Levels of serum IgG and IgG4 antibodies specific to mite (Dermatophagoides farinae) were estimated by an indirect enzyme-linked immunosorbent assay in patients with nasal allergy. A high IgG antibody titer (antibody titer higher than 20) was observed in 39.5% (90/228) of patients with nasal allergy to mite, and IgG4 antibody was detectable in 31.6% (78/228). There were no differences from the point of view of sex or age in the quantity of IgG and IgG4 antibodies. In patients with a low IgE antibody titer to mite (RAST score lower than 1), a high IgG antibody titer was observed among 34.7% (17/49), and IgG4 antibody was detectable in 30.6% (15/49). In the patients with bronchial asthma complications, a high incidence in the number of individuals with detectable IgG4 antibody was observed (p<0.005). In the patients who had received long term immunotherapy by mite (n:122, for an average of 20 months), a high IgG antibody titer was observed in 67.2% (82/122), and IgG4 antibody was detectable in 62.3% (76/122). Therefore, we assumed IgG and IgG4 antibodies were increased by immunotherapy. Furthermore a correlation coefficient in the ratio of IgG4 antibody titer to IgG antibody titer was higher in patients who had received immunotherapy (n: 122, r=0.4720, p<0.005) than in patients who had not received immunotherapy (n=228, r=3165, p<0.005). From these data, we assumed that an increase in IgG antibodies might be caused mainly by an increase in the IgG4 antibody. In order to test whether these antibodies act as blocking antibodies, we selected another 46 patients who had started mite immunotherapy at the same time. IgG and IgG4 antibodies in their serum were measured at 3 points: the beginning of therapy, 12 weeks later, and 24 weeks later. IgG and IgG4 antibodies in their serum began to rise at 12 weeks, and kept increasing to the 24th week (IgG:p<0.02, IgG4:p<0.01). Although both antibodies were increased by immunotherapy, the increase had no influence on the clinical improvement of the allergic symptoms. From this study, it was shown that serum IgG and IgG4 antibodies specific to mite did not act as "blocking antibodies" in patients with nasal allergy to mite.

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A clinical evaluation of the effectiveness of hyposensitization in bronchial asthma induced by Candida albicans (Candida) was carried out during about two years of hyposensitization therapy. The clinical effectiveness of hyposensitization depended on the presence or absence of three different antibodies against Candida, i.e. IgE antibody, precipitin and hemagglutinin, measured at the beginning of hyposensitization. In the case of precipitin positive, hyposensitization therapy promoted bronchoconstriction caused by Candida. However, with hemagglutinin positive, bronchoconstriction was effectively reduced. Basically, IgE antibody positive causes bronchoconstriction; but in combination with precipitin negative, hyposensitization therapy proved also effective.

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An epidemiological examination was carried out on 1514 people in Matsukawa Town (835 of them were engaged in the cultivation of apples and pears and 679 were not) in order to reveal how strong an influence the cultivation of the town's orchards has on the occurrence of pollinosis among the inhabitants. The results were as follows: 1. The rate of people showing positive RAST scores or any allergic symptoms during the period when apples and pears were in bloom was 6.3% for apple pollen and 3.5% for pear pollen among apple and pear-growing farmers in Ueoshima district, 2.5% and 1.8% respectively in Kamikatagiri district and 0.3% and 0.15% among people who had never been engaged in apple and pear cultivation. 2. The positivity rate of RAST scores was also significantly higher among apple and pear-growing farmers than among other members of the population for both orchard grass pollen and Japanese cedar pollen. The rate for orchard grass pollen was markedly high, especially in Ueoshima district (18.9% of all apple and pear-growing farmers) and it was considered that thick growths of orchard grass in the orchards were also an important factor in causing pollinosis in apple and pear-growing farmers.

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The current and cumulative prevalence of wheezing and bronchial asthma was examined in 3149 Japanese elementary school children. The children with a past history of wheezing were selected by the modified ATS-DLD children's questionnaire. Thereafter, a second questionnaire was used to investigate the severity of the symptoms over the last two years and at the time when the respiratory symptoms had been most severe. Total serum IgE values were determined by PRIST, and IgE antibodies to Dermatophagoides pteronyssinus by RAST. The results were as follows: 1) The cumulative prevalence-rate of wheezing was 18.3% in males, 12.8% in females and 15.5% overall in the age group. 2) The cumulative prevalence-rate of asthma was 13.5% in males, 9.0% in females and 11.2% overall. The rate was lower in older children. 3) The current prevalence-rate of wheezing was 9.9% in males, 6.9% in females and 8.3% overall. 4) The current prevalence-rate of asthma was 6.4% in males, 4.8% in females and 5.6% overall. The rate was lower in older children. 5) The mean IgE value of the children with past history of wheezing was 834 IU/ml. It was higher in males. 6) The positive RAST rate of the children with a past history of wheezing was 68.1% overall in the age group. 7) The mean IgE value of the children in remission, or with wheezing only, in the last two years was lower than that of the children with wheezing and dyspnea. 8) The positive RAST rate of the children with wheezing or dyspnea in the last two years was higher than that of the children in remission.

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The relationship between the changes of plasma histamine level and the site of airway obstruction after exercise in 20 asthmatic patients was studied using flow volume curves with air and HeO_2. Plasma histamine was measured by modified Shore's fluorimetric method. The results obtained were as follows. 1. All patients were responders (ΔV_<50>>120%) before exercise, but after EIA was observed 10 patients remained as responders and 10 patients became non-responders (ΔV_<50><120%). 2. In the R-R group (responders before and after exercise), plasma histamine levels increased in 4 patients out of 10. In the R-N group (responders before exercise and non-responders after exercise), plasma histamine levels increased in 8 patients out of 10. But there was no significant difference in % changes of plasma histamine level between the two groups. 3. In the R-N group, % fall in pulmonary functions (PEFR, FVC, FEV_<1.0> and V_<50>) at 20 min after exercise was significantly higher than in the R-R group. From these results it was suggested that not only single but also combined facotrs play an important role in the development of EIA.

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We studied leukocyte procoagulant activity (LPCA) antigenically stimulated by PPD and varicella virus antigen (VVA) in order to determine the clinical usefulness of evaluating cell-mediated immunity in vitro and also to clarify what the effector mechanisms are. Concerning the specificity of LPCA we found as follows: 1. LPCA stimulated by PPD in those whose PPD-skin test was positive increased more significantly than in those whose PPD-skin test was negative. 2. LPCA stimulated by VVA in those who had previously suffered from chicken pox increased more significantly than in those who had no past history of chicken pox. These results show that LPCA is stimulated by the antigen specifically and seems to be a useful assay method for evaluating the delayed-type hypersensitivity in vitro. Concerning the effector mechanisms of LPCA we found as follows: 3. LPCA of T cells stimulated by PPD decreased significantly compared to the LPCA of peripheral mononuclear cells. When the LPCA was stimulated by PPD, monocytes were thought to be the main effector cells. Our results are in agreement on this point with previous reports. 4. When LPCA was stimulated by VVA, a significant increase of LPCA was found in both the T cells and the monocytes. These findings indicate that T cells also become effector cells of LPCA when stimulated by VVA. It is suggested that PPD and VVA have different pathways as effector mechanisms of PPD and VVA.

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[in Japanese]

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[in Japanese]

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