Anna Nowak-Wegrzyn, MD, Gail G

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Presentation transcript:

Contamination of dry powder inhalers for asthma with milk proteins containing lactose Anna Nowak-Wegrzyn, MD, Gail G. Shapiro, MD, Kirsten Beyer, MD, Ludmila Bardina, MS, Hugh A. Sampson, MD Journal of Allergy and Clinical Immunology Volume 113, Issue 3, Pages 558-560 (March 2004) DOI: 10.1016/j.jaci.2003.11.015

FIG 1 A, Silver staining of protein content in selected DPIs compared with silver staining of cow's milk proteins. Proteins of molecular weight similar to β-lactoglobulin are present in Lactose USP, Foradil, and Flovent: 1, molecular weight standard; 2, α-casein; 3, β-casein; 4, κ-casein; 5, α-lactalbumin; 6, β-lactoglobulin; 7, lactose USP; 8, Advair (12.5 mg lactose/dose); 9, Serevent (12.5 mg lactose/dose); 10, Flovent (25 mg lactose/dose); 11, Foradil (25 mg lactose/dose). B, Casein detection in Advair and Lactose USP by labeling with monoclonal antibody against α-casein and β-casein; 1, molecular weight standard; 2, milk; 3, lactose USP; 4, Advair No. 1 (12.5 mg lactose/dose). C, Immunolabeling with sera of patients allergic to milk. Patient 1 is the patient described in the case report; patients 2 through 4 have severe milk allergy and high serum milk-IgE antibody concentrations, and patient 5 is not allergic to milk and serves as a negative control; 1, molecular weight standard; 2, milk; 3, lactose USP; 4, Advair No. 1 (12.5 mg lactose/dose). D, β-Lactoglobulin detection in Foradil (25 mg lactose/dose) and lactose USP by labeling with monoclonal antibody against β-lactoglobulin; 1, molecular weight standard; 2, lactose USP; 3, Foradil (25 mg lactose/dose); 4, Pulmicort (no lactose). E, Immunolabeling with sera of patients allergic to milk. In addition to patients 2 through 4 from C, two other subjects with severe milk allergy were included. Milk-tolerant patient with milk-IgE <0.35 kU/L serves as negative control; 1, molecular weight standard; 2, lactose USP; 3, Foradil (25 mg lactose/dose); 4, Pulmicort (no lactose). Journal of Allergy and Clinical Immunology 2004 113, 558-560DOI: (10.1016/j.jaci.2003.11.015)