Allergic Reactions In Patients Research Articles

Preparation and Properties of Silica-Coated AgI Nanoparticles with a Modified Stober Method

ABSTRACTIodine compounds have been used as X-ray contrast agents in the field of medicine, because of their low transmittance property for X-ray. The iodine compounds may provoke adverse events as allergic reactions in patients, so that they can not be administered to such people. Core-shell nanoparticles are good candidates for prevention of allergic reactions, because the shell materials can keep the contrast agents from living systems. We have proposed a method for silica-coating of iodine compounds as AgI nanoparticles. In the present work, properties of the silica-coated AgI nanoparticles such as colloidal stability, X-ray absorption and X-ray CT imaging were examined.Silica-coated AgI nanoparticles were prepared with Stöber method, which was performed with 2.3×10-5 M MPS, 11 M water, 0.01 M DMA and 0.01 M tetraethyl orthosilicate in the presence of 5×10-4 M AgI nanoparticles that were prepared from AgClO4 and KI. The particles had an AgI core size of ca. 15 nm and a silica shell thickness of ca. 20 nm.Since high iodine concentration in sample solution is desired for practical use as X-ray contrast agents, the colloid of as-prepared coated particles was concentrated with centrifugation. The particle colloid that was concentrated up to an AgI concentration as high as 0.4 M was colloidally stable in saline, and exhibited properties of X-ray absorption and X-ray contrasting comparable to a commercial X-ray contrast agent. Accordingly, the silica-coated AgI nanoparticles prepared in the present work are expected to be applied to a novel X-ray contrast agent.

A Reliable and Sensitive Immunoassay for the Determination of Crustacean Protein in Processed Foods

Among food allergens, crustacea such as shrimps, crabs, and lobsters are a frequent cause of adverse food reactions in allergic patients. The major allergen has been identified as a muscular protein, tropomyosin. A novel sandwich enzyme-linked immunosorbent assay (ELISA) for the detection and quantification of crustacean protein in processed foods was developed using the sample dilution buffer that is added to porcine tropomyosin. The sandwich ELISA method was highly specific for the Decapoda group, apart from minor cross-reactivities to other crustacea and mollusks. The recovery ranged from 85 to 141%, while the intra- and interassay coefficients of variation were less than 2.8 and 8.4%, respectively.

An Unusual Local Reaction after Microsclerotherapy with Chromated Glycerin

A case of papular itching lesions after microsclerotherapy with chromated glycerin (CG) at a 72% concentration for telangiectases of the thighs is reported. Patch-test results were strongly positive for nickel sulfate (+++/+++) and thimerosal (++/++) whereas results were negative for the sclerosing agent CG 72% and glycerol (control). Intradermal injection of CG 72% in the thigh and intravascular injection of CG 72% into telangiectases of the knee produced erythematous papular itching lesions in about 5 to 6 hours. As a negative control, glycerol and sodium chloride 0.9% injected intradermically on the thigh did not cause any reaction. CG can elicit allergic reactions in patients who are sensitive to chromium and can cause new sensitizations to chromium. In our case, no positivity to potassium dichromate was observed.

Allergie alimentaire au lait de vache ou intolérance au lactose ?

Cow's milk allergy (CMA) is an hypersensitivity reaction due to an immunological mechanism, whereas lactose intolerance is a non-immunological reaction due to deficiency of the enzyme, called lactase. These two pathologies share similar digestive symptoms. Two case reports are presented here to support the differential diagnosis of these two entities. The diagnosis of cow's milk allergy or lactose intolerance is established by a double-blind oral challenge with milk containing either milk proteins without lactose or an amino acid formula containing added lactose. Distinguishing these two pathologies is required to establish the appropriate therapeutic diet. Cow's milk allergy requires a strict avoidance diet of all dairy products and their derivatives. Diet for lactose intolerance consists in avoiding lactose-rich products taking into account that: the amount of lactose tolerated by each patient is variable. Moreover, food allergy can induce a lactase deficiency due to digestive mucous inflammation. In some cases of CMA, lactose used as food additive or drug excipient can induce allergic reactions in patients with a low reactive threshold due to milk contamination of lactose.

Nonalloyed titanium as a bioinert metal—A review

Titanium is used for many dental applications and instruments, such as orthodontic wires, endodontic files, dental implants, and cast restorations. The popularity of titanium is primarily due to its good mechanical properties, its high corrosion resistance, and its excellent biocompatibility. A thorough review of the medical and dental literature reveals, however, that titanium can also cause chemical-biological interactions. Tissue discoloration and allergic reactions in patients who have come in contact with titanium have been reported. The biostability of titanium is becoming increasingly questioned. At the same time, new technologies and materials, such as high-performance ceramics, are emerging which could replace titanium in dentistry in the not-too-distant future.—Reprinted with permission of Quintessence Publishing. Titanium is used for many dental applications and instruments, such as orthodontic wires, endodontic files, dental implants, and cast restorations. The popularity of titanium is primarily due to its good mechanical properties, its high corrosion resistance, and its excellent biocompatibility. A thorough review of the medical and dental literature reveals, however, that titanium can also cause chemical-biological interactions. Tissue discoloration and allergic reactions in patients who have come in contact with titanium have been reported. The biostability of titanium is becoming increasingly questioned. At the same time, new technologies and materials, such as high-performance ceramics, are emerging which could replace titanium in dentistry in the not-too-distant future.—Reprinted with permission of Quintessence Publishing.

Anesthetic Management in a Patient with Latex Anaphylaxis after Tourniquet Release: A case report

Latex is the second most common cause of anaphylaxis during anesthesia. The increasing number of reports of latex-induced anaphylaxis are a major concern for anesthesiologists. We encountered a 56-year-old male patient who developed severe anaphylactic shock whilst under anesthesia when the tourniquet was deflated during elbow arthrolysis. A subsequent allergy workup revealed an IgE mediated hypersensitivity to latex. This case highlights the need for anesthesiologists to be able to diagnose the signs and symptoms of allergic reactions in patients under anesthesia.

6. Contact allergic reactions in patients with atopic eczema

The controversy concerning the sensitizing potential of a common agent to which there is contact sensitivity, dinitrochlorobenzene, has been reassessed by Rees et al. (1). Dose-response relationships for contact sensitization and elicitation at three different concentrations of dinitrochlorobenzene were determined for 22 patients with minimal atopic eczema compared to 27 non-atopic healthy control subjects. Atopic patients were significantly less responsive, with smaller reactions at all challenge doses and exhibited flatter challenge doseresponse curves than did healthy controls. This is in keeping with the classic cytokine route of sensitization, which indicates that atopics should be less prone to sensitization under experimental conditions.

A Pilot Study of Feasibility of Ultra-Rush (20–25 Minutes) Sublingual-Swallow Immunotherapy in 679 Patients (699 Sessions) with Allergic Rhinitis and/or Asthma

Few studies have evaluated the occurrence of immediate adverse reactions in allergic patients after an ultra-rush regimen of different commercial allergen extracts for sublingual immunotherapy (SLIT) Methods: 679 patients took part in trials of specific ultra-rush SLIT for the treatment of IgE-mediated rhinitis and/or IgE-mediated asthma. 14 patients received two different sublingual allergen vaccines during two distinct SLIT sessions. On the whole, 699 SLIT sessions were performed. The build up ultrarush phase involved the administration every five minutes of increasing doses of either different allergen extracts. The cumulative allergen extract solution after half an hour was several times the dose administered at the start of subcutaneous immunotherapy (range 4.7-525 microg of major allergens). All patients tolerated the treatment very well. 122 (17.96%) had mild local symptoms (pruritus of the buccal cavity) that spontaneously disappeared with increasing dose. Two patients allergic to Parietaria had urticaria about three hours after the last sublingual Parietaria-extract intake. A subject allergic to Artemisia vulgaris pollen had urticaria and rhinitis two hours later than the last dose of vaccine. As reported in our previous study, no immediate severe adverse reactions were observed after that rapidly increasing doses of allergen extract were administered in a very short period to a large number of patients, showing the excellent safety profile of ultra-rush SLIT.

Simultaneous sodium lauryl sulphate testing improves the diagnostic validity of allergic patch tests. Results from a prospective multicentre study of the German Contact Dermatitis Research Group (Deutsche Kontaktallergie-Gruppe, DKG)

There is evidence that a higher skin susceptibility may induce nonspecific erythematous or weak positive reactions to contact allergens in patch testing. To evaluate whether simultaneous application of sodium lauryl sulphate (SLS) along with diagnostic patch tests with contact allergens can provide information regarding skin irritability which may help to discriminate allergic from nonspecific irritant reactions to contact allergens. Between July 2001 and June 2003, this prospective study collected patch test data of 5971 patients from 19 centres in Germany and Austria in the Information Network of Departments of Dermatology (IVDK). In addition to contact allergens (standard series and eight known 'problematic' allergens with a low reaction index and a high positivity ratio: 1,3-diphenylguanidine, amerchol L-101, benzalkonium chloride, benzoyl peroxide, cocamidopropyl betaine, octyl gallate, phenyl mercuric acetate and propylene glycol), patches with SLS 0.5% and 0.25% aq. were applied. Reactions to the allergens and to SLS were analysed at the IVDK data centre. The association between an erythematous or positive reaction to a certain allergen and an irritant reaction to SLS was assessed with logistic regression analysis, at the same time controlling for the influence of age and sex. Of the 29 allergens of the standard series, 23 and 21 gave a higher percentage of nonspecific erythematous reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, in comparison with SLS-negative patients. All eight 'problematic' allergens gave an increased percentage of nonspecific erythematous reactions. Similarly, 22 and 21 allergens of the standard series gave a higher percentage of positive allergic reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, and seven of the eight 'problematic' allergens gave a higher percentage of positive allergic reactions (exception: octyl gallate). For most allergens, the markers of skin reaction (reaction index and positivity ratio) were worse in SLS-positive patients. Differences were more pronounced when testing with SLS 0.25% than with SLS 0.5%. Because there is a convincing association between skin irritability (evaluated by SLS test) and the degree of skin reaction to contact allergens, the SLS test may help in deciding whether a doubtful erythematous or weakly 'positive' skin reaction should be interpreted as allergic or irritant.

Safety and Tolerability of Ultra-Rush (20 minutes) Sublingual Immunotherapy in Patients with Allergic Rhinitis and/or Asthma

Background The safety and good tolerability of sublingual immunotherapy (SLIT) has already been proved in allergic patients, but only one study has investigated the occurrence of immediate adverse reactions in allergic patients after a 2-hour ultra-rush regimen of SLIT performed with a chemically modified extract (sublingual monomeric allergoid, Lais ®, Lofarma S.p.A., Milan). The objective of the present study was to evaluate the occurrence of immediate adverse reactions in allergic patients after a very fast (20 minutes) ultra-rush regimen of sublingual allergoid SLIT. Methods and results We studied 105 patients: 28 children (20 male, mean age 13.3 ± 2.1 yr) and 77 adults (29 male, mean age 34.7 ± 9.9 years) with a history of intermittent/persistent rhinitis or intermittent/ mild persistent asthma due to House Dust Mite (n = 56), Parietaria (n = 34) and Timothy-grass (n = 15) The build-up ultra-rush phase involved the administration, every five minutes, of increasing doses of the sublingual allergoid SLIT. All patients tolerated the treatment very well. Only one patient out of 105 (0.9 %) had a mild local symptoms (gastric pirosis) that occurred 30 minutes after the last initial dose and spontaneously disappeared as the treatment was continued. Conclusions These data show the excellent safety and tolerability profile of an ultra-rush SLIT regimen performed with a chemically modified extract, even when high doses were administered through an extremely short induction phase (20 minutes), thus confirming the previously reported results.

Safety and tolerability of ultra-Rush (20 minutes) sublingual immunotherapy in patients with allergic rhinitis and/or asthma

Background The safety and good tolerability of sublingual immunotherapy (SLIT) has already been proved in allergic patients, but only one study has investigated the occurrence of immediate adverse reactions in allergic patients after a 2-hour ultra-rush regimen of SLIT performed with a chemically modified extract (sublingual monomeric allergoid, Lais ®, Lofarma S.p.A., Milan). The objective of the present study was to evaluate the occurrence of immediate adverse reactions in allergic patients after a very fast (20 minutes) ultra-rush regimen of sublingual allergoid SLIT. Methods and results We studied 105 patients: 28 children (20 male, mean age 13.3 ± 2.1 yr) and 77 adults (29 male, mean age 34.7 ± 9.9 years) with a history of intermittent/persistent rhinitis or intermittent/mild persistent asthma due to House Dust Mite (n = 56), Parietaria (n = 34) and Timothy-grass (n = 15) The build-up ultra-rush phase involved the administration, every five minutes, of increasing doses of the sublingual allergoid SLIT. All patients tolerated the treatment very well. Only one patient out of 105 (0.9 %) had a mild local symptom (gastric pirosis) that occurred 30 minutes after the last initial dose and spontaneously disappeared as the treatment was continued. Conclusions These data show the excellent safety and tolerability profile of an ultra-rush SLIT regimen performed with a chemically modified extract, even when high doses were administered through an extremely short induction phase (20 minutes), thus confirming the previously reported results.

Contamination of nebulizer equipment with cockroach allergen: there's a bug in the system!

Physicians often have anecdotal reports of patients describing increased asthma symptoms after the use of nebulizers; however, there are few published reports of nebulizer-associated exacerbations. To present 2 cases of asthmatic children who experienced a life-threatening exacerbation of their symptoms after nebulizer use. Case 2's nebulizer was tested for cockroach allergen by washing the medication reservoir with 2 mL of sterile filtered 1% phosphate-buffered saline, 0.05% bovine serum albumin, and Tween 20 overnight with rotation. The patient's sealed albuterol nebulizer medication was used as a control. The control albuterol and test solutions were analyzed for Blattella germanica 1 and 2 allergens using a monoclonal antibody-based immunoenzymetric assay. The reservoir from case 2 was found to have measurable levels of both Bla g 1 and Bla g 2. The control albuterol solution had no measurable cockroach allergen. An insect found in the nebulizer box of case 2 was identified as an infantile German cockroach. Nebulizer use provides an opportunity for antigen exposure directly to small airways, which may lead to severe allergic reactions in patients using contaminated equipment.

FS02.8 Patch testing with gold trichloride can give false test results

Background: Hydrochloric acid is formed in water solutions of gold trichloride. Hydrochloric acid in contact with aluminium generates hydrogen gas which can reduce and transform trivalent gold to elemental gold.Objective: To investigate whether patch testing with aqueous gold trichloride can cause false positive (irritant) reactions in patients without contact allergy to gold and false negative reactions in patients with gold allergy.Methods: 13 patients with and 13 patients without positive patch test reactions to gold sodium thiosulfate were tested with gold trichloride in 2 different vehicles, water and alkaline buffer, using 2 different test techniques, the Finn Chamber technique with aluminium chambers and van der Bend technique with polypropene chambers.Results: Irritant patch test reactions were obtained with aqueous gold trichloride tested in van der Bend chambers in 10 patients without gold allergy. In gold‐allergic patients no positive test reactions were obtained from aqueous gold trichloride in Finn chambers while 2 positive test reactions were obtained from gold trichloride in alkaline buffer tested in van der Bend chambers.Conclusion: If gold trichloride is patch tested in wrong vehicle and with wrong test technique irritant test reactions may occur which can be misinterpreted as positive allergic reactions in patients without gold allergy as well as negative reactions in patients with gold allergy.

Safety and tolerability of ultra-rush (20 minutes) allergoid sublingual immunotherapy in patients with allergic rhinitis and/or asthma

Rationale The safety of sublingual immunotherapy (SLIT) has already been demonstrated in allergic patients, but only one study evaluated the occurrence of immediate adverse reactions in allergic patients after an ultra-rush regimen of SLIT with a monomeric allergoid (Lais, Lofarma, Milan). Aim of the present study is to confirm these preliminary data and to investigate the tolerability of the allergoid SLIT as well. Methods Twenty patients (10M, 10F, mean age: 33 years) took part in this trials on the allergoid ultra-rush SLIT for the treatment of IgE-mediated rhinitis and/or asthma due to House Dust Mite (n=14) or Parietaria (n=6). The build-up ultra-rush phase was done by administering increasing doses of the monomeric sublingual allergoid every 5 minutes. The cumulative dose administered, after 20 minutes, was about 4000 A.U. Careful checks to evaluate the occurrence of any adverse event were done at the same time intervals. Results All patients tolerated the treatment very well. No adverse events were seen in any patients at any time, neither during the build-up phase nor during the first week of the maintenance treatment, performed with 2000 A.U. of the allergoid SLIT. Conclusions Our data, show the excellent safety and tolerability profile of the ultra-rush allergoid SLIT, even when high doses are administered through an extremely short induction phase, thus confirming the previously reported results.

Two cases of ortho-phthalaldehyde induced allergic reactions in patients undergoing surveillance cystoscopy

Rationale Sterilizing agents, including gluteraldehyde, have been implicated as causes of immunologic respiratory reactions. Ortho-phthalaldehyde (OPA), a gluteraldehyde-free agent, is recognized as an alternative disinfectant and has not been associated with allergic hypersensitivity. We report two cases in which OPA has been implicated as the cause of anaphylaxis and angioedema. Methods Case 1: WP is a 70-year-old man diagnosed with bladder cancer three years prior to presentation and has been followed by routine cystoscopic evaluations every three months. After his ninth cystoscopy, WP noted immediate pruritis and angioedema of his genitals followed by urticaria, dyspnea, hypotension, and syncope which responded to IV fluids and diphenhydramine. Our evaluation included RAST for latex, skin testing to local anesthetics, topical lidocaine gel, and the disinfectant–OPA. Case 2: AK is a 68-year-old man diagnosed with bladder cancer 18 months prior to evaluation who is followed by surveillance cystoscopies every three months. His most recent one resulted in immediate angioedema of his genitals and lower abdomen that progressively worsened over the next hour. Our evaluation was similar to the one described in case 1. Results In both cases, the latex RAST and skin tests for local anesthetics and topical lidocaine gel were negative. The pricks for OPA in serum albumin were positive at a 1:10,000 dilution in each patient. Conclusions These are the first reported cases of urticaria, angioedema and anaphylaxis associated with OPA. This gluteraldehyde-free agent should be considered a possible cause of severe allergic reactions in those exposed to it during endoscopic procedures.

Mycotoxins and antifungal drug interactions: implications in the treatment of illnesses due to indoor chronic toxigenic mold exposures.

Chronic exposure to toxigenic molds in water-damaged buildings is an indoor environmental health problem to which escalating health and property insurance costs are raising a statewide concern in recent times. This paper reviews the structural and functional properties of mycotoxins produced by toxigenic molds and their interactive health implications with antifungal drugs. Fundamental bases of pathophysiological, neurodevelopmental, and cellular mechanisms of mycotoxic effects are evaluated. It is most likely that the interactions of mycotoxins with antifungal drugs may, at least in part, contribute to the observable persistent illnesses, antifungal drug resistance, and allergic reactions in patients exposed to chronic toxigenic molds. Safe dose level of mycotoxin in humans is not clear. Hence, the safety regulations in place at the moment remain inconclusive, precautionary, and arbitrary. Since some of the antifungal drugs are derived from molds, and since they have structural and functional groups similar to those of mycotoxins, the knowledge of their interactions are important in enhancing preventive measures.

Native Art v 1 and recombinant Art v 1 are able to induce humoral and T cell-mediated in vitro and in vivo responses in mugwort allergy

Background: Mugwort pollen is an important allergen source in hay fever and pollen-related food allergy. Little is known about the clinical relevance of the major mugwort allergen Art v 1 and its importance in allergy. Objective: In this study we aimed to investigate the allergenicity of mugwort extract compared with the allergenicity of native (n)Art v 1 and recombinant (r)Art v 1, one major allergen of mugwort, in vivo and in vitro. Methods: Thirty-two patients allergic to mugwort and 10 control subjects were investigated by means of skin prick and nasal provocation testing with different concentrations of mugwort extract, nArt v 1, and rArt v 1. nArt v 1 was purified from aqueous mugwort extract, and rArt v 1 was cloned, expressed in Escherichia coli , and then purified. The in vitro allergenicity was measured by means of ImmunoCAP, ELISA, ELISA-inhibition experiments, and T-cell proliferation assays. Results: nArt v 1 and rArt v 1 were able to elicit positive in vivo and in vitro reactions. The IgE-binding capacity, as determined by means of ELISA, was slightly higher for nArt v 1 than for rArt v 1, and both allergens were able to induce T-cell proliferation in sensitized patients. However, rArt v 1 elicited a reduced response in skin and nasal provocation tests compared with nArt v 1. Compared with mugwort extract, both nArt v 1 and rArt v 1 showed lower sensitivity in patients with mugwort allergy in vivo. Conclusions: Art v 1, either in its native or recombinant form, is able to induce allergic reactions in patients with mugwort allergy. rArt v 1 induced comparable humoral and cell-mediated responses in vitro but showed reduced in vivo allergenicity compared with biochemically purified nArt v 1. (J Allergy Clin Immunol 2003;111:1328-36.)

Effect of ramatroban, a thromboxane A2 antagonist, in the treatment of perennial allergic rhinitis

ABSTRACT Background It is known that the symptoms of allergic rhinitis can significantly reduce the quality of life of the patient. One of such typical symptoms of allergic rhinitis is nasal obstruction. Nasal obstruction is currently thought to be closely related to the presence and abundance of lipid mediators, such as leukotriene and thromboxane (TX) A 2 . The novel drug ramatroban, a TXA 2 receptor antagonist, which has been developed by Bayer Yakuhin Ltd. (Osaka, Japan), has been demonstrated, in clinical trials, to improve nasal obstruction in the treatment of patients with allergic rhinitis and it has recently become commercially available. Methods In the present study, ramatroban was administered for 28 days to 10 patients who were diagnosed with perennial allergic rhinitis but were untreated. Changes in self-reported symptom scores and in vivo allergic reaction parameters were assessed during three observational periods. Results From baseline scores, all three symptom scores after 28 days treatment with ramatroban declined clearly in all patients, except for one patient who suffered a cold during the study period and had aggravated rhinorrhea and nasal obstruction as a result. The concentrations of histamine and TXB 2 (a metabolite of TXA 2 ) in the nasal fluid induced by antigen challenge after the 28 day treatment period also decreased in most subjects compared with concentrations during the pretreatment period. The symptom scores for nasal obstruction during the pretreatment period were correlated with the concentration of TXB 2 in antigen-induced nasal fluid. Conclusions The present study reconfirmed the clinical efficacy of a post-marketed drug, namely ramatroban, in the treatment of allergic rhinitis. In addition, the results suggest that ramatroban suppressed the secretion of chemical mediators in nasal that are thought to be involved in the allergic reaction in patients with perennial allergic rhinitis.

A survey of antibiotic prescribing and knowledge of penicillin allergy.

Cephalosporins can cause allergic reactions in patients with penicillin (PCN) allergy. Physicians' prescribing habits for patients with PCN allergy can vary. 1) Survey community and academic physicians, students, residents, and allergists on their tendencies to prescribe cephalosporins and/or perform PCN skin testing in patients with different histories of PCN allergy. 2) Evaluate PCN allergy knowledge in these groups. A questionnaire consisting of four case scenarios and five true/false questions on PCN allergy was distributed at various conferences and by mailings. Three hundred seventy-eight completed surveys were analyzed. Given a patient with a history of rash with PCN, an equal number of allergists and nonallergists (36%) prescribed cephalosporins, although there was a difference between pediatricians (56%) and internists (22%). Given a history of PCN anaphylaxis, no allergists but 11% of nonallergists prescribed a cephalosporin. Skin testing was infrequently requested by nonallergists. The correct response rate for the true/false questions was 89% for allergists, community (63%) and academic (67%) physicians, pediatricians (61%), internists (67%), residents (68%), and students (68%). Pediatric residents had the highest (74%) and community pediatricians the lowest (59%) correct response rate. There is marked variation in prescribing cephalosporins and in requesting PCN skin testing in patients with varied histories of PCN allergy. The survey results indicate a need for increased PCN allergy education.

Hevein, an allergenic lectin from rubber latex, activates human neutrophils' oxidative burst.

Hevein is an N-acetyl-D-glucosamine (GlcNAc) specific lectin that has been hypothesized to participate in the IgE-mediated allergic reactions in patients with latex allergy. In this work we assessed the specificity and biological effect of hevein purified from rubber latex on human leukocytes, using epifluorescence microscopy and flow cytometry. Purified human granulocytes were stimulated in vitro with hevein, and production of oxidative radicals was measured by reduction of nitroblue tetrazolium formazan. Histochemical staining and flow cytometry showed that hevein recognizes specifically monocytes (CD14+) and neutrophils (CD16+), but not lymphoid cells. Hevein induced oxidative response in purified granulocytes; this effect was 1.3-1.5-fold higher than the effect observed with the lectin WGA (wheat germ agglutinin), or other lectins with different sugar specificity. The induced reactions and cellular recognition by hevein were inhibited with GlcNAc and its oligomers; as well as by glycoproteins containing tri-and tetra-antennary N-glycosydically linked glycans. Our findings suggest that neutrophils are the main target for latex hevein; this lectin induces production of oxidative radicals, which seem to play an important role in tissue damage during latex allergy.