The objective of this proposal is to use laboratory techniques, primarily immunologic, to explore diagnostic and therapeutic approaches to human allergic disorders with the aim of improving these techniques and thereby the clinical care of allergic disorders. We will determine patient sensitivity by histamine release, skin testing and the IgE antibody measurements and protection by IgE antibody measurements. Studies will include the measurement of IgE and IgG antibodies against an array of isolated allergens and RAST inhibition; we will also seek to demonstrate the degree and frequency of IgE heterogeneity, both with respect to Fc and Fab portions of the molecule. Two types of allergy will be studied: parenterally induced, typified by Hymenoptera sensitivity, and inhalant allergy, typified by asthma and rhinitis to pollen or dander antigens. With respct to insect allergy, we will try to determine which patients require therapy in the context of the cost and effectiveness. We will study the crossreactivity among the vespid venoms, with the hypothesis that most patients are sensitive only to yellow jacket and, therefore, require therapy only with this venom. We will use modified venom antigens in an attempt to decrease the incidence of local and systemic reactions during immunotherapy. The regimens of immunotherapy will be further explored and a possible endpoint searched for. Finally, an epidemiologic study of the incidence of clinical and immunologic sensitivity to insect venoms will be executed. With respect to inhalant allergy, we will begin studies using antigens which, in animals, are """"""""tolerizing"""""""" with respect to IgE production. This will involve, primarily, ragweed allergens modified by the introducton of polyethylene glycol groups or by DGL. Using standard antigen preparations, we will evaluate the immunotherapy of asthma to cat dander, assessing response by bronchoprovocation and controlled environmental exposure. In each of these studies we will follow the immunotherapeutic effects by antibody measurements and controlled clinical trials to determine efficacy. We will attempt to establish a relationship between the immunologic measurements and the clinical result.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI008270-18
Application #
3124398
Study Section
Immunological Sciences Study Section (IMS)
Project Start
1976-04-01
Project End
1986-03-31
Budget Start
1985-04-01
Budget End
1986-03-31
Support Year
18
Fiscal Year
1985
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Type
Schools of Medicine
DUNS #
045911138
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Golden, David B K (2010) Long-term outcome after venom immunotherapy. Curr Opin Allergy Clin Immunol 10:337-41
Golden, David B K; Kelly, Denise; Hamilton, Robert G et al. (2009) Venom immunotherapy reduces large local reactions to insect stings. J Allergy Clin Immunol 123:1371-5
Golden, David B K; Kelly, Denise; Hamilton, Robert G et al. (2009) Dialyzed venom skin tests for identifying yellow jacket-allergic patients not detected using standard venom. Ann Allergy Asthma Immunol 102:47-50
Golden, David B K (2007) Insect sting anaphylaxis. Immunol Allergy Clin North Am 27:261-72, vii
Golden, David Bk (2007) What is anaphylaxis? Curr Opin Allergy Clin Immunol 7:331-6
Golden, David B K (2006) Insect sting allergy and venom immunotherapy. Ann Allergy Asthma Immunol 96:S16-21
Cruz, Alvaro A; Naclerio, Robert M; Proud, David et al. (2006) Epithelial shedding is associated with nasal reactions to cold, dry air. J Allergy Clin Immunol 117:1351-8
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Guo, C B; Liu, M C; Galli, S J et al. (1994) Identification of IgE-bearing cells in the late-phase response to antigen in the lung as basophils. Am J Respir Cell Mol Biol 10:384-90
Essayan, D M; Kagey-Sobotka, A; Lichtenstein, L M (1994) Nearly fatal anaphylaxis following an insect sting. Ann Allergy 73:297-300

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