History Of Respiratory Allergy Research Articles

Faktor Pencetus Kejadian Alergi Pernapasan Pada Pasien Dewasa Di RSUPN Dr. Cipto Mangunkusumo

Allergy is a hypersensitive reaction in human due to human body produced IgE antibody more than regullary do as a response to the presence of allergens. Asthma and rhinitis are respiratory allergies, could be caused by genetics and environmental factors. The objectives of this study was to analyze the trigger factors of asthma and rhinitis patients at the Allergy-Immunology Polyclinic, Internal Medicine Department, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo National Center General Hospital, Jakarta. The skin test using grass mix pollen, cat, dog, cockroach, and dust mites allergens were done to 90 respiratory allergy patients. History of respiratory allergy from their parents, and environmental factors such as pets, cigarette smoke, and emotional state were asked and recorded. The patients mostly women, and most respiratory allergy patients could be detected by skin test using dust mites allergens, however, their reaction did not the same for other allergens. More than 50% patients of respiratory allergy have atopy from their parents, for most of patients, their emotional state and cigarette smoke in house could trigger the symptom of respiratory allergy.

Food IgE-Sensitization in Respiratory Allergic Patients in Jakarta

Food allergy and respiratory allergy may co-exist in atopic person. Although both conditions can worsen allergic symptoms, food allergen sensitization has not gain much attention in clinical studies. The aim of this study is to evaluate food IgE sensitization in respiratory allergic patients. This was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, on September to December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent test. Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. A total of 100 subjects were eligible for analysis; 76% were women. Patients mean age was 38.8 + 12.1 (range 19-59) years old; 62% of the patients have both asthma and allergic rhinitis. There are 46% patients with at least one positive food-IgE sensitization. The most common sensitization was to shrimp (17%), followed by fruit-mix (14%), goat milk (13%), crab (13%), potato (13%), soybean (11%), and strawberry (11%). Significant difference of IgE sensitization was found between house dust mites and crab or shrimp and between cockroach and crab or shrimp. In conclusion food-IgE sensitization in respiratory allergic patients is common. The most common allergens were shrimp, fruit-mix, goat milk, crab, and potato.

Risk factors for work-related eczema and urticaria among vocational students of agriculture.

Farmers are at high risk of occupational skin diseases which may start already during vocational training. This study was aimed at identification of risk factors for work-related skin diseases among vocational students of agriculture. The study involved 440 students (245 males, 195 females aged 17-21 years) in 11 vocational schools which were at least 100 km from each other. The protocol included a physician-managed questionnaire and medical examination, skin prick tests, patch tests, total IgE and Phadiatop. Logistic regression model was used for the identification of relevant risk factors. Work-related dermatoses were diagnosed in 29 study participants (6.6%, 95%CI: 4.3-8.9%): eczema in 22, urticaria in 14, and co-existence of both in 7 students. Significant risk factors for work-related eczema were: history of respiratory allergy (OR=10.10; p<0.001), history of eczema (itchy rash) provoked by wet work and detergents before entering the school (OR=5.85; p<0.001), as well as history of contact dermatitis to metals, rubber or cosmetics prior to inscription (OR=2.84; p=0.016), and family history of any skin disease (OR=2.99; p=0.013). Significant risk factors for work-related urticaria were: history of allergic rhinitis and asthma prior to inscription (OR=7.29; p=0.006), positive skin prick tests to work place allergens (OR=4.65; p=0.002) and to environmental allergens (OR=3.79; p=0.009), and positive Phadiatop test (OR=3.61; p=0.013). Work-related skin diseases are common among vocational students of agriculture. Atopy, past history of asthma, allergic rhinitis, and eczema (either atopic, allergic or irritant) are relevant risk factors for work-related eczema and urticaria in young farmers, along with family history of any skin disease. Positive skin prick tests seem relevant, especially in the case of urticaria. Asking simple, aimed questions during health checks while enrolling students into agricultural schools would suffice to identify students at risk for work-related eczema and urticaria, giving them the chance for selecting a safer profession, and hopefully avoiding an occupational disease in the future.

Approaching a Scientific Consensus on the Association between Allergies and Glioma Risk: A Report from the Glioma International Case-Control Study.

Several previous studies have found inverse associations between glioma susceptibility and a history of allergies or other atopic conditions. Some evidence indicates that respiratory allergies are likely to be particularly relevant with regard to glioma risk. Using data from the Glioma International Case-Control Study (GICC), we examined the effects of respiratory allergies and other atopic conditions on glioma risk. The GICC contains detailed information on history of atopic conditions for 4,533 cases and 4,171 controls, recruited from 14 study sites across five countries. Using two-stage random-effects restricted maximum likelihood modeling to calculate meta-analysis ORs, we examined the associations between glioma and allergy status, respiratory allergy status, asthma, and eczema. Having a history of respiratory allergies was associated with an approximately 30% lower glioma risk, compared with not having respiratory allergies (mOR, 0.72; 95% confidence interval, 0.58-0.90). This association was similar when restricting to high-grade glioma cases. Asthma and eczema were also significantly protective against glioma. A substantial amount of data on the inverse association between atopic conditions and glioma has accumulated, and findings from the GICC study further strengthen the existing evidence that the relationship between atopy and glioma is unlikely to be coincidental. As the literature approaches a consensus on the impact of allergies in glioma risk, future research can begin to shift focus to what the underlying biologic mechanism behind this association may be, which could, in turn, yield new opportunities for immunotherapy or cancer prevention.

Highlights of This Issue

Several studies have found inverse associations between glioma susceptibility and a history of allergies or other atopic conditions. Using data from the Glioma International Case-Control Study (GICC), Amirian and colleagues examined the effects of respiratory allergies and other atopic conditions on glioma risk. The authors report that a history of respiratory allergies was associated with an approximately 30% lower glioma risk. This GICC study further strengthens the existing evidence that the relationship between atopy and glioma is unlikely to be coincidental.Wilson and colleagues evaluated cancer incidence and trends in Appalachia and non-Appalachian regions of the US. Age-adjusted cancer incidence rates were calculated using the most recent data from the United States Cancer Statistics for 2004 to 2011. Generally, Appalachia carries a higher cancer burden compared to non-Appalachia, particularly for tobacco-related cancers. It is important to continue to evaluate this population to better understand behavioral risk factors related to cancer incidence.In this study, Moss and colleagues evaluated the seasonal uptake of human papillomavirus (HPV) vaccine and other adolescent vaccines in the United States. Data came from health care provider–verified vaccination records and seasonal patterns in uptake of HPV and other recommended adolescent vaccines [tetanus, diphtheria, and pertussis (Tdap) booster and meningococcal vaccine]. HPV vaccine initiation (receipt of the first of the three-dose series) data were for female adolescents. HPV vaccine initiation was highest in June, July, and August. These summer peaks are an important opportunity for interventions focused on concomitant vaccination.Chronic inflammation and oxidative stress are thought to be involved in colorectal cancer development, and both processes are contributed to by leakage of bacterial lipopolysaccharide (LPS) and flagellin, across the gut barrier. In this study, Kong and colleagues examined associations between circulating LPS and flagellin serum antibody levels and colorectal cancer risk. In this prospective study on European populations, the authors found that bacterial exposure levels were positively associated to colorectal cancer risk among men while in women, a possible inverse association may exist.

Perfil clínico-epidemiológico de pacientes con sospecha de alergia alimentaria en México. Estudio Mexipreval

Adverse reaction to food has increased around the world in last years. Prevalence of food allergy raises between 2-4% in adults, and 6-8% in children. The clinical presentation is heterogeneous and varies from mild symptoms to anaphylactic reactions. Even the clinical history focused in the food is important; demonstration of allergen sensitization is mandatory. To describe the profile of the patients with suspicion of food allergy and the regular clinical practice followed in Mexico. An observational, descriptive, cross-sectional study was carried out from March 2013 to March 2014 using a convenience sample of allergic patients who were treated in the office, both private and public, of those physicians who seen food allergy patients. Clinical, epidemiological, diagnostic and therapeutic data were collected from 1,971 suspicious food allergic patients presenting for the first time in the departments of the researchers involved in the study. No difference was found in relation to gender. In relation to age, a bimodal distribution, with peaks at 2 and 35 years old, was found. A history of respiratory allergy was present in 75% of cases; 80% of patients had had any previous symptoms before seeking consultation and the most frequent clinical manifestations were cutaneous, 5% reported anaphylaxis. The foods involved in reactions change with age. The clinical presentation changes with the food, although the skin is the most frequently affected organ. Even if the suspicious were high, the confirmation with specific diagnostic tools is strongly recommended.

Mammal’s meat and cow’s milk allergy – case report

Methods We present the case of a 66 year-old woman that at age 61 developed recurrent episodes of generalized urticaria and angioedema of the upper airways about 4 hours after the ingestion of ham, bean stew with pork meat and rabbit meat. She tolerated other foods, including other meats, fish and cow ’s milk. She worked in a meat factory and handled daily with meat, she had contact with various animals, including dogs, cows, pigs, chickens and doves. Two years after the onset of the clinical manifestations she had other episode after the ingestion of cow’s milk. She avoids all mammalian meat and cow ’s milk. No history of respiratory allergy was reported. Skin prick tests (SPT) and determination of specific IgE (sIgE) to aeroallergens, meats and epithelia from mammals, cow’s milk and to a-gal and nBos d 6 were carried out. We performed SDS-PAGE immunoblotting assays to mammalian meats. Open oral challenge to cow’s milk was also performed.

Anaphylaxis to cow's milk formula containing short-chain galacto-oligosaccharide

On the basis of the proven prebiotic effects of oligosaccharides in cow's milk formula (CMF) in infants, CMFs are supplemented with oligosaccharides. We present a series of 5 cases of cow's milk-tolerant but atopic patients with a history of respiratory allergies. All had anaphylaxis after the ingestion of CMF supplemented with short-chain galacto-oligosaccharide (scGOS). The allergen trigger was investigated. Clinical histories were collated. Skin prick tests (SPTs) and basophil activation tests (BATs) were carried out with the eliciting CMF that triggered anaphylaxis, with or without supplemented prebiotics (scGOS) and with scGOS fractions containing oligosaccharides of different chain lengths. The median age of presentation was 6 years (range, 5-38 years). Anaphylaxis occurred within 30 minutes of the first known exposure to CMF supplemented with prebiotics in all patients. Only 1 patient was subjected to oral challenge, which resulted in an anaphylactic reaction. All patients demonstrated IgE sensitization through SPTs and BATs to scGOS and fractions of scGOS containing 3 sugar units or greater but not to cow's milk or long-chain fructo-oligosaccharide. Eight child control subjects tolerant to regular ingestion of scGOS-supplemented CMF and 1 adult volunteer were found to have negative results to scGOS through SPTs and BATs. In addition, invitro BATs with donor basophils sensitized with sera from 2 of the 3 reported cases showed reactions to scGOS. The scGOS-induced basophil activation was inhibited in the presence of wortmannin, a phosphatidylinositol 3-kinase inhibitor. This study describes an unusual form of IgE-mediated anaphylaxis triggered by low-molecular-weight oligosaccharides in scGOS. The primary sensitizer for this phenomenon requires further investigation.

Ichthyosis prematurity syndrome: Clinical evaluation of 17 families with a rare disorder of lipid metabolism

Ichthyosis prematurity syndrome (IPS) is classified as a syndromic congenital ichthyosis based on the presence of skin changes at birth, ultrastructural abnormalities in the epidermis, and extracutaneous manifestations. Recently, mutations in the fatty acid transporter protein 4 gene have been identified in patients with IPS. We sought to perform a detailed clinical evaluation of patients with IPS identified in Norway. Clinical examination and follow-up of all patients (n = 23) and light and electron microscopic examination of skin biopsy specimens were performed. IPS was characterized prenatally by ultrasound findings of polyhydramnios, separation of membranes, echogenic amniotic fluid, and clear chorionic fluid. All patients were born prematurely with sometimes life-threatening neonatal asphyxia; this was likely caused by aspiration of corneocyte-containing amniotic fluid as postmortem examination of lung tissue in two patients revealed keratin debris filling the bronchial tree and alveoli. The skin appeared erythrodermic, swollen, and covered by a greasy, thick vernix caseosa-like "scale" at birth, and evolved rapidly to a mild chronic ichthyosis. Many patients subsequently had chronic, severe pruritus. Histopathologic and ultrastructural examination of skin biopsy specimens showed hyperkeratosis, acanthosis, dermal inflammation, and characteristic aggregates of curved lamellar structures in the upper epidermis. Peripheral blood eosinophilia was invariably present and most patients had increased serum immunoglobulin E levels. Over 70% of the patients had a history of respiratory allergy and/or food allergy. The study included only 23 patients because of the rarity of the disease. IPS is characterized by defined genetic mutations, typical ultrastructural skin abnormalities, and distinct prenatal and postnatal clinical features.

Sublingual Immunotherapy in Real-Life: When and Why?

Sublingual immunotherapy (SLIT) has gained wide acceptance in many European countries and has raised the level of interest in immunotherapy among practicing allergists and primary care physicians. SLIT was firstly accepted as a viable alternative to subcutaneous immunotherapy (SCIT) in the World Health Organization (WHO) Position Paper, published in 1998, and then included in ARIA guidelines. Since 1986, 60 DBPC-RCT trials have been published. There seem to be 2 distinct and perhaps sequential immunologic responses to SLIT; generation of regulatory T- cells (Tregs) secreting interleukin (IL)-10 and transforming growth factor (TGF)-β and immune deviation from Th2 to Th1 responses. The available meta-analyses are in favor of SLIT (rhinitis and asthma in adults and children).SLIT appears to be better tolerated than SCIT: a few case of SLIT-related anaphylaxis have been reported but no fatalities. SLIT may alter the natural history of respiratory allergy by preventing the onset of new skin sensitizations and/or reducing the risk of asthma onset. The clinical effects of SLIT are not immediate, such those of traditional drugs (ie, bronchodilatators or anti-histamines), but the immune modulation is profound and long-lasting (for 5-8 years after discontinuation). Special SLIT indications exist in everyday clinical practice in the following patients: uncontrolled with optimal pharmacotherapy, in whom drugs induces undesirable side effects, affected by moderate to severe rhinitis with moderate to severe nasal eosinophilia, associated with non specific bronchial hyper responsiveness (BHR) and/or bronchial asthma.

Documentation of the nasal nitric oxide response to humming: methods evaluation

Nitric oxide (NO) is present at higher concentrations in the nasal cavity than in the lower airway, and at even higher concentrations within the paranasal sinuses proper. When the paranasal sinus ostia are patent, acoustic activity produced by vocalization with closed lips (humming) promotes mixing of sinus with nasal gases, producing a further increase in nasal NO. We wished to evaluate procedures for the documentation of the nasal NO response to humming. We compared two ATS-recommended sampling methods: 1) active exhalation of lower airway gas (parallel technique) and 2) passive aspiration of nasal gas with closed velopharynx (series technique). Variables controlled for included sampling rate, external resistance (parallel method), humming frequency, humming duration, and intertrial interval. Prior to upper airway sampling, exhaled lower airway NO was determined utilizing ATS-standardized technique. Ten volunteers (seven males and three females, aged 21-58) with no history of respiratory allergies or sino-nasal disease were studied in a single session each. The parallel technique documented an increase in nasal NO during the humming manoeuvre in all subjects (mean ratio of humming-to-quiet NO, 4.2), whereas the series technique did so in eight of 10 subjects (mean ratio 2.1). Correcting for admixture from the lower airway, the ratio of humming-to-quiet NO was greater with the parallel than series sampling technique (P < 0.05). Documentation of the response of nasal NO to humming in subjects without sino-nasal disease was consistently achievable by parallel sampling using commercially available equipment. Specific operational procedures are proposed.

Risk factors for sleep‐related hypoxia in primary school children

Sleep-related hypoxia has adverse effects on cognition in children. Knowledge of factors contributing to sleep-related hypoxia is sparse. We aimed to identify demographic and clinical factors associated with mild (nadir arterial oxygen saturation 91-93%), moderate (nadir arterial oxygen saturation <or=90%), and recurrent (oxygen desaturation index > 3.9) sleep-related hypoxia in children. Parental questionnaires were distributed and overnight recordings of arterial oxygen saturation performed in a population-based cross-section of primary school children (n = 995). Associations were determined using unconditional logistic regression as well as unadjusted and adjusted odds ratios (OR), and their 95% confidence intervals (95% CI) calculated. Male sex, overweight (i.e., body mass index >or= 75th percentile), household smoking, symptoms of sleep-disordered breathing, a current respiratory tract infection, and histories of asthma and respiratory allergy were all significantly associated with sleep-related hypoxia. In multiple regression analysis, (i) overweight (OR, 95% CI: 2.7, 1.7-4.3) and a history of respiratory allergy (1.7, 1.1-2.7) were independent risk factors for mild sleep-related hypoxia, (ii) overweight (3.2, 1.7-5.8), a history of respiratory allergy (2.4, 1.4-4.4), and household smoking >10 cigarettes/day (1.8, 1.1-2.8) were independent risk factors for moderate sleep-related hypoxia, and (iii) overweight (2.3, 1.04-5.3), a history of respiratory allergy (2.5, 1.2-5.1), and a current respiratory tract infection (4.4, 2.0-9.8), were independent risk factors for recurrent sleep-related hypoxia. Our data suggest that overweight, passive smoking, respiratory allergies, and acute lung disease may independently contribute to sleep-related hypoxia in children.

Segregation analyses of asthma and respiratory allergy: the Humboldt family study.

We performed segregation analyses of asthma and respiratory allergy based on data from 309 nuclear families comprising 1,053 individuals living in the town of Humboldt, Saskatchewan, in 1993, using the REGD program of the S.A.G.E. program package. For adults, information on asthma and history of respiratory allergy was provided by the subjects themselves, and for children by their parents. When asthma was considered as the trait in segregation analysis, models of no major effect, with or without familial effects, were rejected, but they were not rejected after adjusting for history of respiratory allergy. The major gene hypothesis was not rejected before adjusting for history of respiratory allergy. When respiratory allergy was analyzed as the trait, both major gene and multifactorial models fitted the data well, regardless of whether there was adjustment for asthma or not. Other covariates adjusted for in the segregation analyses were age, sex, number of household smokers, current smoking, number of household members, generation, and house type. The data suggest that a major gene related to respiratory allergy may explain the familial aggregation of asthma.

Lymphoid aggregates in endobronchial biopsies from young elite cross-country skiers.

Observation of bronchus-associated lymphoid tissue (BALT) in whole lung specimens from healthy nonsmoking adults has questioned the hypothesis that BALT is not constitutively present in healthy adult human lungs. In our study, we investigated endobronchial biopsies of the second- and third-generation carinae from 44 cross-country ski athletes and 12 healthy control subjects, all nonsmoking young adults. The skiers had a prevalence of respiratory allergy (18%), asthma-like symptoms (59%), beta2 agonist medication (25%), and methacholine bronchial hyperresponsiveness (79%). Biopsy sections were stained by immunohistochemical and hematoxylin-eosin-saffran methods. Lymphoid aggregates of more than 50 cells were identified in 28 (64%) skiers and three (25%) control subjects (p = 0.02). They were small in comparison to those found in rabbits and rats, contained T and B lymphocytes and macrophages, and were seen more frequently in skiers using beta2 agonists (p = 0.04) and with bronchial hyperresponsiveness to methacholine (p = 0.053). The frequency of these aggregates was not significantly different at the two carinal levels (p = 0.6). The aggregates were not associated with a history of respiratory allergy or asthma-like symptoms. These aggregates share some resemblance with what is usually defined as BALT. However, their exact nature and function await further clarification.

Serum level of placental growth hormone is raised in pregnancy rhinitis.

To describe any relationship between pregnancy rhinitis and weight gain or serum levels of estradiol, progesterone, placental growth hormone, or insulinlike growth factor I. Twenty-seven nonsmoking healthy pregnant women aged 22 to 38 years (mean age, 28 years) who had no history of respiratory allergy or chronic nasal or sinus problems volunteered to enter the study. They had no nasal complaints at entry. Nasal patency was registered daily from early pregnancy until 1 month after delivery. Nasal and oral peak expiratory flow rates were established, and the subjective blockage was scored from 0 to 4, with 0 indicating no blockage. Serum samples were collected and weight was measured on 4 occasions during pregnancy and again at the end of the study. Pregnancy rhinitis was diagnosed if the subjective nasal obstruction score was 1 or higher every morning for at least 6 weeks immediately preceding delivery, then returned to 0 within 2 weeks and remained at 0 until the end of the study. If on any day other signs of respiratory tract infection occurred, that day was excluded. Pregnancy rhinitis was diagnosed in 5 women. These 5 women showed significantly higher levels of placental growth hormone than the women without the diagnosis. No significant difference was found between the 2 groups regarding body weight or any of the other serum levels studied. Serum level of placental growth hormone is raised in pregnancy rhinitis and may be involved in its pathogeny. Pregnancy rhinitis does not significantly raise weight gain or serum levels of estradiol, progesterone, or insulinlike growth factor I.

Evidence for major genetic control of wheeze in relation to history of respiratory allergy: Humboldt family study

Evidence for major genetic control of wheeze in relation to history of respiratory allergy: Humboldt family study

Etiologic role of unapparent exposure in cat allergy.

To determine the importance of unnoticed exposure to cat, we studied 20 patients with a history of respiratory allergy. All the patients had a positive prick test to cat dander extract, and none of them kept cats as pets. The prick test was carried out with a dander extract from cat at a concentration of 100 BU/ml. The specific IgE was determined by the commercially available Pharmacia CAP System. We carried out a conjunctival challenge test. The concentration of Fel d 1 was quantified in dust samples from the patients' homes by a commercially available method. The patients were reassessed in order to establish a relation between exposure and symptoms, and concealed allergen sources. Sixteen patients showed significant levels of Fel d 1 in their homes (mean of 3.35 micrograms/g of dust). The conjunctival challenge test was positive in 15 patients. These patients showed an exposure mean of 0.4 microgram/g of dust. The mean levels of specific serum IgE were higher in those patients with a positive challenge than in those with a negative challenge (P = 0.0145). In nine reassessed patients, a relation was established between natural exposure and the onset of the symptoms. A possible hidden allergen source was established in 11 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Responsiveness to Interleukin 4 and Interleukin 2 of Peripheral Blood Mononuclear Cells in Atopic Dermatitis

Although the pathogenesis of atopic dermatitis (AD) is unknown, many immunologic abnormalities such as high levels of serum IgE and increase of IgE Fc receptor-positive lymphocytes have been demonstrated. Recently, interleukin 4 (IL-4) has been shown to induce enormously the production of IgE and to enhance the expression of IgE Fc receptor by B cells, suggesting the possible involvement of IL-4 in the pathogenesis of AD. We examined IL-4 responsiveness or interleukin 2 (IL-2) responsiveness of peripheral blood mononuclear cells of 31 patients with AD, 19 healthy individuals, and seven patients with other skin diseases. We found that IL-4 responsiveness of AD was higher than that of non-AD control, although IL-2 responsiveness of AD showed no significant change. However, the value of the IL-4 responsiveness did not significantly correlate with the clinical severity, personal history of respiratory allergy, serum IgE level, or clinical course of patients with AD. The hyperresponsiveness to IL-4 detected in AD was not likely to be due to the effects of steroids or anti-mast cell drugs because the value of IL-4 responsiveness was significantly low, compared to AD, in patients with other skin diseases who were treated similarly. Because the T-cell-enriched population, but not the B-cell-enriched population, showed significant proliferation in response to exogenous IL-4 or IL-2, T cells were the main population that reacted in our proliferation assay. These results indicate that IL-4-driven proliferative response may be efficiently operative in T cells in patients with AD.

Food allergens and basophil histamine release in recurrent aphthous stomatitis

The leukocytes from sixty patients with recurrent aphthous stomatitis were tested for histamine release in response to environmental and food antigens. Eighteen patients (30 percent of the population studied) were atopic, and this history of respiratory allergy was confirmed by an in vitro histamine release assay. The nonatopic patients with recurrent aphthous stomatitis had a significantly higher incidence of in vitro histamine release to foods than did control subjects. The leukocytes from twenty-three patients (38 percent) released histamine to food antigens. Patients eliminated foodstuffs in a double-blind trial to correlate the in vitro histamine release to the development of oral ulcers. Only 30 percent of the patients had a decreased incidence of ulcers after eliminating foods which had induced in vitro histamine release. On rechallenge in the double-blind trial, 30 percent of the foods which caused histamine release also correlated to increased incidence of oral lesions. In eight patients ingestion of certain foodstuffs was correlated to oral ulceration by food diaries and elimination-rechallenge in an open-trial basis. However, dietary manipulation did not completely eliminate the ulceration in any of the patients. The results suggest that food sensitivity may play a minor role in the development of recurrent aphthous stomatitis.

Two observed associations between respiratory allergies and hypertension in nonsmokers.

Stebbings, J. H., Jr. (Div. Epidemiology, School of Public Health, Mayo Memorial Bldg. Box 197, Univ. of Minnesota, Minneapolis, Minnesota 55455). Two observed associations between respiratory allergies and hypertension in nonsmokers. Am J Epidemiol 97: 4–15, 1973. —Among 270 nonsmokers in Hagerstown, Maryland a threefold excess risk of diagnosed hypertension was found among respondents with a history of respiratory allergies, including asthma, hay fever, sinusitis and nasal catarrh. The association did not vary by age, and was found to be weak or nonexistent among smokers and exsmokers of pipes and cigars. Asthma and hay fever were found to be associated with high systolic blood pressure and the taking of medication for blood pressure in 234 nonsmoking white and Negro New York City transit workers. Among the whites, nasal catarrh was also associated with hypertension; among the Negroes, electrocardiographic evidence of left ventricular hypertrophy was also significantly associated with asthma and/or hay fever. Again, the associations occurred in all age categories. Risks of hypertension associated with a history of asthma and/or hay fever were distinctly stronger among Negroes than among whites. The hypothesis that respiratory allergies are risk factors for hypertension and that tobacco smoking suppresses the relationship deserves further investigation.