellier, Gloucester GL1 1LY, UK. jill_watura blueyonder.co.uk

AIMS: To assess the extent of the problem of nut allergy in schoolchildren within the Severn NHS Trust. To determine how well informed schools are about the condition, their policies and attitudes, and the action that would be taken in the event of an acute reaction. METHODS: A questionnaire addressed to the head teacher was sent to 100 randomly selected mainstream schools in the Severn NHS Trust. RESULTS: Response rate was 83%. There were a total of 21 868 pupils in the schools. Forty five (54%) schools had at least one child currently known to be allergic. The total in all the schools was 87 (0.4%). Only 31 (36%) children had medication available in school. Of these, 18 (58%) had EpiPen alone. Twenty schools (44%) with an allergic child either had no staff trained to administer medication or did not respond to the question. Two (4%) schools with an allergic child had a support assistant for the pupils. Only 19 (43%) schools with a nut allergic child gave information to all teachers about nut allergy and only 21 (47%) gave information to dinner supervisors and other assistants. In only 23 (51%) schools with an allergic child were the cook and catering staff aware of all the children with a nut allergy. Ten (22%) schools with an allergic child served only "nut free dinners". Fourteen (31%) schools with a nut allergic child could not name a single sign of a mild acute allergic reaction (compared to 34 (89%) schools without an allergic child). Fifteen (33%) schools with an allergic child could not state a single sign of a severe acute allergic reaction (compared with 33 (87%) schools without a nut allergic child). CONCLUSION: Schools are not sufficiently well informed about nut allergy and management of acute allergic reactions. Policies and attitudes vary. We have revised the information given to schools regarding nut allergy and prepared a new information pack.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11919094&dopt=Abstract allergy medicine



allergy
Lack of penicillin resensitization in patients with a history of penicillin allergy after receiving repeated penicillin courses.

Solensky R, Earl HS, Gruchalla RS.

The Corvallis Clinic, 3680 NW Samaritan Dr, Corvallis, OR 97330, USA. rtsolen prodigy.net

BACKGROUND: Up to 10% of the population reports an allergy to penicillin, yet more than 80% of these individuals lack penicillin-specific IgE antibodies. A negative result on a penicillin skin test is highly accurate in identifying who can safely receive the antibiotic at the time of testing. However, its negative predictive value for future courses is unknown because it is uncertain whether patients with a history of penicillin allergy are at risk of becoming resensitized. OBJECTIVE: To determine the rate of penicillin resensitization in adult patients with a history of penicillin allergy after they are challenged with repeated courses of oral penicillin. METHODS: Adult patients with a history of penicillin allergy consistent with an IgE-mediated mechanism were recruited and underwent penicillin skin testing. Those with negative skin test results were challenged with 3 successive 10-day courses of penicillin V potassium (250 mg by mouth 3 times a day), providing their penicillin skin test results remained negative prior to each course. Patients with positive skin test results were not challenged. RESULTS: Of 53 patients with initially negative skin test results, 46 completed the protocol, and each tolerated all 3 courses of penicillin with negative skin test results throughout. No patients had a converted skin test result from negative to a positive, yielding a resensitization rate of 0% (upper 95% confidence interval, 2.1%). CONCLUSIONS: Adult patients with a history of penicillin allergy are not at increased risk of resensitization after receiving 3 courses of oral penicillin. Because a negative penicillin skin test result is predictive for subsequent oral administrations beyond the time of testing, adult patients with a history of penicillin allergy can be skin tested electively, which may avoid unnecessary treatment with alternate broad-spectrum antibiotics.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11926858&dopt=Abstract allergy medicine