Shunsaku Oshima

Allergy to insects in Japan: III. High frequency of IgE antibody responses to insects (moth, butterfly, caddis fly, and chironomid) in patients with bronchial asthma and immunochemical quantitation of the insect-related airborne particles smaller than 10 μm in diameter☆

After recognizing that moth, butterfly, caddis fly, and chironomid were the insects predominantly found in our environment, reaginic sensitivities to these insects in patients with asthma were investigated with extracts of silkworm wing for the detection of moth and/or butterfly allergy, caddis fly wing for caddis fly allergy, and chironomid whole body for chironomid allergy. At least 50% of 56 randomly selected patients with asthma had positive intracutaneous reactions to these insect extracts, and at least 80% of the skin reaction positive patients had specific IgE antibodies. An immunochemical assay of these insect-related aeroallergens in the dust collected 18.6 m above ground revealed the presence in the air of insect-related particles less than 10 microns in diameter with two peaks a year, one in the spring (silkworm wing, 3.18 ng protein equivalent to that of the crude extract per cubic meter of air; caddis fly wing, 3.08 ng/m3; and chironomid whole body, 5.21 ng/m3) and one in the autumn (silkworm wing, 8.24 ng/m3; caddis fly wing, 4.74 ng/m3; and chironomid whole body, 18.19 ng/m3). Although we have no idea whether or not such peak values are enough to cause asthmatic symptoms, seasonal fluctuations of specific IgE antibodies to these insects appeared to be similar to those of atmospheric insect allergens measured by this method. These findings suggest that insects are widespread and common inhalant allergens.

Allergy to insects in Japan: I. The reaginic sensitivity to moth and butterfly in patients with bronchial asthma

A high frequency of reaginic sensitivity to moth and butterfly extracts was shown in 66 randomly selected patients with bronchial asthma. Thirty-seven (56.1%) of these 66 patients showed positive intradermal reactions to 1:10,000 dilution of moth allergen and 34 patients (51.5%) had positive reactions to 1:10,000 butterfly allergen. These positive responses were as frequent as those to Candida or house dust which are recognized as the most commonly reactive allergens in Japan. Radioallergosorbent tests (RAST) showed that 20 of 66 sera were positive to moth and 22 sera were positive to butterfly, which indicates that about 1/3 of patients with bronchial asthma had specific IgE to moth and butterfly in the sera. Bronchial testing revealed that skin reaction-positive and RAST-positive patients were commonly provoked by specific allergen but skin reaction-negative and RAST-negative patients were not. These data suggest that moth and butterfly emanations could cause allergy-induced bronchial asthma in certain patients. Since moths are attracted readily to artificial lights and often fly into houses, these insects are especially suspect as important factors in extrinsic asthma.

Allergy to insects in Japan. II. The reaginic sensitivity to silkworm moth in patients with bronchial asthma.

Abstract The reaginic sensitivity to extract of silkworm moth wing (silkworm wing) and to that of silkworm moth body (silkworm body) was studied in 50 randomly selected asthmatic patients. Although none of the patients had occupational exposure to silkworm moth, 34 (68.0%) of these patients showed positive reaction to silkworm wing while 28 (56.0%) patients reacted positively to silkworm body following intracutaneous injection(s). Radioallergosorbent tests (RASTs) showed that 22 (44.0%) of 50 sera were positive to silkworm wing and 11 (22.0%) sera were positive to silkworm body, with less uptake of 125 I-labeled anti-immunoglobulin E in silkworm body than in silkworm wing RASTs. This suggests that wing components are more common sensitizers than body components. A fairly high percentage of these 50 patients also showed reaginic sensitivity to the extracts of butterfly, moth, and mite. That is, 26 (52%), 22 (44%), and 32 (64%) of these 50 patients had butterfly-, moth-, and mite-specific IgE antibodies in their sera, respectively. The seasonal variations of silkworm wing-, butterfly-, moth-, and mite-specific IgE antibodies and mutual RAST inhibition tests revealed that IgE antibodies to silkworm wing, butterfly, and moth were identical but all differed from the antibody to mite. These data suggest that the extract of silkworm wing is useful for the detection of allergy to moth and butterfly and also provides a suitable allergen source of unlimited quantity and consistent quality. It was also shown that the allergy to Lepidoptera (moths and butterflies) in Japan is found as commonly as that to mite, but without cross-reactivity between them.

Stratified Impairment of Pulmonary Ventilation in “diffuse Panbronchiolitis: “ Pet and Ct Studies

Positron emission tomography with radioactive nitrogen gas as well as CT were performed in seven patients with diffuse panbronchiolitis (DPB) to evaluate regional changes on pulmonary ventilation and lung attenuation values. Special focus of this study was on the difference between the central and peripheral parts of the lung. Mean ventilatory time constants measured in the peripheral parts of the lung were significantly greater than those in the central parts. Moreover, mean CT attenuation values in the peripheral parts were also significantly lower than those in the central parts, indicating that hyperinflation of the lung in DPB was located mainly in the peripheral parts. Such stratified distribution of ventilatory impairment is considered to be characteristic of diffuse bronchiolar narrowing because, in the peripheral parts of the lung, there are no large airways. In addition, different branching patterns of airways between the central and peripheral parts of the lung may play an important role in the mechanism of selective injury of bronchioles in the peripheral parts.