Rate Of Positive Skin Tests Research Articles

Skin test: guide of post-marketed re-evaluation of clinical safety in traditional Chinese medicine injection

Anaphylaxis is the most common adverse reaction caused by traditional Chinese medicine (TCM) injection, the most serious of which is type I, so post-marketed safety re-evaluation is necessary. Skin test can be used to screen type I allergy reaction, which is of great significance for TCM injection safe use. Skin test is not only able to find the population sensitization situation of TCM injection, but also is a way of understanding the mechanism of allergy reaction. TCM injection varieties that often occur type I anaphylaxis are applicable to skin test, and study population include healthy volunteers and patients whose disease is listed in the drug specification, intracutaneous test and prick test are the alternative method. The concentration of skin-test solution may influence the positive rate of skin test, penicillin skin-test solution preparation method can be used as the reference in TCM injection. Different doses of TCM injection skin-test solution,glucose injection and normal saline, histamine hydrochloride are comprised in comparison. Given the characteristics of type I allergy reaction,we should be pay close attention to skin test reaction in half an hour, and observation index need be designed based on post-marketed re-evaluation of clinical safety.

Possible involvement of smoking in the development of asthma-like conditions in patients with chronic obstructive pulmonary disease

Indicies of asthma were measured in smokers with chronic bronchitis (CB) + pulmonary emphysema (PE), smokers with CB only, and non-smokers with CB, to examine whether smoking is involved in the development of asthma-like condition in patients with chronic obstructive pulmonary disease (COPD). Airway hypersensitivity was measured with an Astrograph method, and the reversibility of airway obstruction was measured as improvement in FEV1.0 and as percent change in FEV1.0 after inhalation of a beta-agonist. Both hypersensitivity and reversibility were significantly higher in smokers with CB+PE and in smokers with CB only than in non-smokers with CB. The number of eosinophils in sputum, but not in peripheral blood, was slightly higher in the smokers than in the non-smokers. The serum levels of IgE were significantly higher in the smokers than in the non-smokers. No significant difference in the rate of positive skin tests for common allergens was observed among the three groups, but the rate of positive tests for Broncasma Berna was very high in the smokers, and all such tests were negative in the non-smokers. These results indicate that among patients with COPD an asthmatic component is more frequently found in smokers than in non-smokers, and suggest that smoking plays some part in the development of asthma-like condition in these diseases.

Herpes zoster in Japanese patients with systemic lupus erythematosus.

We examined retrospectively the incidence of herpes zoster among 58 Japanese patients with systemic lupus erythematosus (SLE), 42 patients with systemic sclerosis (SSc) and 21 patients with autoimmune bullous diseases (AIBD). The incidence of herpes zoster was significantly higher in SLE (46.6%) than in SSc (9.5%) or AIBD (4.7%) (P < 0.001). The rate of positive delayed-type skin test with varicella zoster virus antigens was significantly lower in SLE than in SSc [4/16 (25.0%) vs. 11/12 (91.7%), P < 0.001]. In addition, the positive rate of skin test with purified protein derivatives of tuberculin was also low in SLE patients (3/16, 18.8%). These results reconfirm the general impairment in cellular immunity in SLE.

Clinical Experience With Penicillin Skin Testing in a Large Inner-City STD Clinic

To establish (1) the prevalence of positive penicillin skin tests among outpatients with well-defined but variable history of penicillin allergy and (2) the reproducibility, safety, and negative predictive value of skin testing with benzylpenicilloyl polylysine (PPL) and a minor-determinant mixture (MDM). Serial consenting outpatients with current indications for penicillin therapy were skin-tested in duplicate with PPL and MDM. Subjects with negative skin tests (93% of those positive by history and 95% of those negative by history) received therapeutic courses of benzylpenicillin (81%) or ampicillin (19%). Negative predictive value of skin testing was established by 72-hour follow-up for adverse reactions to drug. A total of 5063 consecutive, qualifying outpatients in a Baltimore, Md, sexually transmitted disease (STD) clinic. The study group was young (73% between 20 and 40 years old), 66% male, and 90% black; 25% had history of atopy. Follow-up was 94% complete. Positive skin tests were observed in 7.1% of 776 individuals with previous history of penicillin allergy and in 1.7% of 4287 subjects negative by history (P << .001). Previous history of anaphylaxis or urticaria was associated with significantly higher rates of positive skin tests of 17.3% and 12.4%, respectively (P<<.001). Only 4% with history of exanthem had positive skin tests (P = .03). The coefficient of variation for duplicate skin tests was 11%. Time intervals since last penicillin treatment did not influence the rate of positive skin tests. Adverse reactions to skin tests occurred in 13 (1.2% of patients positive by history; 9.4% of those with positive skin tests). A mild anaphylactic reaction occurred in one individual whose preliminary scratch testing was inadvertently omitted; systemic pruritus or urticaria occurred in 11 subjects; one had a large local reaction. After penicillin administration to individuals with negative skin tests, acute allergic reactions occurred in 0.5% of subjects negative by history compared with 2.9% of subjects positive by history (chi 2 = 33.3; P = .0001). Reactions were generally mild and self-limited; only two cases of mild anaphylactic reaction occurred, both in patients with history of severe IgE-mediated reaction. Skin testing with both major and minor penicillin determinants is safe using current recommendations, and both reagents are necessary for maximizing the identification of sensitized subjects. Routine penicillin skin testing can facilitate the safe use of penicillin in 90% of individuals with a previous history of penicillin allergy.

Impaired cell-mediated immunity function in thyroid cancer.

Immunological parameters were studied in 31 patients with thyroid cancer. Serum immunoglobulin levels, T and B cell percentages in peripheral blood, showed no significant difference as compared with those of control group. The blastogenesis with phytohemagglutinin P (PHA) was significantly reduced, especially, in those having larger tumor size or metastasis or in those over age 60. The positive rate of skin test with purified-protein-derivative (PPD) and Streptokinase-Streptodornase (SK-SD) was also markedly reduced. The impaired blastogenesis of lymphocyte and reduced positive rate of skin test in those cancer patients suggested that the cell-mediated immunity function, in spite of adequate count of T-cells, was impaired.

PREVALENCE OF HUMAN SCHISTOSOMIASIS IN THE TAVETA AREA OF KENYA, EAST AFRICA

A total of 963 individuals in three villages were examined for schistosomiasis by both skin test and schistosome ova detection in stool and urine in 1974. The antigen used for skin test was VBS adult S. japonicum antigen (1 : 10, 000 dilution). Stool and urine samples were examined through the concentration methods. Egg-positive rate was 62.2 per cent in Jipe, 68.0 per cent in Eldoro, 69.6 per cent in Kivalwa. Jipe was infested mostly by S. mansoni, Kivalwa by S. haematobium and Eldoro by both two schistosomes. The egg-positive rate was higher in females than in males in Eldoro. In Jipe and Kivalwa, however, the differences in the rate between males and females were not statistically significant. The rate increased with age in children, reached a peak between the ages of 5 and 14 years and then decreased gradually. The positive rate of skin test was 76.4 per cent in total, higher than that of stool and urine examinations. The skin reaction was weak or absent among many egg-positive children. The skin-test-positive rate increased as the age advanced and reached 95 per cent in inhabitants from 40 years up. The positive rate of skin test was higher among males than females in Jipe. No significant difference in the rate between males and females was found in Eldoro and Kivalwa. Among the egg-positive subjects there was no significant difference in skin reaction between S. mansoni infection and S. haematobium infection. In 1975 stool and urine samples from Jipe, Kivalwa, Kuwahoma and Chala were examined. Kuwahoma proved to be infested by S. haematobium. In Chala schistosome infection was rare. There exist villages infested by S. mansoni and/or S. haematobium in the small area. It seems that VBS adult S. japonicum antigen for skin test and the concentration methods for stool and urine examinations are of use in the epidemiological survey in the areas where S. mansoni and/or S. haematobium infections are prevailing.

NARROW-LEAVED CATTAIL POLLINOSIS

Narrow-leaved cattails (n-1 cattails), Typha angustifolia L., are generally distributed in Japan. Although the positive rate of skin test with n-1 cattail extract had been reported relatively high, n-1 cattail pollinosis had not yet been confirmed in Japan.The two cases presented here from Mito district in Ibaraki prefecture mainly complained of sneezing attack, nasal stuffiness and watery nasal discharge at the time of n-l cattail pollination, from July to August. They gave positive intradermal and nasal provocative reactions with n-1 cattail pollen extract. In their sera anti-n-l-cattail IgE antibodies were detected.Another allergens were not detected as the cause of their nasal allergy. Their symptoms were controlled largely through perennial n-1 cattail pollen hyposensitization.In Mito district, n-1 cattails grew thick and pollination was evidenced by pollen survey and positive rate of skin test n-1 cattail pollen extract was significantly higher than that of another district in Japan. It, therefore, was thought that many indviduals in this district had been sensitized with n-1 cattail pollens.Analyzing the distribution of the grade of skin reaction, the specificity of n-1 cattail allergen extract was comfirmed. From the correlation of skin tests between cattail and other several allergens, it was concluded that there was no cross antigenicity between n-1 cattail extract and others except another species in “Typha L.”