apy for the acute management of hereditary angioedema (HAE), a genetic deficiency of the C1-inhibitor. METHODS: Retrospective data were collected from 61 ...
Abstracts S311
J ALLERGY CLIN IMMUNOL VOLUME 119, NUMBER 1
Changes in IgE and IgG Antibody Responses to Cat with Decreased Exposure to Cat Allergen E. A. Erwin, S. M. Satinover, A. J. Reefer, J. A. Woodfolk, T. A. E. PlattsMills; University VA, Charlottesville, VA. RATIONALE: Antibody responses to allergens of dust mite and cat are different in terms of prevalence of sensitization, titer of IgE antibody, and the relationship between IgE and IgG antibodies. METHODS: To assess changes in antibody responses and symptoms to cat that occur with marked decrease in exposure to cats, we recruited 102 university students who had lived with a cat prior to enrollment. We administered questionnaires to assess pet exposure and allergic symptoms, performed skin prick testing, and measured IgE antibody to cat (CAP FEIA) and IgG antibodies to Fel d 1 (radioimmunoprecipitation) in September and April of each school year. RESULTS: IgE antibody titers to cat in sensitized students (n 5 14) increased by a small amount over the first eight months [geometric mean titer (GMT) 2.5 IU/ml and GMT 3.02 IU/ml] and then decreased over the next year to GMT 2.41 IU/ml [repeated measures ANOVA, F 5 0.78, df(3,39), p 5 0.5]. By contrast, IgG antibody levels decreased significantly over the first eight months of decreased exposure (GMT 2020 Units vs 887 Units) and remained significantly lower after two years (GMT 1173 Units)[repeated measures ANOVA, F 5 4.9, df(3,39), p 5 0.005). In students who had IgG antibody without IgE antibody, titers of IgG antibody also decreased significantly; however, no IgE was produced. CONCLUSIONS: Decreased exposure to cat allergens can lead to a selective decrease in IgG antibody to Fel d 1. We speculate that a dissociation between IgE antibody and IgG antibody may be associated with an increase in symptoms upon later cat exposure. Funding: National Institutes of Health
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Dog Exposure at Birth through Age 3 Reduces the Risk of Asthma at Age 6 N. A. Hallett, K. A. Roberg, E. L. Anderson, L. E. P. Salazar, R. A. Grabher, D. F. DaSilva, J. D. Bufford, K. T. Sullivan Dillie, R. Gangnon, M. D. Evans, J. E. Gern, R. F. Lemanske, Jr.; University of Wisconsin School of Medicine and Public Health Madison, WI. RATIONALE: Dog exposure in infancy and early childhood is associated with reduced wheezing and atopic disease later in life. There is relatively little information, however, about the relationship between the timing of exposure and effects on childhood asthma. METHODS: The relationship between pet ownership and asthma diagnoses, classification, and wheezing phenotypes were evaluated for 253 children as part of the Childhood Origins of ASThma (COAST) project. Pet ownership was categorized in groups according to exposure at birth, age 3 years, both, or neither. All statistical analyses compared exposure groups to non-exposed children. RESULTS: Children who owned a dog at both birth and age 3 were less likely to develop asthma at age 6 (18.3% vs. 33.6%, p 5 0.025). This relationship is not apparent with children exposed to dogs only at birth or only at age 3 (25% and 30.8% asthma at age 6 respectively, p 5 NS). Cat ownership at birth and/or age 3 was not significantly related to asthma diagnosis at age 6. CONCLUSIONS:Exposure to dogs, but not cats, throughout infancy is associated with a reduced risk of subsequent asthma at age 6. These findings suggest that infancy may be a critical time for environmental exposures to modulate the risk of asthma. Funding: NIH Grants M01 rr03186, R01 HL61879, P01 HL70831
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Over 10 Years Of Experience With The Use Of C1-inhibitor Concentrate In Hereditary Angioedema, In Retrospect H. Farkas1, G. Temesszentandra´si1, B. Visy2, G. Harmat2, L. Varga1, G. Fu¨st1, G. Sze´plaki1, I. Kara´di1, B. Fekete1, L. Jakab1; 1Semmelweis University, Budapest, HUNGARY, 2Madara´sz street Hospital of the Heim Pa´l’ Pediatric Hospital, Budapest, HUNGARY. RATIONALE: C1-INH concentrate is the only completely effective therapy for the acute management of hereditary angioedema (HAE), a genetic deficiency of the C1-inhibitor. METHODS: Retrospective data were collected from 61 patients with HAE on the efficacy and safety of C1-INH administered to relieve 468 acute edematous attacks. Analyses of the clinical and laboratory information included the localization and severity of acute attacks, time to complete resolution of symptoms, efficacy of short-term prophylaxis, appearance of HbsAg, anti-HCV, anti-HIV1,2 and anti-C1-INH antibodies. RESULTS: Severe abdominal and subcutaneous attacks, as well as acute laryngeal edema were consistently relieved by 500 U C1-INH concentrate. Treatment to mitigate fulminant subcutaneous attacks was more frequent in pediatric patients compared to adult (28/94 vs. 67/374, p50.01). Clinical manifestations improved within 15 to 60 minutes of administration, progression was never observed, there were no recurrent attacks within 72 hours of administration, and efficacy did not decline during repeated use. Used for short-term prophylaxis in 19 patients, pre-intervention administration of C1-INH concentrate prevented edematous attacks in all cases. Moreover, C1-INH concentrate has proven effective and safe in the management of 94 attacks in 22 children and 6 attacks in 4 pregnant women. Adverse reactions, viral infections, or antibody-formation against the purified protein have not occurred. CONCLUSIONS: As evidenced by these results, the administration of C1INH concentrate is a highly effective and safe option without contraindications, both for the treatment of acute attacks as well as for short-term prophylaxis in HAE patients, including pediatric patients and pregnant women.
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Functional Study Of Histamine N-methyltransferase (hnmt) Genetic Polymorphisms In Patients With Aspirin-intolerant Chronic Urticaria Y. Kang1, S. Kim1, Y. Ye1, G. Hur1, S. Lee2, H. Lee1, C. Suh1, D. Nahm1, H. Park1; 1Ajou university, Su-won, REPUBLIC OF KOREA, 2Dong-A University, Busan, REPUBLIC OF KOREA. RATIONALE: The pathogenic mechanism of aspirin-intolerant chronic urtiaria (AICU) is still poorly understood, but it has been known that histamine releasing by cutaneous mast cell activation is considered to be an important role. HNMT palys an important role in histamine metabolism. To investigate the functional variability of HNMT gene according to the genetic polymorphisms, case-control study of HNMT genetic polymorphisms and functional study were processed. METHODS: Two single nucleotide polymorphisms of HNMT gene (304C>T and 939A>G) were genotyped by a primer extension method in 107 patients with AICU, 115 patients with aspirin-intolerant acute urtiaria (AIAU), 154 patients with chronic idiopathic urtiaria (CIU), and 152 normal healthy controls (NC). mRNA stability and protein expression according to 939A>G polymorphism were examined by real-time PCR and fluorometer. RESULTS: Through a case-control study of HNMT genetic polymorphisms, 939A>G polymorphism of HNMT was significantly associated with AICU, while no significant association of 304C>T polymorphism was noted. Moreover, mRNA stability and protein expression were significantly different according to 939A>G polymorphism; mRNA and protein expression was lower in construct with 939A allele than construct with 939G allele. CONCLUSION: These results suggest that 939A>G polymorphism may play a protective role in AIU development through a reduced histamine metabolism. Funding: Korea Health 21 R&D Project of the Ministry of Health & Welfare, Republic of Korea (03-PJ10-PG13-GD01-0002, 03-PJ10-PG13GD01-0007).
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