1,721,000 research outputs found
In vivo and in vitro allergy diagnostics: it's time to re-appraise the costs
No full textBackground: The in vivo skin prick test (SPT) is widely considered less expensive than in vitro gamma-immunoglobulin E flgE) determination in the diagnosis of allergy. The aim of the present paper is to evaluate the relevance of component-resolved in vitro diagnosis in comparison to extract-based diagnosis and the relative global costs in relation to clinical outcomes.
Methods: For 50 individuals with suspected seasonal allergic rhinitis, we compared the costs of skin testing with those of specific IgE antibody measurement.
Results: The costs were higher for in vitro than in vivo testing. However, the clinical information obtained using recombinant reagents allowed correct identification of the sensitizing molecule.
Conclusions: Recombinant allergens for specific IgE in vitro measurement provide more reliable information for immunotherapy prescription. This should be translated into a significant reduction in the overall costs sustained by the healthcare system
Clinical efficiency of in vitro and in vivo tests for allergic diseases.
No full textAbstract
BACKGROUND:
Specific serum IgE determination is widely used in the diagnosis of IgE-mediated allergic diseases but the relative merits of in vitro measurement of IgE antibody in comparison to in vivo skin tests are still debated.
OBJECTIVE:
The aim of this study was to investigate the clinical efficiency of a "second generation" technique for in vitro analysis of IgE antibody (Pharmacia CAP System).
METHODS:
Eighty-six patients with suspected inhalant and/or food allergies and 20 asymptomatic subjects for a total of 655 tests were evaluated. Sera with divergent results between in vitro and in vivo techniques were further analyzed by using ImmunoCAP inhibition and immunoblotting. For the calculation of sensitivity and specificity of both in vitro and in vivo tests we considered as true value (reference value) either the concordant results or, in case of discordance, the datum confirmed by ImmunoCAP inhibition or immunoblot (ie, vitro positive, vivo negative, ImmunoCAP inhibition positive; true result: positive).
RESULTS:
The obtained results demonstrate that the in vitro results correlate well in terms of specificity and sensitivity to this new reference standard. In particular a higher specificity for Pharmacia CAP System in comparison to in vivo skin prick test for grass pollens and a better sensitivity for mites and cat allergens were found.
CONCLUSIONS:
Our results suggest that the in vitro "second generation" testing provides reliable results in all clinical situations
Tear eosinophil cationic protein (ECP) in tears of normal subjects and patients affected by vernal keratoconjunctivitis.
No full textI.F. 5.99
Growth parameters and plasma metabolites of European Sea Bass, Dicentrarchus labrax, L. in relation to the DP/DE ratio of the diet
No full textMeasurement of specific immunoglobulin E: Intermethod comparison and standardization
No full textRecently introduced "second-generation" techniques for specific IgE measurement have produced some analytical improvement, offering better clinical sensitivity than previous techniques. The aims of our study were to compare the analytical and clinical performances of four second-generation techniques for allergen-specific IgE measurement in serum and to ascertain whether the new system for reporting quantitative results contributes to greater clinical agreement between findings using the techniques considered. Allergen-specific IgE was measured using the CAP System, CARLA, ENEA, and AlaSTAT, and the findings were compared. A significant disagreement was found between CAP and ENEA for all allergens and between CAP and CARLA for D1 and G5. However, the clinical discrepancies were reduced by selecting method-specific thresholds using ROC analysis. Second-generation techniques enable us to obtain better standardization of results; however, the identification of a specific threshold appears to be a prerequisite for the appropriate clinical interpretation of the test findings
Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis.
No full textAIM:
To validate the use of tear eosinophil cationic protein (ECP) as a marker for eosinophil activation, and its pharmacological modulation, in addition to evaluating the efficacy of lodoxamide and sodium cromoglycate in the treatment of vernal keratoconjunctivitis (VKC).
METHODS:
Tears were collected from 30 patients affected by active mild to moderate VKC before and after therapy with disodium cromoglycate 4% (DSCG) (n = 15) or lodoxamide 0.1% (n = 15) for 10 days. Tear cytology and ECP measurement were performed, and ocular signs and symptoms evaluated.
RESULTS:
While statistically significant changes did not occur after DSCG therapy, mean tear ECP increased from 343 (SD 363) micrograms/l to 571 (777) micrograms/l due to marked elevation in six eyes. The clinical score in DSCG eyes did not improve. After lodoxamide therapy, both clinical signs and symptoms, and tear ECP levels (560 (756) micrograms/l to 241 (376) micrograms/l) decreased significantly (p < 0.0001 and p < 0.01, respectively). Compared with DSCG treatment, lodoxamide was more effective in reducing signs and symptoms (p < 0.005). ECP levels were significantly correlated with signs, symptoms, corneal involvement, and number of eosinophils in tears (p < 0.0001).
CONCLUSIONS:
In patients with VKC, lodoxamide significantly reduced ECP tear levels, and thus, eosinophil activation, and was more effective than DSCG in reducing clinical signs and symptoms
Eosinophil cationic protein in tears of normal subjects and patients affected by vernal keratoconjunctivitis.
No full textThe objectives of this study were to determine: 1) levels of tear eosinophil cationic protein (ECP) in patients with vernal keratoconjunctivitis (VKC); 2) the effect of pharmacologic therapy on ECP release; and 3) the correlation of this mediator with the severity of the disease. Tears were collected from 10 controls and 20 VKC patients before and after therapy for cytologic analysis and ECP measurement by radioimmunoassay. Ocular signs and symptoms were evaluated before tear collection. Mean ECP levels in controls were 7.5 +/- 0.4 microgram/l, and in VKC patients, 988.3 +/- 128 micrograms/l before therapy (P < 0.001) and 566.3 +/- 121 micrograms/l after therapy (P < 0.005). In dexamethasone (Dex) 0.1% or cyclosporin A (CsA) 2% patients (five per group), tear ECP decreased significantly after 7-14 days of treatment. Disodium cromoglycate (DSCG) 4% (five patients) for 14 days did not significantly affect ECP levels. ECP levels were significantly correlated with allergic signs (P < 0.001), symptoms (P < 0.001), and the number of eosinophils in tears (P < 0.005). The results of this study suggest that tear ECP levels accurately reflect the clinical status of VKC patients. The measurement of ECP may prove useful not only in the diagnosis and monitoring of allergic disease, but also as an objective parameter for the evaluation of new antiallergic therapies
Procollagens and inflammatory cytokine concentrations in tarsal and limbal vernal keratoconjunctivitis.
No full texto quantify the presence of inflammatory/fibrogenic cytokines and procollagens type I (PICP) and III (PIIIP) in active and non-active tarsal and limbal forms of vernal keratoconjunctivitis (VKC), tear and blood samples were collected from 27 VKC patients (20 active and 7 non-active) and 15 normal subjects. Upper tarsal conjunctival biopses were obtained from 8 controls and 8 tarsal VKC patients. From biopses of 4 tarsal VKC, fibroblasts were cultured in F12 medium with 10% FCS. TGF-beta 1, IL-1 alpha, IL-1 beta, IL-6 and TNF-alpha, PICP and PIIIP were measured in: (1) tears, (2) homogenized conjunctival tissues, (3) serum, (4) supernatants of tissue cultures at 24 hr, and fibroblast primary passage cultures. Results showed: (1) in tears, TGF-beta 1 and TNF were identified in several active VKC patients without significant differences between the tarsal and the limbal forms. IL-1 beta (27 +/- 51 pg ml-1, P = 0.03) and IL-6 (28 +/- 43 pg ml-1, P = 0.006) were significantly increased in tarsal VKC compared to controls. Both control and non-active VKC tear samples had undetectable levels of all of the above cytokines. PICP and PIIIP were significantly increased in tarsal VKC compared to both limbal VKC and controls. Non-active VKC levels were similar to controls. (2) In homogenized VKC tissues, TGF-beta 1 and IL-6 were both significantly increased compared to controls (P < 0.01) while no increases were observed in IL-1 and TNF-alpha. (3) In serum, IL-1 alpha, IL-1 beta and TNF-alpha were higher in VKC patients compared to controls. (4) In vitro fibroblasts from VKC patients showed an increased production of TGF-beta 1, IL-1 alpha, IL-1 beta, IL-6, TNF-alpha, PICP, and PIIIP over time. Increased levels of TGF-beta 1, IL-1 and IL-6 in VKC tissues and tears indicate a local production of these cytokines in active VKC. Collagen hyperproduction occurs only in active tarsal VKC and may be related to high levels of TGF-beta 1, IL-1 and IL-6. Increased serum levels of IL-1 and TNF-alpha suggests that systemic immunological changes occur in VKC. Cell culture can be used as a model to further study the pathogenesis of VKC and its characteristic local fibroblast activation
Full automation in allergy testing: measurement of specific IgE by the ENEA System.
No full textWe evaluated the ENEA System, a fully automated instrument for the measurement of specific IgE antibodies. The instrument dispenses sera and reagents, incubates, washes, and reads and prints results automatically. The "core" of the instrument is the reactive unit called ACE (Allergy Chamber Enzymatic), which is a new solid phase to which the allergens are linked. The system uses calibration curves specific for the major allergen families, and data are supplied qualitatively (five classes) and quantitatively. We evaluated the analytic efficiency of the system and its correlation with the in vivo test (skin prick test (SPT)) results in 60 patients with inhalant allergic diseases and in 20 controls. Results: 450 results were available within 4 h. A satisfactory within-run (CVs between 1.58 and 6.2%) and between-run (CVs 6.3-11.5%) precision was found. No significant carry-over was observed. A wide linearity of the assay was demonstrated. With the concordance between the clinical history and SPT as the reference value, the clinical sensitivity of the ENEA System was 84.1%, the specificity 82.8%, and the overall efficiency 83.4%. Finally, a good agreement with the results of another technique for the in vitro measurement of specific IgE (Pharmacia CAP System) was proven
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