Ben Z. Rappaport

Quantitative studies in skin testing II. The form of the dose-response curve utilizing a quantitative response☆☆☆

Abstract 1.1. The relationship between the strength of ragweed extract injected endermally and the longest diameter of the resultant wheals has been investigated quantitatively. This relationship can be expressed by an empirical equation y=ax b , where y=the average longest diameter of the wheal., x=the of ragweed extract injected, and a and b are constants evaluated from the data of the experiment. This equation does not hold below an average wheal diameter of 4 mm. and is not known to hold above an average wheal diameter of 17 millimeters. 2.2. The possible use of this.equation for the assay of allergens has been indicated The nonlinear character of this relationship and the consequences for the interpretation of skin tests have been stressed. 3.3. The error of measurement and the variation of response was found to be, within limits, independent of concentration. 4.4. In confirmation of previous work it was found that there is a decrease in responsiveness to the injected allergen as one descends the forearm. The decrease in sensitivity varies directly with the distance down the forearm, with the rate of decrease independent of concentration in the range of concentrations studied. The decrease between the uppermost and lowermost sites tested on the forearm is equivalent to approximately a 55 per cent decrease in strength of testing solution.The radial side of the arm was found to be less sensitive than the ulnar side, equivalent to approximately a 50 per cent decrease in strength of testing solution.

The treatment of hay fever and asthma with viosterol of high potency

Abstract 1.1. A study has been made of 212 patients suffering from seasonal hay fever and asthma. Of these, 68 were treated with viosterol 10,000X and 144 were treated with viosterol and pollen injections. 2.2. Of the first group, 82.4 per cent experienced definite significant relief; 96.5 per cent of the second group had comparable degrees of relief. Thus 92 per cent of the entire series were definitely and significantly relieved. 3.3. The combined treatment of viosterol and pollen injections is more effective than either one alone. 4.4. The nature of the protective action of viosterol is undetermined, but is under further investigation. It does not seem to be related to the calcium mobilizing power of viosterol. 5.5. The optimum dose of 10,000X viosterol along with pollen injection for pollen sensitivity is between 2 and 10 drops daily, varying with the susceptibility of the individual rather than with the severity of the symptoms.

Acth in ragweed pollinosis: A histologic, immunologic, and clinical study☆☆☆

Abstract 1.1. Nine of 26 ragweed-sensitive patients who received 60 mg. ACTH daily for 4 days showed clinical improvement. 2.2. None of the 8 patients who received placebo injections were improved. 3.3. Neither the reagin titer nor skin sensitivity to ragweed pollen were altered by treatment with ACTH for the indicated period. 4.4. Suggestive evidence was found that there is a correlation between the degree of skin sensitivity, the peripheral eosinophilia, and the tissue eosinophilia. 5.5. No change in histologic characteristics attributable to the use of ACTH could be demonstrated. Edema and eosinophils in various stages of disintegration were found in pretreatment, posttreatment, and control biopsies.

Studies on the Chemistry and Immunology of Ragweed Pollen Proteins

Summary The protein of ragweed pollen has been separated into fractions. The one fraction has relatively large molecular size and is responsible for the precipitin reaction with pollen antiserum. The other fraction is made up of proteins of relatively small molecular size and is the skin reactive protein of pollen. This last observation is similar to that of Benjamins and his collaborators, 1 who in their work on grass pollen, came to the conclusion that the skin reacting substance is of small molecular size. Our results differ from those obtained by Harley. 2 He concludes that in timothy pollen the skin reactive fraction consists of proteins of the albumin type. We failed to produce hyposensitization of ragweed sensitive patients by the use of the fraction containing small protein molecules. There is an indication that it may be possible to do so when it is used in connection with large protein molecules. Benjamins and his collaborators found that the skin reactivity of the small protein molecule from grass pollen could be enhanced by the addition of protein of large molecular size. The immunizing properties of the fraction consisting of the larger protein molecules are now being studied.

Quantitative studies in skin testing: IV. The volume-response relationship

Abstract 1.1. A syringe has been described which has served for the accurate endermal administration of small volumes of fluid. 2.2. A method for obtaining accurate outlines of wheal areas has been described. 3.3. The relationship between average maximum wheal diameters and wheal areas has been quantitatively studied. The importance of the volume injected of an allergen has been quantitatively evaluated and the necessity for its control stressed.

A multiple scarifier for allergic tests

Abstract A description is given of a scarifier producing six incisions simultaneously of practically uniform length and depth and with a minimum degree of pain and skin trauma.

A study of blood constituents in pollinosis with and without treatment

Abstract 1.1. Since it has been shown that allergic symptoms which develop in pollinosis are not due to changes in the blood calcium or potassium, it is not surprising that the protective action of vitamin D is not correlated in any way with changes in these or any other constituents of the blood. 2.2. The nature of the protective action of vitamin D in pollinosis cannot be determined from data available at present. 3.3. Vitamin D in doses large enough to protect against pollen allergy should not be administered to patients with any pathologic condition of the kidney. 4.4. The protective action of vitamin D either alone or in combination with pollen hyposensitization is not apparent in doses less than 4,000 units per kilogram of body weight in any large number of subjects. 5.5. The combination of vitamin D and pollen hyposensitization gave measurable protection against the symptoms of allergy in pollinosis in about 90 per cent of all subjects. Complete relief was apparent in approximately 6 per cent of all subjects so treated in the three seasons.

Use of Optical Density of Fluorescent Conjugates for Analysis of Co-Precipitating Antibody.∗

Summary The O.D. of fluorescein isothiocyanate permits determination of quantity of protein derived from a conjugated precipitin serum when this is added to an unconjugated precipitin serum. This permits one to distinguish in a specific precipitate the antibodies of the 2 sera. This finding could have practical application in co-precipitation technics.

Tulip bulb dermatitis

Abstract A case of tulip bulb dermatitis of the hands is described. The toxic reacting substance was present in the ether soluble fraction of the plant and absent from the albumin and globulin fractions.

The vial syringe technic for intracutaneous tests

Summary A vial syringe technic is described for intracutaneous tests which eliminates the separate use of containers and tuberculin syringes. The advantages which it offers are: 1. Compactness, rendering transportation easy for hospital use; 2. Time saving, since it eliminates the repeated washings of tuberculin syringes; 3. Economy, in the avoidance of tuberculin syringes and in the more efficient use of testing materials.