Toyota Ishii

Comparison of recombinant timothy grass pollen allergens with natural extract for diagnosis of grass pollen allergy in different populations

BACKGROUND Complementary DNAs coding for the major timothy grass pollen (Phleum pratense) allergens Phl p 1, Phl p 2, and Phl p 5 and birch profilin were isolated, expressed as recombinant nonfusion proteins in Escherichia coli, and purified. OBJECTIVE In this study the in vitro IgE-binding capacity of recombinant Phl p 1, Phl p 2, Phl p 5, and birch profilin and their IgE recognition frequencies were investigated by using sera from different populations. METHODS One hundred eighty-three sera from patients allergic to grass pollen were obtained from different populations in Europe, Japan, and Canada. The sera were selected according to clinical criteria, skin testing, and RAST (CAP system; Pharmacia, Uppsala, Sweden) and then tested for IgE reactivity with natural and purified recombinant timothy grass pollen allergens by ELISA and Western blot. RESULTS Most (94.5%) of the patients allergic to grass pollen could be diagnosed with a combination of recombinant Phl p 1, Phl p 2, Phl p 5, and profilin by means of ELISA. Sera that did not react with the recombinant allergens contained low levels of timothy grass pollen-specific IgE. Although considerable variability in IgE recognition frequency of the recombinant allergens was observed in certain populations, a good correlation was found between natural timothy CAP results and the combination of recombinant allergens in all 183 tested sera (r = 0.87). CONCLUSIONS Despite considerable variability in the IgE recognition frequency, purified recombinant timothy grass pollen allergens (Phl p 1, Phl p 2, Phl p 5) and profilin permitted successful in vitro diagnosis of grass pollen allergy in 94.5% of allergic individuals from different populations. The addition of other recombinant allergens (e.g., recombinant Phl p 4) would only slightly improve the in vitro test sensitivity.

Effect of fermented milk prepared with two probiotic strains on Japanese cedar pollinosis in a double-blind placebo-controlled clinical study.

There has been much interest in the potential of using probiotic bacteria for treating allergic diseases. A double-blind, placebo-controlled study was conducted to examine the effectiveness of Lactobacillus GG (LGG) and L. gasseri TMC0356 (TMC0356) in alleviating Japanese cedar pollinosis (JCP), a seasonal allergic rhinitis caused by Japanese cedar pollen. Fermented milk prepared with the tested bacteria or placebo yoghurt was administered to 40 subjects with a clinical history of JCP for 10 weeks. Subjective symptoms, self-care measures and blood samples were compared between the two groups. Peripheral blood mononuclear cells (PBMCs) were collected from seven patients with JCP and in vitro cytokine production by the isolated PBMCs was analysed in the presence of heat-killed lactic acid bacteria. Consumption of the fermented milk significantly decreased the mean symptom score for nasal blockage after 9 weeks (P<0.05) and mean symptom-medication scores after 9 and 10 weeks when compared with the placebo group (P<0.01 and P<0.05 respectively). The tested strains of lactic acid bacteria affected cytokine production by isolated PBMCs in vitro in a strain-dependent manner. LGG significantly inhibited IL-4 and IL-5 production by PBMCs stimulated by both Cry j 1 and PHA. TMC0356 only suppressed IL-5 production stimulated by PHA. The fermented milk prepared with LGG and TMC0356 might be beneficial in JCP because of its effect on nasal blockage. The effects of LGG and TMC0356 might arise at least partly from their specific down-regulation of the human Th2 immune response.

Sclerosing inflammatory pseudotumor arising from the carotid artery region

We report a 42-year-old female patient with sclerosing inflammatory pseudotumor. She had found a mass in her left neck after she caught a cold. An elastic hard mass (25 x 15 mm), unaccompanied by any other symptoms, was palpated adjacent to the left carotid bifurcation. The mass extended vertically along the common carotid artery, partially adhering to the pulsating artery. Under ultrasonography, the mass was characterized by a homogenized low echoic shadow surrounding the left common carotid artery. Angiography revealed a slight narrowing of the common carotid artery with a surrounding hypovascular mass. Computerized tomography (CT) and magnetic resonance imaging (MRI) both showed a mass enclosing the carotid artery; a Ga scintigram also showed a highly concentrated mass. Surgical removal of the mass included removing part of the carotid artery, internal and external carotid arteries and sympathetic trunk. The left internal jugular vein was transplanted to connect the common carotid artery to the internal carotid artery. Although the hypoglossal and vagus nerves adhered to the mass, they were preserved by sharp dissection with the scalpel. Although hypoglossal and vagus nerve dysfunction were observed temporarily after the surgery, Horners syndrome appeared and persisted. Histological examination revealed markedly fibrotic tissues surrounding the carotid artery with extensive lymphocyte and plasmacyte infiltration and a diagnosis of sclerosing inflammatory pseudotumor was made.

Further characterization of dispersed human sinus mast cells

We have examined biochemical and functional characteristics of dispersed sinus mast cells and compared them with those of mast cells dispersed from other tissues. This experiment yielded the following results. 1) Although no difference was observed in histamine content, tryptase content in sinus mast cells was significantly lower than that of skin and lung mast cells. 2) In contrast with the situation in foreskin mast cells, anti-IgE-induced histamine release from sinus and lung mast cells was potentiated with lower concentrations of adenosine. 3) Similar to lung mast cells, sinus mast cells did not respond to compound 48/80 or substance P, whereas skin mast cells were stimulated to release histamine with either 10 micrograms/ml of compound 48/80 (14.0%) or 10(-4) M of substance P (23.4%). 4) Sinus mast cells are similar to lung mast cells in terms of release of arachidonic acid metabolites. Anti-IgE challenge of sinus mast cells caused the generation of both prostaglandin D2 (89.5 +/- 33.7 ng/10(6) mast cells, n = 14) and i-leukotriene D4 (78.7 +/- 46.8 ng/10(6) mast cells, n = 10).

A Case of Multiple Neurofibroma of the Larynx and Cervical Esophagus

A case of multiple neurofibroma of the larynx and cervical esophagus is reported. Key points concerning the follow-up observations of this case are describe.

Differences in urinary leukotriene E4 levels and distribution of eosinophils between chronic rhinosinusitis patients with aspirin-intolerant and -tolerant asthma

OBJECTIVE Urinary leukotriene E4 (U-LTE4) concentrations are significantly elevated in patients with aspirin-intolerant asthma (AIA). However, the relationship between the clinicopathogenetic features of eosinophilic rhinosinusitis and U-LTE4 concentration remains unknown. Here we examined the relationship between U-LTE4 level and eosinophil in chronic rhinosinusitis. METHODS We measured the U-LTE4 concentrations and eosinophil counts in ethmoidal and maxillary sinuses and peripheral blood in 30 asthmatic patients (including 15 AIA patients). RESULTS Eosinophil counts in ethmoidal sinuses and peripheral blood were markedly higher in asthmatic patients than in controls. Although there were no significant differences between eosinophil counts in maxillary and ethmoidal sinuses for ATA group, eosinophil counts were higher in ethmoidal sinus compared to that in maxillary sinus in the AIA group (P<.05). Eosinophil counts were higher in the maxillary than in ethmoidal sinuses for control patients (P<.05). Despite low correlation between eosinophil counts in peripheral blood and eosinophil counts in maxillary sinus (rs=0.4323, P<.001), moderate correlation was observed between eosinophil counts in peripheral blood and eosinophil counts in ethmoidal sinus (rs=0.5249, P<.0001). Basal U-LTE4 concentrations were higher in AIA patients than in those with aspirin-tolerant asthma. Despite low correlation between eosinophil counts and U-LTE4 concentration in maxillary sinus (rs=0.3849, P<.01), moderate correlation was observed between eosinophil counts and U-LTE4 concentrations in ethmoidal sinus (rs=0.4736, P<.001). CONCLUSION We describe the differences in U-LTE4 and other parameters in AIA compared to ATA, and correlation among parameters. We demonstrate that eosinophil-dominant inflammation starts in ethmoidal sinus clinicopathogenetically in CRS with asthma. U-LTE4 concentration was not exclusively associated with eosinophil counts in ethmoidal sinus. Eosinophils in ethmoidal sinus may be a major production site for CysLTs, particularly in AIA. CRS with AIA is assumed to be characterized by leukotriene-eosinophil cross-interaction in ethmoidal sinus.

Enzymatic dispersion of mast cells from human sinus mucosa: Characterization of histamine release and its comparison with chopped fragments of the tissue

Functional characteristics of mast cells in chopped fragments from sinus mucosa, which was dissected from patients with chronic sinusitis, were compared with those from dispersed cells prepared by enzymatic treatment. The results obtained in this study were the following. (1) Both chopped fragments and dispersed cells released histamine in a dose-dependent manner when incubated with anti-IgE. However, higher histamine release was always observed in dispersed cells. (2) Although no differences in the ability to reduce histamine release with salbutamol or forskolin could be observed between chopped fragments and dispersed cells, staurosporin and p-bromophenacyl bromide were more active on dispersed mast cells than chopped fragments. (3) Passive sensitization of dispersed cells with an allergic serum containing IgE to mite could be achieved only after elution of IgE on the cells with lactic acid.

Soybean allergy in a population with a low prevalence of betulacae pollen allergy and a high soybean consumption

Methods The aim of this study was to elucidate the prevalence of sensitization to rGly m 4 in adults with soybean allergy, and to analyze the diagnostic efficiency of the IgE antibody to rGly m 4 (ImmunoCAP) in soybean allergy in central Japan. Twenty-one soybean-allergic patients were prospectively recruited from Jan. to Dec. 2009, and their levels of IgE antibody to rGly m 4 were compared with those of general alder pollen-allergic control subjects without soybean allergy (n=85).

Diagnosis of Tortuosity of Common Carotid Artery by MRA.

Tortuosity of the common carotid artery is not a rare disease. Diagnosis of the disease is usually made by digital subtraction angiography (DSA). However, the examination for the diagnosis should have few effects on the body because the disease often involves seniors who can easily develop complications such as hypertension. We reported two cases in which magnetic resonance angiography (MRA) and ultrasonography were useful in establishing diagnosis. These examinations are also preferable because of their simplicity and minor impact on the body.

One Case of Pemphigus Vulgaris Observed in the Oral Cavity

We report on a case of pemphigus vulgaris with lesions in the oral cavity as well as an outline of differential diagnosis and treatment. Changes in the pemphigus antibodies in blood assisted in judging the therapeutic effects along with the therapeutic course.