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  • 11
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 46 (1991), S. 0 
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: It has been speculated whether the recently developed non-sedating antihistamines may possess other properties than merely being antagonists at the H1-receptors. To investigate this suggestion 12 patients with strictly seasonal allergic rhinitis participated in a double-blind placebo controlled randomized cross-over study outside the pollen season. At steady state levels of 10 mg loratadine, a new non-sedating antihistamine, the patients were challenged with methacholine. This was followed by a nasal challenge with increasing doses of allergen. 24 h later the patients were rechallenged nasally with the same methacholine dose as the day before. The volume of the methacholine-induced nasal secretion was measured and the response to allergen was determined by scoring technique. In returned nasal lavage fluid the levels of histamine and TAME-esterase activity were measured. It was found that loratadine significantly reduced the immediate allergic nasal symptoms compared with placebo (P 〈 0.01). Loratadine also reduced the allergen-induced release of histamine into the nasal cavity after the strongest allergen dose, from 9.6±1.5 (mean ± SEM) to 6.4±1.4 ng/ml (P 〈 0.05). A similar decrease in the TAME-esterase activity after treatment with loratadine was observed. The TAME-esterase activity decreased from 11.6 *103±2.47 *103 to 5.60 *103±1.45 */103 CMP (P 〈 0.05). There were no significant changes between the active and placebo treatments regarding the methacholine-induced secretory response. This was true for the initial methacholine challenge as well as the secretory response 24 h later. This study shows that loratadine is an effective drug in the suppression of immediate allergic nasal symptoms. One of the beneficial effects of this drug could be a reduction in allergen-induced histamine release. A finding which further implicates that antihistamines may possess other effects than just a blocking of the H1-receptor.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The activation of mast cells is generally considered to be an important trigger mechanism in the immediate allergic response. This study focused on the determination of three markers of mast cell activation after an allergen challenge. Nasal allergen challenges were performed in 25 subjects with seasonal allergic rhinitis using three allergen doses increasing in 10-fold steps in a standardised nasal lavage model for the subsequent recovery of the markers of mast cell activation. The levels of histamine and tryptase in the nasal lavage fluid were determined using radioimmunoassays, while the TAME-esterase activity was determined using a radiochemical technique. The nasal symptoms obtained on challenge were assessed using a scoring technique. The allergen challenge resulted in significant increases in the levels of all three markers, tryptase, histamine and TAME-esterase. In the individual measurements after the challenges there was a highly significant correlation between the TAME-esterase levels and the tryptase levels (r = 0.71; P 〈 0.001), while the generation of histamine and tryptase was not significantly correlated. When comparing the cumulative generation of the three markers, significant correlations were found between all three. Allergen challenges in six non-allergic controls using the same technique did not result in any increase in tryptase levels. The findings suggest that the determination of tryptase in nasal lavage fluid may be a valuable indicator of mast cell activation in the upper airways.
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 33 (1978), S. 0 
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In 57 patients with house dust allergy and 20 controls protease inhibitor concentrations in nasal secretions were measured before and after antigen challenge. A correlation was found between low inhibitor levels and long duration of disease. Furthermore, significant differences of inhibitor concentrations could be demonstrated between patients with strong or moderate reactions to antigen provocation, and between patients with isolated rhinitis or a combination of rhinitis and bronchial asthma. The clinical significance of the results will be discussed with special regard to different biochemical mechanisms in the pathophysiology of seasonal and perennial immediate-type rhinitis.
    Type of Medium: Electronic Resource
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  • 14
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 51 (1996), S. 0 
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In recent years, it has been possible to demonstrate mediator release into the nasal secretion after nasal allergen challenge in patients with allergic rhinitis. Using the nasal provocation model, we determined whether the mediator release was altered in immunotherapy-treated patients. Seventeen grass-pollen-allergic patients were examined under controlled, reproducible conditions. Serial challenges with increasing doses of grass pollen produced increasing numbers of clinical symptoms and release of mediators such as kinins, TAME-esterase activity, and histamine. Ten patients received a semidepot perennial grass-pollen extract for 4 years. Seven patients served as controls and did not receive immunotherapy during the observation period. Data from the group of patients receiving immunotherapy over the first year already showed a partially significant decline in the maximal mediator release after nasal allergen challenges compared to the results of pretreated challenges, whereas controls did not show any significant changes. Nasal allergen challenges after termination of 4 years' immunotherapy significantly modified the mediator release compared to pretreatment values (TAME-esterase activity P〈0.05, kinins P〈0.01, and histamine P〈0.01). Decrease of mediator release paralleled the symptom-medication scores and quantitative skin prick test. Finally, we could demonstrate a significant correlation between specific IgG increase and mediator decrease in the treated group.
    Type of Medium: Electronic Resource
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  • 15
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The efficacy and tolerance of short-term immunotherapy (STI) by seven preseasonal injections of tree-pollen allergens (ALK7 FrUhbltihermischung®) was investigated in a double-blind, placebo-controlled, multicenter study with 111 rhinoconjunctivitis patients. Nasal and bronchial symptoms simultaneously analyzed, and nasal symptoms as a single end point, but not the overall score of nasal, bronchial, and conjunctival symptoms, showed a significantly lower increase with STI during birch-pollen exposure (both P= 0.033, n= 105, Mann-Whitney U-test). However, a selective analysis with patients from centers with high recruitment figures (nS10 patients, n=29 STI, n=32 placebo) showed a significantly lower increase of nasal, bronchial, and overall symptom score (STI 11.0 vs placebo 18.0, P=0.001, U-test). STI had equidirected effects on conjunctival, nasal, and bronchial symptoms analyzed as multiple end points, although conjunctival symptoms were not significantly different as a single end point. The seasonal increase in drug use was reduced by 62% in the STI group compared with placebo (P=0.032, Mest), Specific IgG4 increased only after STI (P〈0,001); IgE was not significantly different. Eosinophil cationic protein remained unchanged with STI, but significantly increased with placebo in the pollen season (P=Qm3). STI was well tolerated. In conclusion, STI was shown to be efficacious and safe for the treatment of patients with tree-pollen rhinoconjunctivitis.
    Type of Medium: Electronic Resource
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  • 16
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The concentration of biomarkers from vessels and inflammatory cells in nasal lavage fluid reflects the degree of hyperresponsiveness in patients with allergic rhinitis. The lavage has usually been performed of both nasal cavities together after prewashings and administration of decongestants. To improve the technique, we introduced a modification involving lavage of the nasal cavities separately without any prewashings or decongestants. We challenged 20 rhinitic subjects sensitive to timothy unilaterally with timothy extract. In nasal lavages performed before, immediately after, and 6 h after the challenge, we determined the concentrations of albumin, histamine, bradykinin, TAME (TV-α-tosyl-L-arginine methyl ester)-esterase, and leukotriene C4 (LTC4). In eight subjects, the procedure was repeated 1 and 2 weeks later. After the challenge, albumin, bradykinin, TAME-esterase, and LTC4 in the nasal lavage fluid increased on the ipsilateral side but not on the Contralateral side. Histamine did not increase after antigen challenge. After 6 h, the biomarkers were not increased. The concentrations of biomarkers did not differ between sides before the challenge and not between visits. Thus, the modified nasal lavage technique is reliable and improved compared to previous methods because it involves reproducible determinations of different biomarkers, and it is simple and easy to perform.
    Type of Medium: Electronic Resource
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 249 (1992), S. 318-321 
    ISSN: 1434-4726
    Keywords: Chronic non-allergic rhinitis ; Kinins ; Methacholine challenge ; Muscarinic receptor stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Following nasal challenges with the muscarinic neurotransmitter methacholine in 14 patients with chronic non-allergic rhinitis, kinin generation was induced. This occurrence was inhibited by pretreatment with anticholinergic agents (ipratropium bromide) and by an overdose of neurotransmitter, indicating that a muscarinic receptor is stimulating the liberation of kinin. These observations suggest that patients with chronic non-allergic rhinitis exhibit cholinergic neurotransmitter-induced kinin generation.
    Type of Medium: Electronic Resource
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    Pflügers Archiv 382 (1979), S. 193-195 
    ISSN: 1432-2013
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 226 (1980), S. 187-197 
    ISSN: 1434-4726
    Keywords: Nasenpolypen ; Rhinitis allergica ; Nasal polyps ; Nasal allergy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A safe differentiation between allergic and non-allergic polyps appears impossible by means of light or electron microscopical examination of polyp tissue. There are some indications, however, which point to the allergic or non-allergic origin and it seems that the relationship between eosinophils and plasma cells with a low index is characteristic for polyps of allergic origin. Eosinophils and round-cell infiltrations are present in all types of polyps. An index of eosinophils to plasma cells below 5 is indicative for allergy and should induce the pathologist to give a hint to the clinician for allergological work-up. An index above 5 is more corresponding with infective etiology. Any changes of the basement membrane, i.e., smaller or larger gaps or even absence, are found only very irregularly and are not typical findings in either way. An increased number of glands and collagenic fibres, especially under the epithelium, are more an expression of the age of the polyp. Since the conservative therapy as mentioned above leads to good therapeutical results, it is desirable that an allergological work-up should be done in any case which shows the histological findings indicative for allergic etiology. Thus, repeated operations with all the risks and uncertain therapeutical benefit can be avoided.
    Notes: Zusammenfassung 1. Eine exakte Differenzierung zwischen allergischen und nichtallergischen Polypen erscheint mittels licht- oder elektronenmikroskopischer Untersuchung vom Polypgewebe unmöglich. Es gibt jedoch einige Anzeichen, welche die allergische oder nichtallergische Ätiologie anzeigen und es scheint, daß das Verhalten zwischen Eosinophilen und Plasmazellen mit einem niedrigen Index charakteristisch für Polypen allergischer Ursache ist. Eosinophile und Rundzellinfiltrationen sind in allen Typen von Polypen vorhanden. Der Index Eosinophiler zu Plasmazellen unter 5 zeigt eine Allergie an; ein solcher Befund sollte den Pathologen veranlassen, dem Kliniker einen Hinweis zu geben, daß eine allergologische Untersuchung vorgenommen werden sollte. Ein Index über 5 korrespondiert mehr mit infektiver bzw. nichtallergischer Ätiologie. 2. Veränderungen an der Basalmembran, wie kleine oder größere Gaps oder auch Fehlen der Basalmembran treten selten auf und sind keine typischen Befunde der einen oder der anderen Art von Polypen. 3. Eine zunehmende Zahl der Glandulae mucosae und der kollagenen Fasern, besonders unter dem Epithelium, sind mehr Ausdruck des Alters des Polyps als einer der Ätiologie. 4. Da die konservative Therapie, wie eingangs erwähnt, zu guten Resultaten führt, ist es wünschenswert, daß eine allergologische Diagnostik in den Fällen von Polypen vorgenommen wird, bei denen die histo-morphologischen Befunde für eine allergische Ätiologie sprechen. So könnten wiederholte Operationen mit all den Risiken und unsicherem therapeutischen Nutzen häufig vermieden werden.
    Type of Medium: Electronic Resource
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  • 20
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 327-329 
    ISSN: 1432-2102
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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