(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Food-Hypersensitivity

A major aetiologic role for foods has been demonstrated in urticaria, atopic eczema and dermatitis herpetiformis. In some patients with urticaria, whealing occurs within minutes of the ingestion of a particular food. In most, but not necessarily all cases, this appears to be a consequence of IgE-mediated cutaneous mast cell degranulation, i.e. a classical type I hypersensitivity response. In other patients with recurrent urticaria, the whealing may be provoked by foods by a much slower and more insidious reaction. This type of reaction has been established in the case of several common food additives, notably azo dyes, but other foods may be able to cause urticaria in a similar fashion. Foods appear to play an important provocative role in many patients with atopic eczema. The reaction in such cases appears to be slow and insidious, almost always unrecognized by the patient and not detected by skin testing or tests for IgE antibodies. There can be no real doubt that dietary gluten is responsible for most, if not all dermatitis herpetiformis, though this relationship was revealed only by the finding of concurrent and usually asymptomatic jejunal villous atrophy in affected individuals. The mechanisms responsible for the slow food reactions in urticaria, atopic eczema and dermatitis herpetiformis remain largely unknown, but are likely to be different in each case.

Topics: Aging; Animals; Azo Compounds; Beclomethasone; Benzoates; Cattle; Child; Child, Preschool; Dermatitis Herpetiformis; Dermatitis, Atopic; Eggs; Food Additives; Food Hypersensitivity; Glutens; Humans; Immunoglobulin A; Immunoglobulin E; Infant; Infant, Newborn; Intestinal Diseases; Milk; Skin Diseases; Sulfones; Time Factors; Urticaria

Topics: Administration, Oral; Adult; Aspirin; Beclomethasone; Child; Cromolyn Sodium; Dermatitis, Atopic; Food Hypersensitivity; Histamine H1 Antagonists; Humans; Ibuprofen; Indomethacin; Infant; Ketotifen; Nifedipine

Four subjects with clinical histories of milk-induced asthma were studied (three allergic to cow's milk; one to soya milk). In each instance, skin prick tests, RAST (IgE and IgG4), the basophil histamine release, and serum precipitins, using appropriate milk extracts, were negative. After the ingestion of milk all the subjects developed a reproducible and dose-dependent increase in airflow limitation. Three patients (two allergic to cow's milk; one to soya milk) gave a characteristic immediate-type reaction, which was maximal at 30 min after challenge. The fourth individual developed an isolated late-phase response, with maximal airways obstruction 3 hr after ingesting milk. In the three subjects who gave an early reaction, wheezing was accompanied by an elevation in circulating neutrophil chemotactic activity (NCA). This was not observed in the individual with the isolated late reaction. By Sephacryl S-400 gel-filtration chromatography it was shown that NCA of the early reactions eluted with proteins having an estimated molecular weight of 600,000 daltons. The immediate asthmatic response in peak expiratory flow rate and the elevation in NCA were inhibited by the prior oral administration of either disodium cromoglycate (DSCG) or oral beclomethasone dipropionate (BDP). In contrast, DSCG had no effect on airways obstruction in the subject with the isolated late asthmatic response, although inhibition was achieved by BDP.

Topics: Adult; Animals; Asthma; Beclomethasone; Chemotaxis, Leukocyte; Cromolyn Sodium; Female; Food Hypersensitivity; Humans; Male; Middle Aged; Milk; Neutrophils

A 45-year-old woman with intestinal malabsorption due to eosinophilic gastro-enteritis was found to have markedly fluctuating total serum IgE levels with a positive intradermal skin test and a positive radio-allergosorbent test to milk antigen. No organ-specific or non-organ-specific auto-antibodies were detected in the patient's serum, and her complement profile was normal. Low doses of disodium cromoglycate failed to improve intestinal absorption, whereas a 16-day course of a corticosteroid, beclomethasone dipropionate 3 mg daily, improved D-xylose and carotene absorption without suppressing the hypothalamic-pituitary-adrenal axis.

Topics: Beclomethasone; Cromolyn Sodium; Eosinophils; Female; Food Hypersensitivity; Gastroenteritis; Humans; Immunoglobulin E; Middle Aged