Tobacco Documents Online

T©c:. W.- T. Hoyt PR'OM: -- Leonard' S. Zahn C April 2, 1197, 9 SUBJECT: American Academy of Allergy New Orleans, March 26-28„.1979 Three papers on tobacco, two of them from a CTR-supported -pro ject.•at_ the Mhyo~. Clinic i~n, Ro_chestery, _1~inm- ,__ p'lus_ a_paster very minor fashion. / Ad 'lht Thecaey ms press ress peope soug gairln press attention t© presentation on passive smoking in asthma, were featuredlat this meeting. A few other papers'cited smoking but-only in a porters frornr the medical "Itrade 'press,'r such as n'Medical World! News,, " "'Medical Tribune, " "Journal of' the American Medical As- sociation" (news section)„ and a few others.-Local ireporters. droppedlin occasionally. A reporter was present for Physicians. the poster presentation. Press coverage consi:stedlmostly of re- .to the tobacco papers. Press conferences were held for grantee Gerald Gleich of Mayo and Raymond Slavin of St. Louis, who had Radio Network; an interview was taped with Slavin. ,, The highlights : gens in rabbits andlas allergens in humans. These antigens are present in smoke condensate,, he said. (UIp'T"s-science ed- itor in Washington participated in the conference via`phone.) ~ - - ... ,nPatients can become allergic to tobacco antigens, " Gleich, said in opening the press conference, moting,he was going to report later on.one person,, a tobacco factory worker, whQ, was exposed for years to dust that "presumablyrr contained materials derived fromcurEd tobaccolle~af. is good evidence that materials in tobacco,leaf can act as anti- Qxleiich said the -possi:bility existed that there is allergy to . cigarette smoke but this hais not yet been shown..He said there. .1!. At a press conference before formal delivery of his paper, He referred to green leaf (in the field), cured leaf and smoke condensate (tar). "It indeed would appear that the most inimical factors in tobacco smoke are in the tar and they are the benzpyrenes and the materials that induce aryl hydrocarbon hydroxylase and in turn function as carcinogens,,'" he said. . .- ~ He said the other paper being given by his group wouldide- scribe data showing that in condensate (from tobacco smoke)' .there are antigenic materials which stimulate production of andAssociateslne ~,j;~ PUBLIC RELATIONS COUNSEL , IA.r~'~i~0 antibodies by rabbits. ~ . eonard ('P: O. BOX, 223) 13 LINCOLN ROAD . GREAT NECK, N.Y:,11021 t(212)I 895-7445

Z. nSo the first message is that antigens are present in tobac- co smoke,'" Gleich contined. The second messag;e,, and' the thrust of his paper; "is that people can become sensitizedi, i.e., they can produce IgE antibodies and develop alclinical -sensitivity to tobacco antigens."! He said the tonacco factory worker had produ;ced'I[gE anti- bodies, and "'the body of evidence strongly supports the con- tention that this patient is allergic to antigens present in tobacco leaf." C.~leich- w,em:t on: -ThE important- question is- whe,ther smoke "on a crowded plane (or"room) might contain sufficient quantities. of antigeds .to provoke.symptoms "on an allergic basis" in a. passenger who is troubled by smoke. "I fear I will have tolbe vague. I cannot answer'that question because„ in fact, we have yet to piin down that point. The question becomes a,complicated ,one because the symptoms provoked by simple irritation, i.s.,, the inhalation_ of smoke per s_e, can be very similar to those whichicould be.produced by a mild allergic reaction, and as yett in our lab we have not been able to, identify anyone whom we are convinced is having reactions to cigarette smoke ori an immuno- logical basis." The tobacco worker complained of getting,the same occupa- tion-re]:ated symptoms when she was in airoom filled with smoke. 'rStilli., that does not answer the question, as those- symptoms could ble_on the basis of an~ irritative phenomenon and not an allergic phenomenon:"" ' The information.being reported at the meeting encourages the belief that "'nthe occurrence of allergy symptoms on expo-,- sure to cigarettes is possible. Heretofore we've lacked the basis of information. Now we have information that provid'es,, in my judgment, a firm foundation for including within our framework of thought this possibility. n" -'"I must hasten to point out one thing. Even were we able to. identify certain reactions to cigarette smoke on an allergic basis, these in my judgment would pale beside the wellknown im- portance of the variety of'carcinogens which are present in cigarette smoke and to which one is exposed when one is sitting in an environment where smokers are exhalirlg these material s. "' Asked whether-we now have evidience that people are allergic to cigarette smoke, Gleich said: "'I would, not go. quite that far. I would say we do not have that evidence. We have good informa- ~ tion now that materials preserit in tobacco- now here I am re- ~ ferring to tobacco leaf -- caniact as antigens in rabbits and Q,J allergens in humans. Second these antigens are present in the -.1 , tobacco smoke condensate. Now, the obvious conclusion from this N is precisely what you say, but the fact of'proving this exist- ence is another thing.rr ~

"We haven't demonstrated that there is allergy to cigarette smoke. We have not done it. I wouldi like to say that but I can' t.''' Respond'ung to a comment about people who complain of being allergic to smoke: "We've looked hard'for such~'individ'uals andi, in fact„ in the people who complain the most we don''t find any- thing. "' .but in other immunoglobulin classes. He said he''s looking at 7IgG sent could stimulate an immune response not just in the IgE class Gleich said the possibility exists that the allergens pre- -and the data are .G]leich volunteered that his work was being supported by CTR restraints hadibeen placed on his researchlor disclosure'. and praiised the C'ounciil. for being extremely helpfwl. He said no, ~ He noted his current work is to be reported in the "'New Eng,- history of.the tobacco factory worker. . landl Journal of Medicine."' This apparently will include the case col-growing states and this worker was the only one whose sera, sera from, 1,, 458 patients had been sent him by doctors in tobac- formal paper in whichihe ga Je details of' the tobacco worker,, a 3I1-year-old female with clinical sensitivity to tobacco. He said 2. "'Allergy to tobacco antigens" was the title of Gleich's showed extremely highi levels of' IgE antibodies. He also gave data for establishing the radioallergosorbent test (RAST) for tobacco antigens,, particularly those contained in green tobacco leaf. wi some suspiciaon. W acted at 1©ug and 7 at 10©ug.`Ome of 51atopic nonsensitive in- ©! d'ividuals d'id react. rrSo the skin reactivity must be looked at ~' th nr' bodies were found in emphysemalpatients treated withigreen leaf or condensate. I[n individual;s with suspected allergy -- 8%'in- cidence with green leaf, 7% with conderlsate. The highest fre- quency was found in persons with atopic dermatitis -- S9°~ and 58/, respectively. Ragweed hayfever victims also were positive, but asthmatics were not. None of 38 susZpected tomato-sensitive (the tomato and tobacco leaf are from the same plant famiily), individuals were positive. A larg,e number of blood donors were screened and only a small percentage was positive. . . He described skin reactivity tests with green leaf extract in 8 normal individuals: none reacted at 10 nanograms, 2.re- GlEich, reported findings .~in, regardi to IgE levels in smokers and nonsmokers; most of the fiindings were negative. Extracts from green leaf, cured tobacco andicondenisate were usedi.' IMJo anti- N;. N

4. 3'. "Physicochemical and immunocl'Lemical properties of tobac- co extracts"" -- P. W'. Welsh (and Gleich). This paper, the first of the three'~on tobacco, was a technical presentation of find- ings fromianalysiisby various techniques ofextlracts~ from green tobacco (GT')'„ cured tobacco (CT) and smoke condensate ('SC)I. Isoelectric focusing,showed distinctly different banding, patterns for the three extracts. Electrophoresis showedia vari- ety of compounds were present. I[mmunochemical properties were studied in rabbits and guinea -pigs with these extracts- C1mg/ml -samples -followed by- boc>ster in- ,jectionO. F'indings'suggested that materials present in f'resh GT are also present in SC, recognizable as antigens in the animal model.. ` The curing process causes marked degradation of tobacco pro- teins, Welsh said. Analysis of SC revead.ed data suggesting the presence of'prolteinaceous material. The data also showed that SC .-contains arntigens that stimulate the prodhiction of antibodies reactive wa.th,CT. 4. "Presence of tobacco antigens in cigarette smoke'n "- S.B. Lehrer,, New Orleans (with, M.R. Wilson andi Joseph Salvagg~o) . In the second of'the three tobacco reports, Lehrer described var- ious experiments with_mice andirabbits and with sera from smok- ers„ nonsmokers and.persons reporting sensitivity to smoke. R'e- sults generally did not support claims of'a relationship to to- bacco, allergy. Leaf extracts 'used were o!btained .from flue-cured tobacco, Maryland tobacco and air-curediB!urley. A smoke condensate ex- tract was prepared as were extracts from: filter cigarette smoke, nonfilter cigarette smoke, air passed' througli an unlit cigarette, and from filter cigarette smoke but with the use of a different serum (mouse). ..Tn tests with four different strains of mice, allergens were foun:d'to be present in smoke in minimal amounts, Lehrer said. It is possiible that these may be related to dust present in to- blacco]Leaf s:ince!they we~red'etected in extracts of air passed through unlit cigarettes. Results with rabbits: Some rabbits may have a pre-existing response to, tobacco leaf antigen, possibly as result of prior exposure to, smoke or plant antigens in their feed or bedding,. Other rabbits which do not have alpre-existing response clearly react'to leaf antigens f©llowing immunization with smoke extraict.Qi The animal findings suggest cigarette smoke which stimulate Lehrer said. that immunogens are present in w airesponse to leaf antigens, ~ N -1 O;b

z tion of complaints.to tobacco sensitivity with IgE antibodies to Preliminary ±-esults, Lehrer said,, suggested there is no corre]la- uals were testediwith leaf extracts for IgE antibodies (RAST used) Sera from smokers, nonsmokers and smoke-sensitive individ- tobacco leaf antigens. in smoke hypersensitivity. to~tobacco leaf'in man as measured by the RAST assay to smoking, could~not demonstrate any correlation of.an immune-response to. They do not seem to'bie very potent antigens. Initial studies tained from unlit cigarettes; *they appear to bie of leaf' origin. aginic antibodies in mice and'precipiitating antibodies in rab- blits to tobacco leaf antigens. These antigens are not products of'incineration since they are present in extracts of air ob- sent in tobacco smoke since extracts of smoke can stimulate re- He summarized: It has been shown that immunogens are pre- 5. "Effects of passive smoking on asthma" -- J.F. Dolin„ T.E: Dahns and FZ'aymond Slavin,, 'St. Louis.-Slavin made these comments at a press conference,, talking to visitors in the post.er areaa and at a plenary session following the poster exhibit: (all at once, no intermittent puffing); the cigarettes were smoked every 15 minutes for one hour (,4 smoking periods ),. l A study was done of 10 normal persons and 101asthmatics (all nonsmokers), exposed to cigarette smoke in a well-ventilated en- vironmental chamber. There were about 5 males and'51females in each group;_age range was 18!-50. Sidestream smoke was generated by a'''home-mad,en machine which consumed 4 cigarettes at a time . The sub j,ects had pulmonary function tests done prior to the start and at 15'-mi:nute intervals during,the 1-hour'exposure per- iod. Carbioxyhemoglobin (,COHb), levels were measured before and' after. At the conclusion of`the hour„ COHb in the controls was upp about 0.43/;I in the asthmatics, 0i.3',8%. These figures suggest each group had identical exposures. None of the controls had any change in lung function, but there was a significant (,linear) decline in lung function inn the asthmatics. This indicates that passive smoking may be a precipitating factor in bronichial asthma. low. Air COland particulate levels increased as the ho ur progressed. All subjiects were previously challenged with mecholyl. Asth- ~ matics who were more sensitive to mecholyl responded "worst'0 in ~ the study. Particulate levels measured in the chamber were quite TYie study was done for two reasons: proponents of smoking ~ say it doesn't hurt nonsmokers,, andd allergists reports anecdotal 6J material about asthmatics and smoking. ~'. An application for aniexpanded study has been submitted to

6. 6. In discussion after the three tobacco papers, Bernard Zuss- man of'Memphis cited Carl Becker's work and said (again that at least 8-10 million people with common allergies are clinically sensitilveto: tobacca. Hed'i:sagareed with~ Gleich'simplication that tobacco allergy in atopic patients is rare. His atopic nonsmoking patients show sensitivity on exposure to smoke. He asked Gleich if RASTs were done on atopics clinically sensitive to smoke ex- posure. . Gleich~: We "ve done that. When we examined sera from people who complainedi "most bitterly" of apparent tobacco aLlergy, '!'we have yet to find any IgIE antibodies and that includes eminent individy= ualis from science who've made such claims.n' (',Gleich earlier had referred to B'ecker ais reporting fi:ndings similar to his. He 'said. ,he hadibeen in touch with Becker to see i:f' they're both using the same material. Becker, he saidi, apparently has aismall: amount of the material. )' •'•'At the end of the discussion, J!oseph Harkavy was granted time to read a statement in which he repeated his familiar claims abo ut tobacco's role in allergy and cardiovascular d'isease. r , ~ b, 6L'6!' ~ ~dy"I-~-' h Ir.q "l , ,