Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aims of the study were to develop and evaluate methods for quantitative measurement of itch, to investigate the perception of itch in patients with atopic dermatitis (AD), and to measure itch in such patients during treatment with H1-receptor antagonists or cyclosporin A, thereby exploring possible mechanisms in the pathogenesis of itch in AD. In a double-blind, randomized, placebo-controlled, cross-over study of 30 AD patients using a potent, topical, antipruritic corticosteroid, two methods for measuring itch both successfully detected the itch-relieving effect of the corticosteroid. The two methods comprised new portable data-loggers (Pain-Track) for continuous recording of itch, and conventional visual analogue scale (VAS) forms for retrospective recording. The main advantages of the Pain-Track method are possibilities for frequent sampling, surveillance of compliance, and analysis of a large amount of data. Induction and measurement of experimental histamine-induced itch were studied in 38 healthy subjects. It was shown that pruritic stimuli should be presented in a random order so as to avoid systematic errors in the perception of itch. Two rating scales, a seven-stepped non-verbal scale on a Pain-Track logger, and a 100-mm VAS on a potentiometer, were found valid for continuous recording of itch. The perception of experimental itch was studied in 32 AD patients and 32 healthy controls. The itch responses provoked by wool fibres were significantly stronger in AD patients than in controls, whereas the histamine-induced dose-response curves for itch did not differ significantly between the two groups, who discriminated equally well between weak and strong histamine stimuli. No increased skin mast cell releasability was shown in vivo to compound 48/80 in AD patients. Their itch responses to the different pruritic stimuli did not correlate with clinical itch intensity, eczema score or serum IgE-level. In a double-blind, randomized, placebo-controlled, cross-over study of 25 AD patients, the effect on clinical itch of a sedative (clemastine) and of a non-sedative (terfenadine) antihistamine did not differ from that of placebo, although both drugs had a pronounced H1-receptor-antagonizing effect in the skin and clemastine was significantly sedative. These findings support the view that histamine is not the major pruritogen in AD, and that sedation is not necessarily associated with itch relief. In a double-blind, randomized, placebo-controlled, cross-over study of 10 AD patients, 10 days' treatment with cyclosporin A (CSA), 5 mg/kg/day, significantly reduced itch intensity, eczema score and the number of peripheral blood eosinophils.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Itch and atopic dermatitis: clinical and experimental studies. 168 30

Adverse reactions, such as skin flush and pruritus, have been observed among hemodialyzed (HD) patients. A potential relationship between hemodialysis and allergic phenomena prompted us to investigate some allergologic parameters. Total IgE, specific IgE antiethylene oxide and anti-isocyanate toluene diisocyanate, and in vitro spontaneous histamine release (SHR) were measured in 105 long-term stable HD patients. Thirty-two of the patients had occasionally developed skin flush reactions and/or pruritus during dialysis sessions. Blood samples were taken at the start of dialysis, sera were kept frozen until assay, and in vitro SHR was performed on washed leukocytes at 37 degrees C for 40 minutes. A high (range, 20% to 80%) and reproducible in vitro SHR was observed among 24% of patients. No correlation was found between SHR and the type of dialysis membrane used (copolymer of acrylonitrile-methallyl-sodium sulfonate, cuprophan, and polysulfone). High SHR (i.e., greater than 20%) was observed mainly among patients with detectable antiethylene oxide IgE antibodies (p less than 0.001). High levels of IgE (greater than 300 ng/ml), specific IgE antibodies, and a high in vitro SHR were all observed concomitantly in 26% of the patients with skin flush reactions and/or pruritus, whereas all three of these parameters together were present in only 3% of the symptom-free patients. To our knowledge, this is the first time that a high in vitro SHR has been described among HD patients, and putative correlations with in vivo phenomena are discussed.
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PMID:High in vitro spontaneous histamine release in long-term hemodialyzed patients. 169 47

Itch and flare responses were investigated in 32 patients with atopic dermatitis (AD) and in 32 healthy controls. Itch was induced chemically by intradermal injections of histamine (1, 3.3, 10 and 100 micrograms/ml) and compound 48/80 (10 micrograms/ml) into non-lesional skin and mechanically by wearing a woollen sweater. Continuous recording of itch intensity allowed the calculation of itch duration (ID), maximal itch intensity (Imax) and a "total itch index" (Tii). The itch responses were significantly increased in AD patients compared with controls for wool fibres and one of the histamine concentrations (10 micrograms/ml), but not for the remaining three histamine concentrations or compound 48/80. Conversely, the flare response was significantly smaller in AD patients than in controls for the two strongest histamine solutions and compound 48/80. Significant dose-response relationships were found between histamine concentration and each of ID, Imax, Tii and flare in both patients and controls. The slope of the flare-regression line was significantly steeper in controls than in AD patients, whereas the slopes of the itch-regression lines did not differ significantly between the two groups, i.e. their ability to discriminate between weak and strong histamine concentrations did not differ significantly. No increased skin mast cell releasability in vivo to compound 48/80 was shown in AD patients compared with controls. The itch and flare responses of AD patients did not correlate significantly with clinical itch intensity, eczema score or serum IgE level.
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PMID:Patients' perception of itch induced by histamine, compound 48/80 and wool fibres in atopic dermatitis. 172 58

Actual incidence of vulvovaginitis is unknown, but apparently about 75% of women experience at least 1 episode of yeast vulvovaginitis during their reproductive years. Candida species causes almost all cases, e.g., Candida albicans causes about 90% of cases. Other species include C. glabrata and C. tropicalis. The spore form of C. albicans spreads the infection and is asymptomatic. The mycelia form induces symptoms. Neither C. glabrata nor C. tropicalis produce mycelia. The 1st step in establishing an infection is bonding to the vaginal mucosa. C. albicans adheres better than do the other 2 species. Proteolytic enzymes help the fungus bind to the mucosa. Research indicates that differences in the composition of normal vaginal bacteria, dearths in site functions that are specific for Candida, or prostaglandin or IgE interference with the cellular mediated immune response specific to Candida may be responsible for recurrent infections. The signs and symptoms of yeast vulvovaginitis are not clear cut so clinicians need to request laboratory tests on samples to confirm diagnosis. The most common symptom is considerable itching. Antifungal medicine is either topical or systemic. The most common yet oldest antifungal agent is 0.5-1% gentian violet applied topically to the affected mucous membranes. There is dome evidence, however, that it causes chromosome damage in some mammal cells. No reported cases of cancer in humans exist though. Imidazoles and polyene compounds constitute the mainstays of candidiasis treatment. Oral ketoconazole has shown promise in preventing recurrence. Colonization and symptomatic vaginitis rates rise during pregnancy. Symptomatic vaginitis is most common during the 3rd trimester. Diabetes mellitus also predisposes women to vaginitis. Women who use high dose oral contraceptives, the contraceptive sponge, and antibiotics also face increased risk of colonization and symptomatic vaginitis. Vaginitis is common among women with AIDS.
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PMID:Fungal vulvovaginitis. 181 23

Allergic reactions have been described as an occupational hazard among nurses and pharmaceutical workers who handle psyllium-containing laxatives. This study reports the case of a 38-year-old female nurse who ingested a bowl of psyllium-containing Heartwise Cereal (Kelloggs, Battle Creek, MI) and 25 minutes later developed severe systemic anaphylaxis manifested by hypotension, a feeling of constriction in the throat, hoarseness, dyspnea, wheezing, generalized pruritus, urticaria, and vomiting. She was treated with epinephrine, normal saline, diphenhydramine, and methylprednisolone, and recovered completely. Subsequent IgE immunoblot assay was strongly reactive to psyllium. Ingestion of psyllium-containing breakfast foods by sensitized individuals can be associated with life-threatening systemic anaphylaxis.
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PMID:Systemic anaphylaxis after ingestion of a psyllium-containing breakfast cereal. 186

While there are increasing data supporting the view that mite allergen sensitivity is one of the major causes of atopic dermatitis (AD) as well as asthma, it is practically difficult to avoid house dust allergens as part of the management of AD. Therefore, we served a conditioned room in which mites were eliminated to the level less than 3 mites/m2, named mite free room (MFR) for experimental treatment of AD to evaluate the possible therapeutic effect of the mite-free condition. Thirteen relatively severe patients with high-IgE RAST score to the mite allergens were treated with night time admission to the MFR without disturbing their social activities in the day time. Our MFR treatment gave eleven of the thirteen patients relief from itch and dermatitis within 2 to 3 weeks, yet they stayed average only 11 hours a day in the MFR. These results may provide a possible candidate in the treatment of AD instead of topical and/or systemic medicines of which prolonged usage is sometimes associated with adverse side effects.
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PMID:[The mite-free room (MFR) for the management of atopic dermatitis: living in the MFR improved first the itch and then the dermatitis]. 189 45

Seminal fluid hypersensitivity usually is characterized by postcoital vulvovaginal itching, swelling, redness, with or without systemic signs and symptoms. Efforts to manage this condition have either met with poor patient acceptance or have not been uniformly successful. We describe a 23-year-old atopic woman with documented IgE-mediated local and cutaneous hypersensitivity to SF. Using a controlled, single-blind challenge method, pretreatment with intravaginal 4% cromolyn sodium in a water-based cream completely blocked both local and cutaneous immediate hypersensitivity reactions to SF in this highly sensitive patient. We believe this may represent an alternative and more desirable method of preventive management in such patients.
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PMID:Successful prevention of local and cutaneous hypersensitivity reactions to seminal fluid with intravaginal cromolyn. 190 63

While the pathomechanisms of respiratory atopy are rather well established, the role of IgE-mediated hypersensitivity in the elicitation and maintenance of eczematous skin lesions in atopic eczema is still controversial. Few diseases are characterized by an equally elevated production of IgE antibodies as atopic eczema. Many authors, however, regard this only as epiphenomenon. On the other hand, there is clearcut clinical evidence for exogenous elicitation of atopic eczema by contact with aero or food allergens. A variety of hypotheses may help to explain the participation of IgE antibodies in the induction of eczema: vasoactive mediators secreted by skin mast cells or basophils after allergen contact may produce itch, contact urticaria or a 'late-phase-reaction' with consequent eczematous skin changes further maintained by scratch responses. Recent investigations stress a possible role of Langerhans cells in the epidermis with a low affinity receptor for IgE with possible function for antigen presentation, mediator release or regulatory interactions. Certain cytokines such as interleukin-4 or gamma-interferon are able to enhance the expression of the IgE-receptor on the surface of Langerhans cells. IL-4 and gamma-interferon act synergistically in this respect on Langerhans cells, contrary to B cells. Furthermore lymphocytes may act directly via certain cytokines (e.g. histamine releasing factor, chemotactic factors etc.) on mast cells or eosinophil granulocytes in a proinflammatory sense. Eosinophils seem also to be involved in the inflammatory response in atopic eczema by releasing products such as major basic protein (MBP) or eosinophil cationic protein (ECP) which has been found to be elevated in severe atopic eczema.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Atopic eczema, Langerhans cells and allergy. 193 74

Components in the insect venom and probably also in their saliva may have direct toxic effects or may cause sensitization and may result in allergic reactions to subsequent stings. In Denmark, only the stings of honey bees and wasps (yellow jackets) are of clinical significance and it is important to be aware that these insects contain separate allergenic components. Clinical manifestations following stings are observed from all of the organ systems on the whole. The commonest are itching of the skin, urticaria, possibly angioedema and slight generalized symptoms with vertigo, headache and fatigue. Life-threatening reactions may also occur and one or two fatal cases are registered annually in Denmark. It may be difficult to decide whether an allergic or a toxic reaction is involved on the basis of the symptoms. Possible IgE-sensitization must therefore be assessed by means of a prick test and measurement of specific IgE. The main treatment in cases of acute systemic reactions is adrenaline which may possibly be supplemented with antihistamine and corticosteroid. In cases of massive local reactions and urticaria, antihistamines will, as a rule, prove sufficient. Hyposensitization with insect venom preparations eliminates the future risk for systemic insect sting reactions practically entirely and this must be recommended for patients with demonstrated IgE-sensitizing and generalized reactions. At present, treatment should be continued for three to five years and protection lasts for a series of years after cessation of treatment.
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PMID:[Allergy to insect stings]. 194 33

Cutaneous reactions to mosquito bites are usually pruritic weals and delayed papules. Arthus-type local and systemic symptoms can also occur but anaphylactic reactions are very rare. Both clinical and experimental evidence suggest that the various bite reactions result from sensitization to the mosquito saliva injected into the skin during feeding. Recent immunoblot studies have shown both IgG- and IgE-class anti-mosquito antibodies, but their species-specificity and clinical importance is at present unknown. In addition to an Arthus-type mechanism, both cutaneous late-phase reactivity and cell-mediated immunity may be involved in the pathophysiology of delayed mosquito-bite lesions. Cutaneous sensitization to mosquito bites can be divided into five different stages ranging from the stages of immediate wealing and delayed bite papules, to the stage of non-reactivity. No desensitization treatment is generally available for mosquito allergy but it has recently been shown that cetirizine, a potent non-sedating antihistamine, is effective against the wealing and pruritus caused by mosquito bites.
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PMID:Immunology and treatment of mosquito bites. 198 Aug 55


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