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  • 1
    Electronic Resource
    Electronic Resource
    Intranasal insulin therapy: the clinical realities (1995)
    Springer
    Diabetologia 38 (1995), S. 680-684 
    Details
    ISSN: 1432-0428
    Keywords: Intranasal insulin administration ; absorption enhancers ; metabolic control ; subcutaneous insulin administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate metabolic control and safety parameters (hypoglycaemia frequency and nasal mucosa physiology), 31 insulin-dependent diabetic patients were treated with intranasal insulin at mealtimes for 1 month and with subcutaneous fast-acting insulin at meals for another month in an open, crossover randomized trial. During both treatment periods the patients were treated with intermediate-acting insulin at bedtime. Six of the patients were withdrawn from the study during intranasal insulin therapy due to metabolic dysregulation. Serum insulin concentrations increased more rapidly and decreased more quickly during intranasal as compared with subcutaneous insulin administration. Metabolic control deteriorated, as assessed by haemoglobin A1c concentrations, slightly but significantly after intranasal as compared with subcutaneous insulin therapy. The bioavailability of intranasally applied insulin was low, since intranasal insulin doses were approximately 20 times higher than subcutaneous doses. The frequency of hypoglycaemia was similar during intranasal and subcutaneous insulin therapy, and nasal mucosa physiology was unaffected after intranasal insulin. We conclude that due to low bioavailability and to a high rate of therapeutic failure, intranasal insulin treatment is not a realistic alternative to subcutaneous insulin injections at the present time.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401839
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  • 2
    Electronic Resource
    Electronic Resource
    Intranasal insulin therapy: the clinical realities (1995)
    Springer
    Diabetologia 38 (1995), S. 680-684 
    Details
    ISSN: 1432-0428
    Keywords: Key words Intranasal insulin administration ; absorption enhancers ; metabolic control ; subcutaneous insulin administration.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate metabolic control and safety parameters (hypoglycaemia frequency and nasal mucosa physiology), 31 insulin-dependent diabetic patients were treated with intranasal insulin at mealtimes for 1 month and with subcutaneous fast-acting insulin at meals for another month in an open, cross-over randomized trial. During both treatment periods the patients were treated with intermediate-acting insulin at bedtime. Six of the patients were withdrawn from the study during intranasal insulin therapy due to metabolic dysregulation. Serum insulin concentrations increased more rapidly and decreased more quickly during intranasal as compared with subcutaneous insulin administration. Metabolic control deteriorated, as assessed by haemoglobin A1c concentrations, slightly but significantly after intranasal as compared with subcutaneous insulin therapy. The bioavailability of intranasally applied insulin was low, since intranasal insulin doses were approximately 20 times higher than subcutaneous doses. The frequency of hypoglycaemia was similar during intranasal and subcutaneous insulin therapy, and nasal mucosa physiology was unaffected after intranasal insulin. We conclude that due to low bioavailability and to a high rate of therapeutic failure, intranasal insulin treatment is not a realistic alternative to subcutaneous insulin injections at the present time. [Diabetologia (1995) 38: 680–684]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401839
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  • 3
    Electronic Resource
    Electronic Resource
    Glucose recovery after intranasal glucagon during hypoglycaemia in man (1994)
    Springer
    European journal of clinical pharmacology 46 (1994), S. 15-17 
    Details
    ISSN: 1432-1041
    Keywords: Hypoglycaemia ; Glucagon ; intranasal ; glucose appearance rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract We compared the hyperglycaemic effect of intranasal and intramuscular (i.m.) administration of glucagon after insulin-induced hypoglycaemia. Twelve healthy subjects were examined twice, receiving on both occasions an intravenous insulin bolus. Somatostatin and propranolol were administered to block endogenous glucose counterregulation, and glucose turnover was estimated by a 3-[3H]-glucose infusion. When hypoglycaemia was reached, the subjects received either i.m. glucagon of pancreatic extraction (1 mg) or intranasal genetically engineered glucagon (2 mg). The incremental values for plasma glucose concentrations 15 min after intranasal and i.m. administration of glucagon differed marginally. However, after 5 min the glucose appearance rate, as well as the incremental values for plasma glucose, were significantly higher for the i.m. glucagon treatment. The mean time taken for incremental plasma glucose to exceed 3 mmol·l−1 was significantly shorter for i.m. glucagon. The mean plasma glucagon level increased faster after i.m. glucagon than after intranasal glucagon, and the levels remained higher throughout the study period. We conclude that glucose recovery was significantly better after i.m. administration of glucagon than after intranasal administration. However, the differences between the incremental plasma glucose and the time for incremental plasma glucose to exceed 3 mmol·l−1 were not considered of major clinical importance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00195909
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  • 4
    Electronic Resource
    Electronic Resource
    Urinary excretion and origin of 11-dehydro-2,3-dinorthromboxane B2 in man
    Amsterdam : Elsevier
    Prostaglandins 45 (1993), S. 401-411 
    Details
    ISSN: 0090-6980
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0090-6980(93)90117-P
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  • 5
    Electronic Resource
    Electronic Resource
    High IgG4 antibody level is associated with failure of immunotherapy with inhalant allergens (1987)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 17 (1987), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We have analysed all available data on the relationship between IgG4 Ab level and clinical effect of immunotherapy (IT) with inhalant allergens. The data from three of the seven independent studies could, without reservations, be analysed by a joint statistical analysis. We found that late high IgG4 Ab level, measured at the end of IT, was strongly associated with treatment failure (P= 6.54 ± 105; n= 67). The ratio of risks for treatment success in the group with late low IgG4 Ab level was 1.82, whereas the ratio of risks for treatment failure in the group with late high IgG4 Ab level was 11.4. The data from a fourth, presumably comparable, study further supported the existence of an association between high IgG4 Ab level and treatment failure. In contrast, two other studies found that high mean IgG4 Ab level was associated with good clinical response. Possible reasons for this apparent discrepancy are discussed. We also found that early high IgG4 Ab level, measured within 3 months after initiation of IT, was strongly associated with treatment failure after 1–2 years of IT (P= 1.05 ± 10−4; n= 30). The sensitivity and specificity of early high IgG4 Ab level as indicator for treatment failure was 100% and 83%, respectively. At the prevalences found in the present study, the predictive value of early high IgG4 Ab level for treatment failure was 0.6, whereas the predictive value of early low IgG4 Ab level for treatment success was 1.00.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.1987.tb02040.x
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  • 6
    Electronic Resource
    Electronic Resource
    Diagnosis and immunotherapy of mould allergy (1988)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 43 (1988), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The IgG subclass response was evaulated by a sensitive allergen- and subclass-specific solid phase immunoradiometric assay during a 1-year placebo-controlled, double-blind study of immunotherapy with Cladosporium herbamm in 22 adult asthmatics. The IgG response was mainly restricted to subclasses 1 and 4 but a few patients were IgG2 and IgG3 responders. An intense and early IgG1 response was observed during the first clusters of injection followed by a levelling down of the titer. The IgG4 response had a later onset and showed slowly increasing levels during the 12 months of immunotherapy. The graded clinical efficacy estimated by symptom-medication score was significantly correlated to the preseasonal IgG1 value, with high values indicating a deleterious response of immunotherapy (deterioration of disease activity). Likewise, the fold increase of IgG1 and IgG4 after two clusters of immunotherapy (i.e. after 4 weeks) was significantly related to the clinical outcome, Little or no increase of IgG1 and IgG4 was associated with improvement, i.e. decrease in symptom-medication score. The magnitude of the IgG1 response during the dose-increase phase was directly correlated to the number of systemic side effects. No relation of IgG1, IgG4 or IgG4/IgG1 ratio to changes in the IgE-mediated parameters (skin prick test, bronchial challenge and circulating specific IgE) was observed. Our data, which are based on few patients and only one allergen system, do not support the hypothesis of IgG acting as blocking antibody being the immunologic mechanism of immunotherapy. The association between high IgG4 values and a deleterious efficacy of immunotherapy might be caused by IgG4 acting as sensitizing antibodies. This explanation, however, is opposed by the lack of relation to systemic side effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1988.tb02045.x
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  • 7
    Electronic Resource
    Electronic Resource
    IgG Subclass Antibody Response in Grass Pollen-Allergic Patients Undergoing Specific Immunotherapy (1984)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 39 (1984), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: All four subclasses of IgG antibodies to timothy grass pollen extract were measured by a three-layer immunoradiometric assay in sera from 20 grass pollen-allergic patients who underwent specific immunotherapy in a 3-year prospective study. Both IgG1 and antibody level passed its peak (median 5,4 U/ml) after 12 weeks. At this time, the ratio between the medians of IgG1 and IgG4 antibodies was 2.25 IgG4 antibody level reached its peak (median 11.6 U/ml) just before termination of immunotherapy. At this time IgG1/IgG4 ratio was 0.43. Two years after the end of immunotherapy, IgG1 and IgG4 antibody levels were 0.0 and 1.8 U/ml in median, respectively. The amounts of IgG2 and IgG3 antibodies detected in the sera were less than 1.6 U/ml and were considerd insignificant. Preseasonal serum IgG1 and IgG4 antibody levels did not correlate significantly with symptom scores in the subsequent season. Serum IgG4 level obtained after 12 weeks of immunotherapy was significantly correlated to symptom score in the third season i.e. the season just after termination of therapy (rs =0.529. t= 2.567. P= 0.02). In this work. A scrum IgG4 antibody level higher than 8.0 U/ml after 12 weeks of therapy predicted poor clinical result at the end of immunotherapy with 100% sensitivity and 87% specificity. An IgG4/IgG1 ratio greater than 1.0 after 12 weeks' therapy had the same predictive value.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1984.tb01965.x
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  • 8
    Electronic Resource
    Electronic Resource
    Determination of IgE-Containing Immune Complexes in Human Sera (1984)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 39 (1984), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied the polyethylene (PEC) precipitability of monomeric human IgE, and of human IgE artificially complexed with rabbit anti-human IgE. At conditions where precipitation of monomeric IgE did not occur, from 0.2 to 20% of the complexed IgE was precipitated. The PEG precipitability of the complexes was inversely related to the IgE/anti-IgE ratio used for preparation of the complexes. From 1.5 to 19.2% of the IgE in the redissolved precipitates could be detected by use of a two-site IgE immunoradiometric assay, the percentage being highest for complexes formed at equivalence. We conclude that exact quantitation of circulating IgE immune complexes (IC) probably is impossible by any PEC precipitation assay. However, the optimized assay was found to be useful for identification of IgE IC in sera with total IgE concentrations below 5,000 U/ml. IgE IC were found in 5/20 sera from patients with Felty's syndrome, in 5/39 sera from patients with extrinsic allergy and high levels of specific IgE, and in 1/17 sera from immunized wasp allergies. No IgE IC were found in 20 normal human sera.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1984.tb01958.x
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  • 9
    Electronic Resource
    Electronic Resource
    An Automated Particle Counting Immunoassay (PACIA) for Determination of Blocking Antibodies against Timothy Grass Pollen in Sera from Desensitized Allergies (1983)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 38 (1983), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: AN automated particle counting immunoassay (PACIA) for measurement of blocking antibodies (antigen neutralizing capacity) against timothy grass pollen extract in sera from desensitized allergies is described.Latex particles coated with E(ab')2-anti-timothy are agglutinated by timothy. Serum containing anti-timothy antibodies inhibits the agglutination. Non-agglutinated particles are counted in a modified Auto Counter. Nineteen of 20 sera from timothy allergies who had undergone immunotherapy with purified timothy extract for 30 weeks, showed significant agglutination-inhibition. None of 42 normal human sera gave significant inhibition. The inhibiting antibody could be removed by absorption with protein A and was thus of non- IgE nature, i.e. blocking antibody. The results obtained correlated statistically significantly with those found with a double-antibody method (rS= 0.62, n= 20, t= 3.35, P 〈 0.01) and with the cumulated dosage of timothy allergen extract administered to the individual patient (rS= 0.56, n= 20, t= 2.87, P 〈0.02). Between-assay coefficient of variation was from 6.4% to 18.3%. The capacity is 40 samples per hour. The method has also been applied to measurement of blocking antibodies to boney bee and wasp venom.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1983.tb01603.x
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  • 10
    Electronic Resource
    Electronic Resource
    Enprofylline - Effects of a New Bronchodilating Xanthine Derivative in Asthmatic Patients (1983)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 38 (1983), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The bronchodilating effect of two doses of peroral enproffylline was compared with Placebo in 24 asthmatic patients, Enprofylline produced significantly greater bronchodilatation than placebo, A dose of 2 mg/kg b.wt. and 4 mg/kg b.wt. caused a mean maximal increase in FEV1 of 26% and 35%, respectively. The degree and the incidence of headache and nausea were estimated by means of a scoring system. Dose-related effects on both parameters observed. Other side effects were negligible. In seven patients the means plasma half-life of enprofylline was found to be 113 min. It is suggested that enprofylline should be studied further in Patients suffering from obstructive lung disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1983.tb00859.x
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