Leukocyte Migration Test Research Articles

Clinico-immunological justification of the use of a new dental ointment developed on the basis of a long-acting beekeeping product for topical treatment of inflammatory parodontal diseases

Relevance of the research topic. The composition and technology for the manufacture of dental ointment based on antimicrobial metronidazole, anesthetic anesthesin and an immunomodula-tor are substantiated and developed - for the frst time a biological product of the beekeeping product of a large wax moth larvae extract.Puprose – the goal is a clinical and immunological rationale for the use of dental ointment developed composition based on the product of beekeeping for the treatment of inflammatory periodontal diseases. Materials and methods. Studies have been conducted in patients with inflammatory periodontal disease (CDL), aged from 20 to 70 years. Group I control (n = 25), who had no dental pathology and practically healthy at the time of examination, group II (n = 204) received basic thera-py, group III (n = 120) used a developed dental ointment based on ( Galleria mellonela). Evaluation of the effectiveness of treatment was carried out according to clinical and laboratory parameters. Analysis of the hygienic and clinical state of periodontal tissues was taken into account by the Green-Vermillion, Russel, PMA indices in the Parma modifcation. The state of local immunity was investi-gated according to the indicators of the leukocyte migration test, the quantitative and qualitative con-tent of spontaneously released mixed saliva, the content of total protein in it, secretory immunoglobu-lin A, lysozyme.Results. The effectiveness of the developed dental ointment is confrmed by the positive dy-namics of clinical indicators in comparison with the basic therapy in 72.3% of cases. The number of sessions per course of treatment for gingivitis and mild periodontitis was reduced to 3, moderate –5–6, and severe to 8 sessions. Indices (GI, PI, PMA) decreased by 6.7; 2.6; 5.1 times, respectively, in comparison with the group before treatment and in 3; 2; 2.6 times, respectively, compared with base-line therapy. Local immunity revealed: an increase in the production of mixed saliva in comparison with baseline data by 2.6 times, its recovery and an increase of 1 ml above the control level (p> 0.05), an increase in protein level (p <0.05), lysozyme concentration and sIgA exceeded the level before the treatment and after the baseline therapy, however, the indices did not recover to the level in the con-trol.Summaru. Inclusion of dental ointment on the basis of Galleria mellonell into the complex therapy of VZP is a means of correcting violations of local immunity and is a promising new dosage form in practical periodontology

Pathogenic Mechanism and Diagnostic Testing for Drug Allergies

Three stages of the pathogenic mechanism of drug allergies can be considered: antigen formation, immune reaction and inflammation/disorder reaction. Drugs are thought to form 4 types of antigens: drug only, polymers, drug-carrier conjugates, and metabolite-carrier complexes. Antigens are recognized by B cell receptors and T cell receptors. Helper T cells (Th) are differentiated into four subsets, namely, Th1, Th2, Th17 and regulatory T cells (Treg). Th1 produces interleukin (IL)-2 and interferon (IFN)-γ, and activates macrophages and cytotoxic T cells (Tc). Macrophages induce type IV allergies, and Tc lead to serious type IV allergies. On the other hand, Th2 produces IL-4, IL-5, and IL-6, etc., and activates B cells. B cells produce IgE antibodies, and the IgE antibody affects mast cells and induces type I allergies. Activated eosinophil leads to the chronic state of type I allergy. Diagnostic testing for allergenic drugs is necessary for patients with drug allergies. Because in vivo diagnostic tests for allergenic drugs are associated with a risk and burden to the patient, in vitro allergy tests are recommended to identify allergenic drugs. In allergy tests performed in vitro, cytological tests are more effective than serological tests, and the leukocyte migration test (LMT) presently has the highest efficacy. An LMT-chamber is better than LMT-agarose in terms of usability and sensitivity, and it can detect about 80% of allergenic drugs.

Anti-inflammatory effects of essential oils from Mangifera indica.

Mangifera indica is widely found in Brazil, and its leaves are used as an anti-inflammatory agent in folk medicine. The aim of this study is to perform composition analysis of essential oils from the M. indica varieties, espada (EOMIL1) and coração de boi (EOMIL2), and confirm their anti-inflammatory properties. Twenty-three volatile compounds were identified via gas chromatography-mass spectrometry (GC-MS) in two essential oils from the leaves. Paw edema and myeloperoxidase (MPO) activity were evaluated using the carrageenan-induced paw model, while leukocyte migration was analyzed using the pleurisy model. At oral doses of 100 and 300 mg/kg, the essential oils significantly reduced edema formation and the increase in MPO activity induced by carrageenan in rat paws. For a dose of 300 mg/kg EOMIL1, 62 ± 8% inhibition of edema was observed, while EOMIL2 led to 51 ± 7% inhibition of edema. At a dose of 100 mg/kg, the inhibition was 54 ± 9% for EOMIL1 and 37 ± 7% for EOMIL2. EOMIL1 and EOMIL2 significantly reduced MPO activity at doses of 100 mg/kg (47 ± 5 and 23 ± 8%, respectively) and 300 mg/kg (50 ± 9 and 31 ± 7%, respectively). In the pleurisy model, inhibitions were also observed for EOMIL1 and EOMIL2 in the leukocyte migration test. The results of the present study show that essential oils from M. indica differ in chemical composition and anti-inflammatory activity in rats.

EVALUATION OF ANALGESIC AND ANTIINFLAMMATORY ACTIVITY OF CUSCUTA REFLEXA EXTRACTS ON ANIMAL MODELS

Cuscuta reflexa (Roxb.) belonging to the family Convolvulaceae and popularly known as dodder, is a parasitic plant with claims of antibacterial, antiproliferative and anti-inflammatory properties in literature. HPTLC analysis and investigation of analgesic and anti-inflammatory activities of Cuscuta reflexa extracts, petroleum ether extract, methanol extract, and aqueous extract of Cuscuta reflexa (PECR, MECR, and AECR respectively) at three dose levels of 50, 200 & 300 mg/kg body weight of an animal by oral route were used for biological activities. The analgesic activity of was determined using hot plate analgesia, acetic acid-induced writhing response and formalin test. The anti-inflammatory activity was determined using models like carrageenan, serotonin and histamine-induced paw edema models along with cotton pellet induced granuloma. Probable mechanism involved in the antiinflammatory effect of methanol and aqueous extracts was evaluated with various tests like ulcerogenicity test; acetic acid induced vascular permeability test and leukocyte migration test using a single dose of 300 mg/kg orally. Acute oral toxicity test revealed the LD50 of >2 g/kg. PECR, MECR and AECR (200 and 300 mg/ kg p.o.) significantly (P< 0.05) increased latency against thermal stimulus, decreased the acetic acidinduced writhing responses and licking times of the second phase in the formalin test. Moreover, MECR and AECR (200 and 300 mg/kg p.o.) exhibited significant (P<0.01) antiinflammatory effect against carrageenan and mediator-induced paw edema. The most promising fraction of methanol extract was found to be quercetin, which could be responsible for the biological activity. Results suggest significant analgesic and antiinflammatory effects produced by MECR and AECR.

Examination of patients suspected as having hypersensitivity to iodinated contrast media with leukocyte migration test.

In vivo tests may be used for the diagnosis of allergy to iodinated contrast media (ICM); however, the tests do not provide definitive diagnosis and are associated with risks for patients. Diagnoses based on in vitro tests are limited, and there are almost no relevant studies. Herein, the authors examined involvement of allergic reaction from a multilateral standpoint in 39 patients suspected of having ICM allergies using leukocyte migration test (LMT). The positive rate of LMT was 44%. A comparison with the positive rate of LMT in drugs other than ICM (74%) indicated 30% difference, which was significantly low value, suggesting that there is poor involvement of these drugs in the allergic reaction. In LMT positives, 76% of hypersensitivity reactions were skin rash mainly erythema, and 18% was anaphylactic reactions. Cases considered as non-immediate hypersensitivity accounted for about 4 times as many as immediate-type hypersensitivity. In examination of relevancy between a history of drugs or food allergies, the incidence of ICM allergies was 35%. There is a high possibility that these adverse reactions were caused by pseudoallergy to drug. It was suggested that most hypersensitivity reactions were skin rash related to non-immediate hypersensitivity, and approximately 20% of the reaction was immediate anaphylactic reaction. Therefore attention should be paid not only to immediate-type hypersensitivity but also delayed reactions. Moreover, it was considered that patients with past history of drug or food allergies have a high potential for manifestation of the reactions.

Study on Patients Who Underwent Suspected Diagnosis of Allergy to Amide-Type Local Anesthetic Agents by the Leukocyte Migration Test

There are problems in diagnosis of allergy to amide-type local anesthetic agents (ALAs), because definitive diagnosis is not obtained by in vivo tests, which are used for the diagnosis. Consequently, patients may be exposed to risk. There are few diagnoses based on in vitro tests, and there are almost no relevant studies. Authors examined involvement of allergic reaction using the leukocyte migration test (LMT) through multiple standpoints in 43 patients who underwent suspected diagnosis of allergy to ALAs. Rate of LMT-positives was 54%, and especially the positive rate of lidocaine hydrochloride preparations was significantly high. In 15 positives to lidocaine hydrochloride preparations, all cases were indicated as positive in a test with drugs containing antiseptic agent, but only 3 cases were indicated as positive in a test with lidocaine hydrochloride alone. In addition, test with paraben was conducted in 4 cases; 2 cases were confirmed as positive. In relevance of histories of drug or food allergies, development rates of ALAs-allergies were the highest in both allergies, and were 35% and 13%, respectively. There is a high possibility that these adverse reactions were caused by pseudoallergy to drug. Even by allergic reactions, it was assumed that 80% of them might be caused by antiseptic agents such as paraben. In addition, it was suggested that ALAs, especially lidocaine hydrochloride preparations have high antigenicity (sensitizing property). Furthermore, it was considered that patients with past history of drug or food allergies have a high potential for manifestation of the reactions.

Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches

Drug-induced interstitial lung disease (DILD) is not uncommon and has many clinical patterns, ranging from benign infiltrates to life-threatening acute respiratory distress syndrome. There are two mechanisms involved in DILD, which are probably interdependent: one is direct, dose-dependent toxicity and the other is immune-mediated. Cytotoxic lung injury may result from direct injury to pneumocytes or the alveolar capillary endothelium. Drugs can induce all types of immunological reactions described by Gell and Coombs; however, most reactions in immune-mediated DILD may be T cell-mediated.DILD can be difficult to diagnose; diagnosis is often possible by exclusion alone. Identifying the causative drug that induces an allergy or cytotoxicity is essential for preventing secondary reactions.One method to confirm the diagnosis of a drug-induced disease is re-exposure or re-test of the drug. However, clinicians are reluctant to place patients at further risk of illness, particularly in cases with severe drug-induced diseases. Assessment of cell-mediated immunity has recently increased, because verifying the presence or absence of drug-sensitized lymphocytes can aid in confirmation of drug-induced disease. Using peripheral blood samples from drug-allergic patients, the drug-induced lymphocyte stimulation test (DLST) and the leukocyte migration test (LMT) can detect the presence of drug-sensitized T cells. However, these tests do not have a definite role in the diagnosis of DILD. This study explores the potential of these new tests and other similar tests in the diagnosis of DILD and provides a review of the relevant literature on this topic.

A Study of Elevated Interleukin-8 (CXCL8) Detection of Leukocyte Migration Inhibitory Activity in Patients Allergic to Beta-Lactam Antibiotics

The leukocyte migration test (LMT) is effective in identifying the causative drug in drug allergies. Both leukocyte migration activating activity (LMAA) and leukocyte migration inhibitory activity (LMIA) are involved in the development of drug allergies. However, no cytokines associated with LMIA have been identified to date. Because CXCL8 played an important role in neutrophil infiltration and activation, we performed the LMT and measured CXCL8 levels in patients with hypersensitivity to beta-lactam antibiotics (beta-lactams) and antipyretic analgesics (APAs) and investigated the pathogenic mechanism of hypersensitivity to these drugs. The LMT was performed according to an improved version of the agarose plate method and CXCL8 levels in the reacted solution that had been stored as described were measured using a solid-phase sandwich enzyme-linked immunosorbent assay. Migration index (MI) values for the LMT were 77.7 ± 11.7 for patients with hypersensitivity to beta-lactams and 83.6 ± 1.9 for those with hypersensitivity to APAs. The CXCL8 concentrations were significantly higher in patients after beta-lactams administration (175.9 ± 71.2 ng/mL) than those without beta-lactams administration (48.3 ± 34.9 ng/mL). The CXCL8 concentrations were significantly lower in patients after APAs administration (41.7 ± 24.3 ng/mL) than those without APAs administration (63.1 ± 30.2 ng/mL). Increased CXCL8 levels produced by beta-lactams administration were accompanied by LMIA. CXCL8 may be involved in LMIA and play a role in beta-lactam allergies. In contrast, the LMIA detected in patients with allergies to APAs may be a cytokine or chemokine other than CXCL8.

Ｓ‐１による薬剤性皮膚障害でのアレルギー反応の関与

S-1 (tegafur-gimeracil-oteracil potassium combination) is a biochemical modulating agent which enhances anti-cancer efficacy and reduces the toxicity of 5-FU with respect to the digestive tract.We collected data on its adverse effects at Fukuoka University Hospital for evaluation and analysis,using the leukocyte migration test (LMT) for evaluation of adverse effects.We report the results of the evaluation for patients with skin eruption caused by S-1.After extracting mononuclear cells from heparinized peripheral blood taken from the patients,we mixed them with 3 drugs (S-1,5-FU,UFT capsule 100 mg® (UFT)) and incubated for 72 hours.We then collected the supernatant fluid and conducted the LMT using granulated leukocytes from healthy subjects in a 96-well chemotaxis chamber.In a period of 1 year,we encountered 5 patients with skin eruption associated with S-1 and evaluated 2 of them by the LMT.The results for 5-FU,S-1,and UFT were negative,positive,and positive,respectively,suggesting that tegafur,the common component of S-1 and UFT,was the cause of the allergic reaction and skin eruption.

薬剤アレルギーの起因薬検出，臨床解析および発現機構に関する研究

As drug allergies are specific,dose independent,and unpredictable,they are difficult to prevent and manage in the clinical setting.The objectives of this study were to analyze drug allergies and elucidate their pathogenesis from the viewpoints of detection of the causative drug,the allergen (drug),the patient (organism) and the mechanism of manifestation of drug hypersensitivity.As for detection of the causative drug,our findings suggest that the leukocyte migration test (LMT) may be more effective than other tests,i.e.the intradermal test,patch test,sensitized hemagglutination test,enzyme-linked immunosorbent assay and drug-induced lymphocyte stimulation test.In addition,the LMT-chamber method appeared to be more sensitive than the LMT-agarose method From the allergen viewpoint,our findings suggest that β-lactam antibiotics and X-ray contrast media have very high allergenicity,and macrolide antibiotics have the lowest allergenicity among antibacterial drugs.In addition,cross-allergic reactions arising among β-lactam antibiotics may be induced by drugs having similar structures in terms of parent skeleton and side chain.From the organism viewpoint,our findings suggest that skin eruption may be the most common drug-induced hypersensitivity symptom,fever alone may be strongly related to allergic reactions,itching may be closely connected with allergic drug eruptions and concomitant symptoms strongly related to drug-induced allergic hepatic injuries.Also,drug-induced blood disorders with short latent periods may be serious and closely related to allergic reactions and patients with previous medical histories of drug allergy may have a very high risk of drug-induced hypersensitivity.Furthermore,drug allergies in elderly persons have a low incidence and a long latent period,and women a high incidence of drug eruption and a low incidence of drug-induced hepatic injury.As regards the mechanism of manifestation of drug hypersensitivity,our findings suggest that IL-1,IL-2 and TNF-α play a part in drug allergies detected by means of the leukocyte migration activating factor and IL-8 in β-lactam antibioticinduced allergies detected by means of the leukocyte migration inhibitory factor.In addition,Shosaiko-to,a traditional Chinese medicine,may have a phytohemagglutinin-like immunologic activity (pseudoallergic effect).Pseudoallergic effects may also be involved in shock in response to lidocaines,iodinated contrast media and NSAIDs.

薬物アレルギー起因薬検出における白血球遊走試験 (ケモタキシス·チャンバー法)の臨床的有用性の検討

We performed a comparison between leukocyte migration tests performed by the chemotaxis chamber method (LMTchamber) and the agarose plate method (LMT-agarose) to study the usefulness of the LMT-chamber method in the identification of causative drugs in drug allergies.For LMT-agarose,the positive rate among 210 patients suspected of hypersensitivity to drugs (subject patients) was 67.6 % and for the LMT-chamber the positive rate among 197 subject patients was 81.2%,a significantly higher positive rate for the latter (p<0.001,χ2-test).The positive rate for LMT-agarose was 6.9% in 102 patients without hypersensitivity to drugs (control patients) and 9.8% for the LMT-chamber in 82 control patients,but this difference was not significant.In addition,the LMT-chamber produced a higher positive rate than LMT-agarose for all hypersensitivity symptoms and all efficacy categories of the suspected drugs.It also produced a significantly higher positive rate than LMT-agarose in subject patients without addition of self serum (p<0.05,χ2-test) and there were no significant differences between males and females or young and old persons,as there were in the case of LMT-agarose.Our findings indicate that the LMT-chamber may be more sensitive than LMT-agarose in identifying the causative drug in drug allergies and more useful than LMT-agarose for many hypersensitivity symptoms and suspected drugs.In addition,the LMT-chamber is much less influenced than LMT-agarose as regards patient’s own serum,or by sex and age.

Evaluation of cell-mediated immune response in chickens vaccinated with Newcastle disease virus

The leukocyte-migration inhibition test for the evaluation of cell-mediated immunity was developed for the use in chickens vaccinated with newcastle disease vaccine and other infected with local virulant strain of newcastle disease virus. Results indicated that the leukocyte migration test was reproducible and relatively easy assay to be performed .Serological antibody titers were determined to study the correlation between haemagglutination inhibition titers and leukocyte-migration level using the HI macro-assay .By results of this study cellular immunity level very important for evaluation the level of immunity beside the humoral immunity.

Comparative Study of the Usefulness of the Drug-Induced Lymphocyte Stimulation Test and the Leukocyte Migration Test in Drug Allergies

In 133 patients suspected of hypersensitivity to drugs and 102 control patients without hypersensitivity to drugs, the identification of allergenic drugs was performed by the drug-induced lymphocyte stimulation test (DLST) and the leukocyte migration test (LMT) to compare their usefulness in identifying drug allergies. In the 133 subject patients, the positive rate was 24.8% on the DLST and 60.9% on the LMT (agreement rate; 77.4%); thus, the LMT showed a significantly higher positive rate than the DLST (p<0.000001, chi(2)-test). In the 102 control patients, the positive rates on the DLST and LMT were 6.9%. In addition, the LMT showed a higher positive rate than the DLST for many hypersensitivity symptoms such as skin eruptions and hepatic injury, and for many drug efficacy categories of the suspected drugs such as antibacterial drugs, etc. Furthermore, the positive rate of the DLST did not change when adjusted for the patients' serum and sex, while that of the LMT increased when adjusted for the patients' serum and was found to be higher in females than in males. Our findings indicate that the LMT may be more useful than the DLST in identifying the causative drug in drug allergies and that its interpretation is influenced by the patient's serum and sex.

Evaluation of the anti-inflammatory and analgesic activities of Liu-Shen-Wan and its individual fractions

Liu-Shen-Wan (LSW), a famous traditional Chinese medicine for treatment of upper respiratory tract inflammation, was evaluated for its anti-inflammatory and analgesic activities. Acetic acid-elevated vascular permeability, carboxymethylcellulose sodium (CMC-Na)-induced leukocyte migration and ear edema induced by picryl chloride were used to test anti-inflammatory activity. Moreover, acetic acid-induced writhing and hot-plate tests were used to determine analgesic effect. It was observed that LSW exerted significant anti-inflammatory and analgesic activities in these models at doses of 30 and 90 mg/kg crude drug in vivo. In addition, LSW potently inhibited proliferation of human peripheral blood mononuclear cell (PBMC) stimulated by streptococcal pyrogenic exotoxin at doses of 0.5–5 μg/ml in vitro. LSW was then partitioned with chloroform, methanol, water and mineral fraction. Several fractions inhibited inflammation and pain in varying degrees. Among them, chloroform fraction was the most active in hot-plate and writhing tests, and exerted the remarkable inhibitory effect on human PBMC proliferation. Methanol and water fractions had more suppressive activities in vascular permeability, leukocyte migration and PC-DTH tests. These results suggest that LSW has significantly anti-inflammatory and analgesic activities. The chloroform fraction is a key fraction of LSW to the overall anti-inflammatory and analgesic effects, while methanol and water fractions also partly contribute to anti-inflammatory activities of LSW.

アレルギー性薬疹における掻痒感の検討

We examined the occurrence of itching in 310 patients in whom allergic drug eruption was suspected and studied various aspects of itching for 221 leukocyte migration test (LMT)-positive patients.The incidence of itching was 75.1% in the LMT-positives and 64.0% in LMT-negatives,a significant difference (p<0.05,χ2-test).In the former,there was a negative correlation between the incidence of itching and aging (correlation coefficient ; r=-0.78,p<0.01).As regards latent period,the incidence of itching was 65.0% in less than 3 days and 83.0% in more than 4 days,and this difference was also significant (p<0.05,χ2-test).Regarding leucocyte migration factors (LMFs),there was a signifant difference between the incidence of itching for the leukocyte migration activating factor (LMAF) which was was 82.2% and that for the leukocyte migration inhibitory factor (LMIF) which was 69.2% (p<0.05,χ2-test).In terms of causative drugs,the incidence of itching was 80.2% for antibacterial drugs and 62.5% for non-steroidal antiinflammatory drugs (NSAIDs),the difference again being significant (p<0.02,χ2-test).The detection rate of LMAF was significantly higher than that of LMIF for the antibacterial drugs (p<0.05,χ2-test),but in the case of NSAIDS,the LMIF detection rate was significantly higher than that for LMAF (p<0.00001,χ2-test).Our findings indicate that the itching may arise as an allergic reaction in drug eruption and is present in 3/4 of allergic drug eruption cases.It also seems to be decreased by aging and to be influenced by the latent period,causative drug and LMFs.

Anti-inflammatory activity of hexane leaf extract of Aspilia africana C.D. Adams

The anti-inflammatory activity of hexane leaf extract of Aspilia africana C.D. Adams (Compositae) was evaluated in rodents using the xylene-induced ear edema, egg albumin- and agar-induced paw edema, formaldehyde-induced arthritis, cotton pellet granuloma, gastric ulcerogenic, acetic acid-induced vascular permeability and dextran-induced in vivo leukocyte migration tests. Results showed that the extract (5 mg/ear) inhibited topical edema in the mouse ear and at 200 and 400 mg/kg (i.p.), it significantly ( P < 0.05) suppressed the development of egg albumin- and agar-induced paw edema, and the global edematous response to arthritis induced by formaldehyde in rats. Oral administration of the extract (200 or 400 mg/kg) evoked a significant ( P < 0.05) dose-related ulceration of the rat gastric mucosa and inhibition of vascular permeability induced by acetic acid in mice. The extract also significantly ( P < 0.05) reduced total leukocyte and neutrophils counts in a non-dose-related manner. However, it significantly ( P < 0.05) increased lymphocyte counts and stimulated the growth of granuloma tissues induced by subcutaneously implanted cotton pellets in rats. Phytochemical tests showed that the extract contained sterols and terpenoids. These findings suggest that the leaves of Aspilia africana possess anti-inflammatory activity in acute and certain aspects of chronic inflammation, which may derive from inhibition of prostaglandins synthesis, inhibition of increased vascular permeability, inhibition of neutrophil migration into inflamed tissues, and stimulation of lymphocyte accumulation, which may enhance tissue repair and healing. The terpenoids present in the leaves may account for the anti-inflammatory activity.

The effect of transfer factor on the in vitro migration of tuberculin stimulated white cells from sarcoid and normal subjects.

In the mixed leukocyte migration test, white cells from Mantoux positive and Mantoux negative individuals and from patients with sarcoidosis responded similarly to tuberculin, there being no significant difference in the migration index of the three groups. The cells from patients with sarcoidosis, however, showed a depressed response to phytohaemagglutinin. Transfer factor prepared from an individual with a very positive Mantoux reaction did not have any significant effect on the migration index when added to the white cells from sarcoid patients either in the presence or absence of tuberculin.

The effects of long-term occupational exposure to dust from herbs

Herbs are a heterogeneous group of many species with several thousand plants, which are used in large quantities in the pharmaceutical and food industries. The aim of the study was to analyse the health effects of long-term occupational exposure to dust from herbs. A group of 150 people occupationally exposed to dust from herbs, consisting of farmers and workers from herbs processing industry, was examined. As a reference group, 50 urban dwellers not exposed to any kind of organic dust were examined. Examined people were interviewed with the help of the ATS questionnaire compiled by Ferris and by the questionnaire developed in the Institute of Agricultural Medicine in Lublin, Poland for examination of work-related symptoms caused by organic dust. The lung function examination (vital capacity (VC), forced expiratory volume in the first second (FEV(1)), and FEV(1)/VC (%) of normal ranges) and allergological tests (skin prick test, precipitin test and inhibition of leukocyte migration (MIF) test) with microbial antigens were conducted. 71.3% (95% CI 64.1-78.6%) of the exposed people reported occurrence of work-related symptoms. A post-shift decrease of spirometric values (VC, VC%) was observed in the exposed group (mean decrease 2.6%, P<0.01). A significant relationship was found between the number of work-related symptoms and decrease of FEV(1) values, both before (Spearman correlation coefficient r=-0.21, P<0.05) and after work (r=-0.31, P<0.01). In allergological tests, the frequencies of positive reactions in the exposed group were significantly higher than in the reference group. Precipitins specific to Pantoea agglomerans were found in 30.6% (95% CI 23.2-38.1%) of exposed, compared to 12.0% among unexposed (P=0.01). The frequency of positive results in the migration inhibition test was significantly higher among exposed workers for all antigens tested. Long-term exposure to dust from herbs causes work-related symptoms and decrease of lung function parameters, which, finally, may lead to occupational disease.

白血球遊走試験による薬剤過敏性血液障害の検討

The leukocyte migration test (LMT) was performed on 54 patients suspected to be suffering from drug-induced blood disorders in order to identify the allergenic drugs responsible. It was also performed on 42 patients who had been receiving the drugs but had not manifested any allergic symptoms (patients without hypersensitivity to drugs).Leukocytopenia was noted in 72.2% of the 54 patients suspected of suffering from drug-induced blood disorders, throm-bocytepenia in 42.6% and erythrocytepenia in 42.2%. The positive rates for the LMT were 66.7% in these 54 patients and 7.1% in the 42 patients without hypersensitivity showing that the positive rate was significantly higher in the patients suspected of suffering from drug-induced blood disorders than in the patients without hypersensitivity to the drugs (p<0.0001, X2-test). The positive LMT rate was 88.5% in a short latent period (<10 days) group and 46.4% in a long latent period (10 days) group. Thus, the LMT positive rate was significantly higher in the short latent period group than in the long latent period group (p<0.01, X2-test). In addition, the incidence of serious blood disorder cases was significantly higher in the short latent period group than in the long latent period group (p<0.01, X2-test).Our findings indicate that the LMT is a valuable method for identifying allergenic drugs in drug-induced blood disorders and that drug allergies are greatly involved in the pathogenesis of short latent period blood disorders.

薬剤性出血性大腸炎におけるアレルギー反応の関与―白血球遊走試験による検討―

In 12 patients suspected of drug-associated hemorrhagic colitis, the identification of the allergenic drugs was made based on the findings of a leukocyte migration test (LMT) to study the value of LMT and also based on the presence of an allergic reaction in drug-associated hemorrhagic colitis.The LMT was positive in 8 (67%) of 12 cases. When it was absent in the patient' s serum, the positive rate was 3/12 (25%), whereas when it was present in the serum the rate increased to 7/10 (70%). Leukocyte migration activating factor (LMAF) was detected in 5 cases (42%) and leukocyte migration inhibitory factor (LMIF) was detected in 3 cases (25%). LMT-positive drugs were detected in 9 of all 41 suspected drugs, in which 6 drugs (67%) were β-lactam antibiotics and 2 drugs (22%) were nonsteroidal anti-inflammatory drugs and 1 drug (11%) was a hemostatic drug. Penicillin antibiotics accounted for 67% (4/6) in β-lactam antibiotics. Abnormal growth bacteria, i.e., K.oxytoca, Cl. Difficile, E. coli O-18 were detected in 3 cases by a bacteriological examination of a stool culture. However, all the 3 cases were positive for LMT.Our findings indicate that in drug-associated hemorrhagic colitis, an allergic reaction may play a major role and LMT may be highly useful for identifying such allergenic drugs. As a result, it may be important to add the patient's serum when performing the LMT. In addition, both LMAF and LMIF may be involved in the pathogenesis. β-lactam antibiotics may also be major drugs that can cause allergic hemorrhagic colitis. Furthermore, hemorrhagic colitis may be partly related to drug allergy even in cases where an abnormal growth of bacteria is detected.