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2. Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)
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Roberto Berni Canani, Carlo Caffarelli, Mauro Calvani, Alberto Martelli, Laura Carucci, Tommaso Cozzolino, Patrizia Alvisi, Carlo Agostoni, Paolo Lionetti, and Gian Luigi Marseglia
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Adverse food reactions ,Food allergy ,Carbohydrates intolerance ,Lactose intolerance ,Anaphylaxis ,Component resolved diagnosis ,Pediatrics ,RJ1-570 - Abstract
Abstract Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and therapeutic intervention that could be adopted in the context of public health policies for FAIs are needed. This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy.
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- 2022
- Full Text
- View/download PDF
3. Frequency of allergic reactions in egg allergic patients after receiving the yellow fever vaccine.
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García-Paba MB, Aparicio C, Rodríguez M, Moreno S, and García E
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- Humans, Cross-Sectional Studies, Retrospective Studies, Vaccines, Anaphylaxis, Egg Hypersensitivity epidemiology, Egg Proteins adverse effects, Yellow Fever Vaccine adverse effects
- Abstract
Background: Immunization with live attenuated viral yellow fever vaccine (YFV) grants effective immunity in most cases, and is recommended and prioritized for residents and travelers of endemic countries. YFV is seldom administered to egg-allergic patients (EAP) since it is cultivated in embryonated chicken eggs and may contain residual egg proteins, being a problem for egg-allergic residents and travelers of endemic countries., Objective: Describe the frequency of allergic reactions after YFV administration in confirmed EAP from an allergy outpatient center in Bogotá, Colombia., Methods: An observational, retrospective, cross-sectional, and descriptive study was conducted from January 2017 to December 2019. EAP whose allergy was confirmed with a positive Skin Prick Test (SPT) and/or egg protein-specific IgE levels who hadn't received the YFV were included. Every patient had an SPT, severe EAP, and an additional Intradermal Test (IDT) done with the vaccine. If the vaccine SPT and IDT were negative, the YFV was administered as a single dose; if either were positive, the YFV was administered in graded doses. Statistical analysis was done in Stata16MP., Results: Seventy one patients were included, 24 (33.8%) of those had a history of egg anaphylaxis. All patients had negative YFV SPTs, and two of the five YVF IDTs were positive. Two patients, with previous egg-anaphylaxis, presented allergic reactions to the vaccine., Conclusions: YFV did not trigger allergic reactions in EAP without history of egg-anaphylaxis. With further research, safe single-dose vaccination to this population could be considered; however, patients with previous egg-anaphylaxis should be evaluated by an allergist before vaccination.
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- 2023
- Full Text
- View/download PDF
4. The role of mobile health technologies in allergy care: An EAACI position paper
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Jean Bousquet, Jean-Christoph Roger J-P Caubet, James Gardner, Ralph Mösges, Simon Blank, Dermot Ryan, Alla Nakonechna, Daniel Perez-Formigo, Markus Ollert, Ignacio Esteban-Gorgojo, Ileana Ghiordanescu, Darío Antolín-Amérigo, Giovanni Battista Pajno, Jörn Wittmann, Jeroen Buters, Elisa Boni, Constantinos Pitsios, Karin Hoffmann-Sommergruber, Knut Brockow, Philippe Gevaert, Uwe Berger, Harmieke van Os-Medendorp, Matteo Bonini, Tania Elliott, Peter Hellings, Jennifer Shih, Marina Atanaskovic-Markovic, Salvatore Tripodi, Michael S. Blaiss, Stephanie Dramburg, A. Fusun Kalpaklioglu, Ioana Agache, Oliver Pfaar, Lauri-Ann Van der Poel, João Fonseca, Christian Apfelbacher, Ozlem Cavkaytar, Gilda Varricchi, Jose Oteros, S. Sanchez-Garcia, Farid Marmouz, Alberto Alvarez-Perea, Victoria Cardona, Ángela Meijide Calderón, Paolo Maria Matricardi, Michael Rudenko, Catalina Panaitescu, Margitta Worm, KKÜ, Ear, Nose and Throat, Kırıkkale Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kalpaklıoğlu, A. Fusun, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Hospital General Universitario 'Gregorio Marañón' [Madrid], Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), University of Regensburg, University of Belgrade [Belgrade], Medizinische Universität Wien = Medical University of Vienna, Augusta University - Medical College of Georgia, University System of Georgia (USG), Center of Allergy & Environment (CK-CARE, ZAUM), Helmholtz-Zentrum München (HZM), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Royal Brompton Hospital, Fondazione 'Policlinico Universitario A. Gemelli' [Rome], Università cattolica del Sacro Cuore [Roma] (Unicatt), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Technical University of Munich (TUM), Vall d'Hebron University Hospital [Barcelona], Geneva University Hospital (HUG), Istanbul Medeniyet University [Istanbul, Turquie] (IMU), New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU), General Hospital of Villalba [Madrid], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto, Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Great North Children's Hospital, Partenaires INRAE, Newcastle University [Newcastle], Ghent University Hospital, Emergency University Hospital Elias, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), University of Kirikkale, Hopital Réné Dubos, University of Vigo [ Pontevedra], University Hospital of Cologne [Cologne], Clinical Research International Ltd., Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool Hope University, Luxembourg Institute of Health (LIH), University of Southern Denmark (SDU), University of Messina, Romanian Primary Care Respiratory Group (RespiRo), Hospital Universitario de Torrejón, Univ Politecn Madrid, Ctr Tecnol Biomed, Pozuelo De Alarcon 28223, Madrid, Spain, Philipps Universität Marburg, University of Cyprus (UCY), Centre Harley Street Allergy Clinic, Centre of Medical Informatics [Edinburgh, UK] (Usher Institute of Population Health Sciences and Informatics), University of Edinburgh, Hospital Infantil Universitario Niño Jesús [Madrid, Spain] (HIUNJ), Institute of Health Carlos III, Emory University School of Medicine, Emory University [Atlanta, GA], Policlinico Casilino (Ospedale Policlinico Casilino), Medical Physics Department,Guy's and St Thomas'NHS Foundation Trust, London, UK, Medical Physics Department, London, UK, Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust-Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust, University Medical Center [Utrecht], 'Federico II' University of Naples Medical School, Transilvania University of Brasov, Helmholtz Zentrum München = German Research Center for Environmental Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Universidade do Porto = University of Porto, Philipps Universität Marburg = Philipps University of Marburg, University of Cyprus [Nicosia] (UCY), Hospital Infantil Universitario Niño Jesús (HIUNJ), Salvy-Córdoba, Nathalie, Matricardi, Paolo Maria, Dramburg, Stephanie, Alvarez-Perea, Alberto, Antolín-Amérigo, Darío, Apfelbacher, Christian, Atanaskovic-Markovic, Marina, Berger, Uwe, Blaiss, Michael S, Blank, Simon, Boni, Elisa, Bonini, Matteo, Bousquet, Jean, Brockow, Knut, Buters, Jeroen, Cardona, Victoria, Caubet, Jean-Christoph, Cavkaytar, Özlem, Elliott, Tania, Esteban-Gorgojo, Ignacio, Fonseca, Joao A, Gardner, Jame, Gevaert, Philippe, Ghiordanescu, Ileana, Hellings, Peter, Hoffmann-Sommergruber, Karin, Kalpaklioglu, A Fusun, Marmouz, Farid, Meijide Calderón, Ángela, Mösges, Ralph, Nakonechna, Alla, Ollert, Marku, Oteros, José, Pajno, Giovanni, Panaitescu, Catalina, Perez-Formigo, Daniel, Pfaar, Oliver, Pitsios, Constantino, Rudenko, Michael, Ryan, Dermot, Sánchez-García, Silvia, Shih, Jennifer, Tripodi, Salvatore, Van der Poel, Lauri-Ann, van Os-Medendorp, Harmieke, Varricchi, Gilda, Wittmann, Jörn, Worm, Margitta, Agache, Ioana, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), and Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
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0301 basic medicine ,MESH: Drug Hypersensitivity ,MESH: Asthma ,Allergy ,MESH: Chronic Urticaria ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,immunoglobulin E ,0302 clinical medicine ,Immunology and Allergy ,Chronic Urticaria ,Position paper ,Disease management (health) ,MESH: Desensitization, Immunologic ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,mHealth ,Self-management ,ddc:618 ,Health technology ,Disease Management ,allergen-immunotherapy ,Mobile Applications ,Telemedicine ,EAACI ,allergy ,digital health ,mobile health technology ,position paper ,3. Good health ,Dermatitis, Allergic Contact ,biomarker ,MESH: Mobile Applications ,Psychology ,allergic rhiniti ,Digital health ,Food Hypersensitivity ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,allergen ,molecular allergology ,Immunology ,Internet privacy ,component-resolved-diagnosi ,Context (language use) ,Mobile health technology ,MESH: Disease Management ,Dermatitis, Atopic ,Drug Hypersensitivity ,03 medical and health sciences ,[SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics ,MESH: Dermatitis, Allergic Contact ,IgE test ,MESH: Dermatitis, Atopic ,Humans ,Mobile technology ,Anaphylaxis ,Physician-Patient Relations ,[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics ,MESH: Humans ,business.industry ,Rhinitis, Allergic, Seasonal ,MESH: Rhinitis, Allergic, Seasonal ,asthma ,molecular spreading ,[SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology ,diagnostic algorithm ,MESH: Anaphylaxis ,030104 developmental biology ,030228 respiratory system ,Desensitization, Immunologic ,Digital Health ,Eaaci ,Mobile Health Technology ,Position Paper ,MESH: Telemedicine ,MESH: Food Hypersensitivity ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,MESH: Physician-Patient Relations ,business ,[SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology - Abstract
Oteros, Jose/0000-0002-9369-8633; Fonseca, Joao Almeida/0000-0002-0887-8796; Alvarez-Perea, Alberto/0000-0001-7417-7309; Oteros, Jose/0000-0002-9369-8633; Gevaert, Philippe/0000-0002-1629-8468; Antolin, Dario/0000-0001-5699-4022; Apfelbacher, Christian/0000-0003-3805-8219; Buters, Jeroen/0000-0003-3581-5472; Berger, Uwe E./0000-0002-9265-2131; Blank, Simon/0000-0002-5649-1078; Cardona, Victoria/0000-0003-2197-9767; Dramburg, Stephanie/0000-0002-9303-3260 WOS: 000486665800001 PubMed: 31230373 Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed.
- Published
- 2020
5. White paper on peanut allergy- part1: Epidemiology, burden of disease, health economic aspects
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Hans F. Merk, Christian Vogelberg, Natalija Novak, Sven Becker, Katja Nemat, Thomas Spindler, Eckard Hamelmann, Michael Gerstlauer, Adam Chaker, Randolf Brehler, Torsten Zuberbier, Norbert Mülleneisen, Thomas Fuchs, Kirsten Beyer, Holger Wrede, Wolfgang Czech, Wolfgang Wehrmann, Tobias Ankermann, Ludger Klimek, Sebastian Schmidt, Kirsten Jung, Andrea Bauer, Wolfgang Schlenter, Katharina Blumchen, Uta Rabe, Lars Lange, Johannes Ring, and Thilo Jakob
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Burden of disease ,medicine.medical_specialty ,Allergy ,Review ,Food allergy ,Anaphylaxis ,Oral immunotherapy ,COVID-19 ,Children ,business.industry ,Peanut allergy ,food and beverages ,Allergen avoidance ,medicine.disease ,ddc ,White paper ,Environmental health ,Epidemiology ,medicine ,Immunology and Allergy ,ddc:610 ,business - Abstract
Peanuts are Leguminosae, commonly known as the legume or pea family, and peanut allergy is among the most common food allergies and the most common cause of fatal food reactions and anaphylaxis.The prevalence of peanut allergy increased 3.5-fold over the past two decades reaching 1.4–2% in Europe and the United States. The reasons for this increase in prevalence are likely multifaceted. Sensitization via the skin appears to be associated with the development of peanut allergy and atopic eczema in infancy is associated with a high risk of developing peanut allergy.Until recently, the only possible management strategy for peanut allergy was strict allergen avoidance and emergency treatment including adrenaline auto-injector in cases of accidental exposure and reaction.This paper discusses the various factors that impact the risks of peanut allergy and the burden of self-management on peanut-allergic children and their caregivers.
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- 2021
6. Primary, secondary and tertiary prevention of food allergy: current practices and future directions.
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Cronin C, Salzberg N, Woon Y, and Wurttele JT
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- Infant, Child, Female, Pregnancy, Humans, Child, Preschool, Tertiary Prevention, Breast Feeding, Diet methods, Allergens, Arachis, Anaphylaxis prevention & control, Food Hypersensitivity epidemiology
- Abstract
The incidence of food allergies has risen around the globe, and experts have been exploring methods of preventing such allergies in young children to ease the burden of disease and reduce the morbidity and mortality caused by anaphylaxis to food allergens. Such preventative measures can be categorised as primary, secondary and tertiary prevention, which are discussed in detail in this review. Primary prevention is defined as the prevention of becoming sensitised towards specific allergens. The evidence suggests that avoiding common allergenic foods during pregnancy and breastfeeding is not protective against food allergies, and guidelines recommend weaning from 4 to 6 months of age, with recent studies supporting the early introduction of peanuts at 4 months to prevent peanut allergy. Secondary prevention targets patients who are already sensitised and aims to halt the progression of sensitisation, with evidence for high rates of success and safety in trials of early introduction to milk and peanuts using oral immunotherapy in sensitised infants. Tertiary allergy prevention focuses on reducing the risk of a patient having anaphylaxis, with oral immunotherapy being the most common method of promoting tolerance in allergic children. Several studies have demonstrated successful reintroduction for milk, egg and peanut; however, no such guidelines are recommended for other foods. Finally, dietary advancement therapy in the form of milk and egg ladders has been employed as a method of primary, secondary and tertiary prevention of allergies, particularly in Ireland, the UK and Canada.
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- 2024
- Full Text
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7. An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions
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Didier G. Ebo, Ingrid Terreehorst, Susanna Voltolini, Tomaz Garcez, Peter Kopač, Jose Julio Laguna, Paul-Michel Mertes, Pascale Dewachter, Kathrin Scherer, Lene H. Garvey, Anca Mirela Chiriac, Ear, Nose and Throat, and AII - Inflammatory diseases
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0301 basic medicine ,Hypersensitivity, Immediate ,Premedication ,Severity of Illness Index ,antibiotics ,alergija in imunologija -- diagnostika ,opioid analgesics ,0302 clinical medicine ,opioidni analgetiki ,Immunology and Allergy ,opioidi ,Incidence ,Disease Management ,preobčutljivost za zdravila -- diagnostika ,anafilaksija ,Phenotype ,Disease Susceptibility ,medicine.medical_specialty ,udc:616.097:(615.211+615.216.2) ,non-steroidal opioids ,Immunology ,anesthesia ,anti-inflammatory agents ,anestezija ,Diagnosis, Differential ,03 medical and health sciences ,allergy and immunology -- diagnosis ,antibakterijska sredstva ,anti-bacterial agents ,anesthetics ,medicine ,anaphylaxis ,Humans ,anestetiki ,nesteroidna protivnetna sredstva ,Intensive care medicine ,Perioperative Period ,Skin Tests ,drug hypersensitivity -- diagnosis ,Task force ,business.industry ,Diagnostic Tests, Routine ,Perioperative ,Immunoglobulin E ,030104 developmental biology ,030228 respiratory system ,Position paper ,Allergists ,Human medicine ,business ,antibiotiki - Abstract
Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate-type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations.
- Published
- 2020
8. Increasing emergency department visits for anaphylaxis in very early childhood: A canary in the coal mine.
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Rueter K, Moseley N, Ta B, Bear N, Borland ML, and Prescott SL
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- Infant, Child, Child, Preschool, Humans, Retrospective Studies, Epinephrine therapeutic use, Emergency Service, Hospital, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Anaphylaxis etiology, Food Hypersensitivity epidemiology
- Abstract
Aim: The incidence of anaphylaxis is increasing globally in tandem with changing environmental and lifestyle factors. There is very limited data on very early childhood presentations. We aim to assess changes in rates, characteristics and management of infant anaphylaxis in a paediatric ED over a 15-year period., Methods: We conducted a retrospective study of children <2 years of age who presented with verified anaphylaxis comparing cases in years 2003-2007 with those in 2013-2017. Standardised information was collected on demographics, clinical presentation, management and triggers., Results: Manually confirmed anaphylaxis rates in <2 year olds increased from 3.6 to 6.2 per 10
4 population (OR 1.7, 95% CI: 1.3-2.7; p < 0.001) with the greatest increase in <1 year olds. Anaphylaxis severity increased between 2003-2007 and 2013-2017 (OR 2.3, 95% CI: 1.2-4.3; p = 0.018). Failure to administer adrenaline was reduced in 2013-2017 (p = 0.007). Food was the leading anaphylaxis trigger (97.85%)., Conclusion: This is the first study to suggest an increase in the incidence and severity of ED anaphylaxis presentations in children aged <2 years. Increased awareness of specific characteristics in this age group is required to facilitate timely recognition and optimal management. Further large-scale studies are warranted to understand underlying environmental drivers and find prevention strategies to reduce the burden of disease., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)- Published
- 2023
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9. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper
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Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Mäkelä, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, and University of Helsinki
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food allergy ,Respiratory Medicine and Allergy ,PEANUT ALLERGY ,CHILDREN ,COWS MILK ,ORAL IMMUNOTHERAPY ,DIAGNOSIS ,SESAME ,EXERCISE-INDUCED ANAPHYLAXIS ,nutrition ,3121 General medicine, internal medicine and other clinical medicine ,ADOLESCENTS ,TESTS ,anaphylaxis ,CHALLENGE ,Lungmedicin och allergi - Abstract
Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Conclusion Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
- Published
- 2022
10. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food: A first step in an initiative to better inform patients and avoid fatal allergic reactions, A GA²LEN position paper
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Giovanni Battista Pajno, Stefan Wöhrl, Sasho Stoleski, Caroline Nilsson, Mary Jane Marchisotto, Ronald van Ree, Carina Venter, Anna Nowak-Wegrzyn, Montserrat Fernandez-Rivas, Akio Tanaka, Barbara Rogala, Benjamin Kendziora, Michihiro Hide, Stefano Del Giacco, Katarina Stevanovic, Dragan Mijakoski, Enrico Heffler, Nikolaos G. Papadopoulos, Werner Aberer, Antoine Deschildre, Lisa A. Beck, Kate Grimshaw, M. Gotua, Torsten Zuberbier, Hugh A. Sampson, Marek Jutel, Mikela Odemyr, Carlo Lombardi, Erkka Valovirta, Antonella Cianferoni, Nicolette W. de Jong, Jovanka Karadzinska Bislimovska, Michael J. Cork, Christer Janson, Karin Hoffmann-Sommergruber, Gianenrico Senna, Jean Bousquet, Michael Makris, Carsten Bindslev-Jensen, Tamara Dörr, Joan Bartra, Ana Todo-Bom, Mika J. Mäkelä, Ulf Darsow, Margitta Worm, Richard Loh, Rosan Meyer, Giampaolo Ricci, Roy Gerth van Wijk, Audrey Dunn Galvin, Joaquim Mullol, M Alvaro, Alessandro Fiocchi, Zuotao Zhao, Stefania Arasi, Marta Ferrer, Norito Katoh, Philippe Bégin, Brigita Sitkauskiene, Sushil Paudel, Knut Brockow, Johannes Ring, Edward F. Knol, Susanne Lau, Gary W.K. Wong, Jordan Minov, Cristoforo Incorvaia, Marcus Maurer, Hasan Arshad, Fatih A Topal, Bright I Nwaru, Hania Szajewska, Andrew Bush, Tamar Kinaciyan, Adnan Custovic, Elizabeth Angier, O M Kurbacheva, Diana Deleanu, Harald Renz, Peter Smith, Motohiro Ebisawa, J. Grünhagen, Swen Malte John, Carla P. Jones, Barbara Ballmer-Weber, Ear, Nose and Throat, Experimental Immunology, AII - Inflammatory diseases, APH - Global Health, and APH - Personalized Medicine
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Food industry ,Eggs ,Immunology ,Provocation test ,Declaration ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Food allergy ,Food Labeling ,Environmental health ,anaphylaxis ,Immunology and Allergy ,Medicine ,Ingestion ,Animals ,Humans ,SDG 2 - Zero Hunger ,030304 developmental biology ,2. Zero hunger ,0303 health sciences ,Meal ,food allergy ,business.industry ,digestive, oral, and skin physiology ,Allergens ,medicine.disease ,3. Good health ,nutrition ,030228 respiratory system ,Food processing ,business ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit ,Food Hypersensitivity - Abstract
Background\ud \ud Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin.\ud \ud \ud \ud Methods\ud \ud MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results.\ud \ud \ud \ud Results\ud \ud In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds.\ud \ud \ud \ud Conclusion\ud \ud Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement “this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product” for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
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- 2021
11. EAACI/ENDA Position Paper: Diagnosis and management of hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) in children and adolescents
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Ingrid Terreehorst, Jean-Christoph Roger J-P Caubet, Chiang Wen Chin, Eva Rebelo Gomes, Natalia Blanca-López, Claude Ponvert, Luciana Kase Tanno, Marina Atanaskovic-Markovic, Ozge Soyer, Miguel Blanca, Francesca Mori, Mona Kidon, Ear, Nose and Throat, and AII - Inflammatory diseases
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Male ,Allergy ,Anti-Inflammatory Agents ,Desensitization ,0302 clinical medicine ,Risk Factors ,Immunology and Allergy ,030212 general & internal medicine ,Child ,media_common ,ddc:618 ,Anti-Inflammatory Agents, Non-Steroidal ,3. Good health ,Child, Preschool ,Practice Guidelines as Topic ,Female ,Immunologic/methods ,medicine.drug ,Drug ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Immunology ,Drug allergy ,Cross Reactions ,Non-Steroidal/immunology/therapeutic use ,Drug Hypersensitivity ,03 medical and health sciences ,Internal medicine ,medicine ,Animals ,Humans ,Antipyretic ,Anaphylaxis/diagnosis/etiology/therapy ,Preschool ,Allergens/immunology/therapeutic use ,Anaphylaxis ,Expert Testimony ,Skin Tests ,business.industry ,Drug Hypersensitivity/diagnosis/therapy ,Allergens ,medicine.disease ,030228 respiratory system ,Non steroidal anti inflammatory ,Desensitization, Immunologic ,Pediatrics, Perinatology and Child Health ,Interest group ,Position paper ,business ,Pediatric population - Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in the pediatric population as antipyretics/analgesics and anti-inflammatory medications. Hypersensitivity (HS) reactions to NSAID in this age group, while similar to adults, have unique diagnostic and management issues. Although slowly accumulating, published data in this age group are still relatively rare and lacking a unifying consensus. This work is a summary of current knowledge and consensus recommendations utilizing both published data and expert opinion from the European Network of Drug Allergy (ENDA) and the Drug Hypersensitivity interest group in the European Academy of Allergy and Clinical Immunology (EAACI). This position paper summarizes diagnostic and management guidelines for children and adolescents with NSAIDs hypersensitivity.
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- 2018
12. Papers On Anaphylaxis
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Dixon, W. E., Woodhead, G. Sims, Thiele, F. H., Embleton, Dennis, and Goodall, E. W.
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- 1913
13. Food allergy in adolescents: validation of the food allergy independent measure and the EuroPrevall food allergy quality of life questionnaire into Spanish.
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Jang DT, Ibáñez L, Buendía E, Sabido MP, Ester B, María N, Blanca S, Sonia U, Antonio N, and Ángel M
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- Humans, Adolescent, Quality of Life, Surveys and Questionnaires, Immunoglobulin E, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Food Hypersensitivity diagnosis, Food Hypersensitivity epidemiology
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Background: Different questionnaires have been developed globally to assess and compare the impact of food allergy on the quality of life. The aim of this study was to validate a Spanish translation of the Food Allergy Independent Measure (FAIM) and the EuroPrevall Food Allergy-Quality of Life Questionnaire-Teenage Form (FAQLQ-TF) for adolescents aged 13-17 years., Methods: Sixty adolescents diagnosed with immunoglobulin E-mediated allergy to food completed the questionnaires. Cronbach's alpha was used to assess internal consistency; correlation between FAQLQ-TF and FAIM was used to test construct validity. The discriminant validity was evaluated by comparison with the number of offending foods, the perceived impact on social life, the diagnosis of anaphylaxis, and the previous prescription of adrenaline auto--injectors (AAI)., Results: No question fulfilled criteria to be removed from the questionnaire. For FAIM, Cronbach's alpha = 0.763, and for the four domains of FAQLQ-TF, Cronbach's alpha = 0.797-0.847. A significant correlation existed between FAQLQ-TF and FAIM, and of both of them with anaphylaxis and the prescription of AAI (P ˂ 0.05 for all comparisons)., Conclusions: This Spanish translation of FAIM and FAQLQ-TF for adolescents had good internal consistency and construct validity as well as ability to discriminate patients according to the number of foods to avoid, impact on social life, diagnosis of anaphylaxis, and AAI prescription.
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- 2023
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14. Peach extract induces systemic and local immune responses in an experimental food allergy model.
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Steigerwald H, Krause M, Gonzalez-Menendez I, Quintanilla-Martinez L, Vieths S, Scheurer S, Albrecht M, and Blanco-Pérez F
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- Humans, Mice, Animals, Antigens, Plant, Immunoglobulin E, Mice, Inbred CBA, Allergens, Immunoglobulin G, Immunity, Plant Extracts pharmacology, Plant Proteins, Prunus persica adverse effects, Food Hypersensitivity, Anaphylaxis
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Peach allergy is among the most frequent food allergies in the Mediterranean area, often eliciting severe anaphylactic reactions in patients. Due to the risk of severe symptoms, studies in humans are limited, leading to a lack of therapeutic options. This study aimed to develop a peach allergy mouse model as a tool to better understand the pathomechanism and to allow preclinical investigations on the development of optimized strategies for immunotherapy. CBA/J mice were sensitized intraperitoneally with peach extract or PBS, using alum as adjuvant. Afterwards, extract was administered intragastrically to involve the intestinal tract. Allergen provocation was performed via intraperitoneal injection of extract, measuring drop of body temperature as main read out of anaphylaxis. The model induced allergy-related symptoms in mice, including decrease of body temperature. Antibody levels in serum and intestinal homogenates revealed a Th2 response with increased levels of mMCPT-1, peach- and Pru p 3-specific IgE, IgG1 and IgG2a as well as increased levels of IL-4 and IL-13. FACS analysis of small intestine lamina propria revealed increased amounts of T cells, neutrophils and DCs in peach allergic mice. These data suggest the successful establishment of a peach allergy mouse model, inducing systemic as well as local gastrointestinal reactions., (© 2023. The Author(s).)
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- 2023
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15. A new classification option for NSAID hypersensitivity: Kalyoncu classification.
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Özdemir E, Damadoğlu E, Karakaya G, and Kalyoncu AF
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- Humans, Female, Adult, Middle Aged, Male, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Drug Hypersensitivity diagnosis, Anaphylaxis diagnosis, Anaphylaxis chemically induced, Angioedema diagnosis, Rhinitis, Urticaria diagnosis
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Background: The European Network for Drug Allergy (ENDA) proposed a consensus document for hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in 2011. A subgroup of patients with NSAIDs-exacerbated respiratory disease (NERD) develop urticaria/angioedema type reactions in response to NSAIDs. The Kalyoncu classification might be a novel option to classify patients with NSAID hypersensitivity (NH). In this study, we compare the ENDA and the Kalyoncu classifications., Methods: This study enrolled a total of 196 patients. NH reaction types were categorized as asthma, rhinitis, urticaria/angioedema and anaphylaxis. Based on the reaction history and oral provocation test findings, patients were grouped according to ENDA and Kalyoncu classifications., Results: The mean age of the 196 patients was 40.32±13.28 years, and 130 (66.3%) of them were female. Under the ENDA and Kalyoncu classifications, the most common NH subgroups were NERD (32%), and isolated NH (34.2%), the least prevalent NH subgroups were single NSAID-induced delayed reactions (SNIDR) (1.5%), and pseudo Samter's syndrome (11.7%)., Conclusions: Our research revealed that the Kalyoncu classification is more descriptive of patients with NERD exhibiting urticaria/angioedema-type reactions. It also provides future risk assessment for development of NERD. For controversial cases, the Kalyoncu classification can be utilized as a new complimentary option alone or in conjunction with ENDA classification., Competing Interests: The authors declare no potential conflicts of interests with respect to research, authorship and/or publication of this article.
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- 2022
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16. Prostaglandin-generating factor of anaphylaxis. Identification and isolation.
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Steel L and Kaliner M
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- Amino Acids analysis, Animals, Chromatography, Gel, Chromatography, Ion Exchange, Chromatography, Paper, Guinea Pigs, Histamine Release, Humans, Lung immunology, Anaphylaxis physiopathology, Prostaglandins biosynthesis
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Anaphylaxis of human lung in vitro is accompanied by prostaglandin (PG) formation. To search for factors capable of generating PG, supernatants prepared by reversed anaphylaxis of human lung tissue were added to guinea pig lung and PG formation examined. The PG-generating activity fractionated between Mr = 500 and 5000 by ultramembrane filtration and was designated prostaglandin-generating factor of anaphylaxis or PGF-A. Partially purified PGF-A was soluble in 80% ethanol and insoluble in chloroform or ethyl acetate. Paper chromatography of anti-IgE-treated human lung preparations revealed a ninhydrin-positive spot at RF 0.27 to 0.41 with PG-generating activity. When subjected to gel filtration on Sephadex G-50 or G-25, PGF-A demonstrated peak PG-generating capacity at Mr = 1200 to 1800. Peak fractions were pooled and chromatographed on CM52 cellulose with PGF-A activity eluting at 0.16 to 0.3 M NH4COOH. The pooled peak of PGF-A activity from Sephadex G-25 filtration and CM52 chromatography eluted as a single peak at 0.024 M NH4HCO3 on DE52. Application of the peak off DE52 to a paper chromatogram revealed a single ninhydrin-positive spot with an RF 0.27 to 0.41 with the capacity to generate PGs. Amino acid analysis of three purifications revealed the following: Glu/Asp/Gly/Ser/Thr (6:3:2:1:1). Based on these analyses, a Mr = 1450 was calculated for the PGF-A. Therefore, PGF-A represents a novel mediator of lung anaphylaxis which may be partly responsible for PG generation accompanying allergic reactions.
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- 1981
17. Safety of an inactivated COVID-19 vaccine in patients with - wheat-dependent exercise-induced anaphylaxis.
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Du Z and Yin J
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- Gliadin, Humans, Retrospective Studies, Anaphylaxis epidemiology, Anaphylaxis etiology, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Exercise adverse effects, Wheat Hypersensitivity
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Background: Inactivated vaccines against coronavirus disease-2019 (COVID-19) offer an effective public health intervention to mitigate this devastating pandemic. However, little is known about their safety in patients with wheat-dependent exercise-induced anaphylaxis (WDEIA)., Methods: We recruited 72 WDEIA patients and 730 healthy matched controls who received an inactivated COVID-19 vaccine. Participants were monitored for 4 weeks after each immunization for adverse reactions and completed questionnaires regarding local and systemic reactions at 7 and 28 days after each vaccination. For those who had received the COVID-19 vaccine prior to enrollment, adverse event data were obtained retrospectively., Results: Local and systemic adverse events occurred at similar rates in the WDEIA group and the control group. In both groups, injection-site pain and fatigue were the most common local and systemic reactions, respectively. Compared with healthy controls, more allergic events were reported in the WDEIA group (after dose 1, 0.5% vs. 4.2%, p=0.019; after dose 2, 0% vs. 1.4%, p=0.089). Allergic reactions mainly manifested as rash, urticaria, and edema, which were mild and controllable. No serious allergic events were reported., Conclusions: The adverse event profile of inactivated COVID-19 vaccine did not differ between WDEIA patients and healthy controls. The risk of allergic reactions in patients with WDEIA seems higher, but no anaphylaxis was reported, and the allergic reactions were controllable. Inactivated COVID-19 vaccines appear to be well-tolerated in WDEIA patients, but patients with potential allergy risks should be cautious.
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- 2022
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18. Sublingual immunotherapy (SLIT) - indications, mechanism, and efficacy Position paper prepared by the Section of Immunotherapy, Polish Society of Allergy
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Marek Jutel, Małgorzata Bartkowiak-Emeryk, Anna Bręborowicz, Ewa Cichocka-Jarosz, Andrzej Emeryk, Radosław Gawlik, Paweł Gonerko, Barbara Rogala, Anna Nowak-Węgrzyn, Bolesław Samoliński, and and other members of IT Section PTA
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Allergy ,Parietaria ,desensitization ,medicine.disease_cause ,Sublingual administration ,lcsh:Agriculture ,Allergen ,Humans ,Medicine ,Adverse effect ,Waste Management and Disposal ,Ecology, Evolution, Behavior and Systematics ,lcsh:Environmental sciences ,Asthma ,lcsh:GE1-350 ,Sublingual Immunotherapy ,child ,biology ,business.industry ,adult ,Public Health, Environmental and Occupational Health ,lcsh:S ,immunologic/methods ,medicine.disease ,biology.organism_classification ,Slit ,Immunology ,allergen/therapeutic use ,Poland ,business ,Anaphylaxis - Abstract
SLIT ( sublingual immunotherapy ) induces allergen-specific immune tolerance by sublingual administration of a gradually increasing dose of an allergen. The mechanism of SLIT is comparable to those during SCIT (subcutaneous immunotherapy), with the exception of local oral dendritic cells, pre-programmed to elicit tolerance. In the SLIT dose, to achieve the same efficacy as in SCIT, it should be 50–100 times higher with better safety profile. The highest quality evidence supporting the efficacy of SLIT lasting 1 – 3 years has been provided by the large scale double-blind, placebo-controlled (DBPC) trials for grass pollen extracts, both in children and adults with allergic rhinitis. Current indications for SLIT are allergic rhinitis (and conjunctivitis) in both children and adults sensitized to pollen allergens (trees, grass, Parietaria ), house dust mites ( Dermatophagoides pteronyssinus, Dermatophagoides farinae ), cat fur, as well as mild to moderate controlled atopic asthma in children sensitized to house dust mites. There are positive findings for both asthma and new sensitization prevention. Severe adverse events, including anaphylaxis, are very rare, and no fatalities have been reported. Local adverse reactions develop in up to 70 – 80% of patients. Risk factors for SLIT adverse events have not been clearly identified. Risk factors of non-adherence to treatment might be dependent on the patient, disease treatment, physician-patient relationship, and variables in the health care system organization.
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- 2016
19. Allergic reactions to midazolam: A case series from an Italian allergy unit.
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Nucera E, Parrinello G, Buonomo A, Aruanno A, and Rizzi A
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- Humans, Anaphylaxis, Drug Hypersensitivity diagnosis, Midazolam adverse effects
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Midazolam is a short-acting benzodiazepine with central nervous system depressing action, commonly used for conscious sedation for various procedures and for its pharmacologic properties.In literature, severe adverse reactions to this drug are described, but only in few cases positive allergological tests were demonstrated.The authors collected herein five clinical cases of different allergic reactions to midazolam demonstrated by positive skin tests., Competing Interests: The authors declare that they have no conflicts of interest.
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- 2021
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20. Food-induced anaphylaxis in children up to 3-years-old preliminary study.
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Gawryjołek J and Krogulska A
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- Age Factors, Anaphylaxis diagnosis, Anaphylaxis epidemiology, Child, Preschool, Female, Heart Diseases etiology, Hospitalization statistics & numerical data, Humans, Immunoglobulin E blood, Incidence, Infant, Male, Milk Hypersensitivity complications, Preliminary Data, Respiration Disorders diagnosis, Respiration Disorders etiology, Retrospective Studies, Symptom Assessment, Urticaria etiology, Anaphylaxis etiology, Food adverse effects, Food Hypersensitivity complications
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Introduction and Objectives: The aim of this study was to determine the frequency of food-induced anaphylaxis, analyze the symptoms, and triggering factors in a group of youngest children. Also, the study aims to estimate the frequency of anaphylaxis episodes in children in the Kuyavian-Pomeranian Voivodeship region., Methods: Retrospective analysis of medical records of 29 children aged 0-3 years that presented symptoms of food-induced anaphylaxis. Medical charts were reviewed using a collection of documents with the clinical data., Results: The frequency of anaphylaxis was determined to be 0.3% of all hospitalized children aged 0-3 years and 1.9% of children suspected of food allergy. The mean age of an anaphylactic reaction was 12±9 months. The most common symptom was mild-moderate urticaria. The respiratory symptoms were significantly more prevalent in toddlers than in infants (p = 0.148). Cardiac symptoms occurred only in the infant group, i.e., in two (11%) infants. As a possible cause of the symptoms, in 18 (62%) cases, parents most often indicated the consumption of milk or milk-rice porridge. Anaphylaxis as the first manifestation of food-allergy was significantly more prevalent in infants than in older children (p = 0.0002)., Conclusions: The incidence of anaphylactic reactions rated at 0.3% of all children hospitalized at this age. The most common symptoms of anaphylactic reaction were skin lesions. The primary cause of allergic reactions was cow's milk after the first exposure at home. Anaphylaxis has different patterns of symptoms depending on the age of the child.
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- 2021
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21. COVID-19 pandemic
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W. J. Fokkens, Jürgen Schwarze, Cezmi A. Akdis, J Mullol, W. Czarlewski, Claudia Traidl-Hoffmann, Claus Bachert, D. Larenas-Linnemann, Tomas Chivato, M. Gotua, Mateo Bonini, Ludger Klimek, Vincenzo Patella, A. A. Cruz, Stephanie Dramburg, Kari C. Nadeau, H W Fritsch, K. Ohta, Thomas Eiwegger, Robert M. Naclerio, Antti Lauerma, A. Yorgancioglu, Aslı Gelincik, Piotr Kuna, Oliver Pfaar, Carmen Riggioni, Violeta Kvedariene, Markus Ollert, Sinthia Bosnic-Anticevich, V. Cardona, S. Del Giacco, Sanna Toppila-Salmi, Helen A. Brough, Heimo Breiteneder, Valérie Hox, B. Samolinski, Zuzana Diamant, G.W. Canonica, Lihong Zhang, María José Torres, Y. Okamoto, Liam O'Mahony, Radosław Gawlik, Jolanta Walusiak-Skorupa, Sharon Chinthrajah, Winfried Rief, T. Haatela, M. Morais-Almeida, Ioana Agache, Manfred Schedlowski, I Skypala, R. Brehler, D. Y. Wang, João Fonseca, I. J. Ansotegui, Robyn E O'Hehir, Oscar Palomares, Charlotte G. Mortz, J. C. Ivancevich, C. Suppli Ulrik, M. T. Ventura, P M Matricardi, S Untersmayr, Gabrielle L. Onorato, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Vanitha Sampath, Arũnas Valiulis, Marek Jutel, Luisa Brussino, Pedro Carreiro-Martins, Jean Bousquet, Nikolaos G. Papadopoulos, A. Bedbrook, Torsten Zuberbier, Karin Hoffmann-Sommergruber, Edward F. Knol, Ear, Nose and Throat, AII - Inflammatory diseases, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Philipps Universität Marburg = Philipps University of Marburg, Allergologie, Stimm und Sprachstörungen [Wiesbaden, Germany], Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], University of Wrocław [Poland] (UWr), ALL-MED, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Medizinische Universität Wien = Medical University of Vienna, Stanford University, Skane University Hospital [Malmo], Lund University [Lund], Charles University [Prague] (CU), University Medical Center Groningen [Groningen] (UMCG), Univ Toronto, Hosp Sick Children, Peter Gilgan Ctr Res & Learning, Mol Med, Toronto, ON M5G 0A4, Canada, The Hospital for sick children [Toronto] (SickKids), University of Toronto, Amsterdam UMC - Amsterdam University Medical Center, Alfred Health, Victoria University [Melbourne], University College Cork (UCC), Sean N. Parker Center for Allergy and Asthma Research [Stanford], Stanford Medicine, Stanford University-Stanford University, University Clinics of Essen, University of Essen, Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Helmholtz Zentrum München = German Research Center for Environmental Health, University Hospital Augsburg, National University of Singapore (NUS), Beijing Tongren Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Evelina London Children's Hospital, King‘s College London, CEU-San Pablo University and HM-Hospitals School of Medicine, University of Cagliari, Medical University of Silesia (SUM), Istanbul University, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Helsinki University Central Hospital, University of Helsinki, Odense University Hospital (OUH), Luxembourg Institute of Health (LIH), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Hospital Sant Joan de Déu [Barcelona], Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], University of Edinburgh, NHS Foundation Trust [London], The Royal Marsden, Nofer Institute of Occupational Medicine (NIOM), Hospital Quirónsalud Bizkaia [Bilbao], Ghent University Hospital, Sun Yat-Sen University [Guangzhou] (SYSU), Karolinska Institutet [Stockholm], Woolcock Institute of Medical Research [Sydney], The University of Sydney, University of Turin, Mauriziano Umberto I Hospital, Humanitas University [Milan] (Hunimed), Vall d'Hebron University Hospital [Barcelona], Hospital de Dona Estefania, NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Federal University of Bahia School of Medicine, Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Medical Consulting Czarlewski, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, MEDIDA, Lda, David Tvildiani Medical University (DTMU), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Barlicki University Hospital, Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], Pantai Hospital [Kuala Lumpur], Hospital CUF Descobertas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), CIBER de Epidemiología y Salud Pública (CIBERESP), Johns Hopkins University School of Medicine [Baltimore], Fukujuji Hospital, Tokyo National Hospital, Chiba Rosai Hospital, Chiba University Hospital, Royal Manchester Children's Hospital, University of Manchester [Manchester], General Children's Hospital of Athens P & A Kyriakou, 'Santa Maria della Speranza' Hospital, Centro Hospitalar e Universitário [Coimbra], Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), University of Coimbra [Portugal] (UC), Medical University of Warsaw - Poland, Hvidovre Hospital, University of Copenhagen = Københavns Universitet (UCPH), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Transilvania University of Brasov, Salvy-Córdoba, Nathalie, Department of Dermatology, Allergology and Venereology, and HUS Inflammation Center
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0301 basic medicine ,viruses ,Eaaci Position Paper ,Medizin ,Cochrane Library ,GUIDELINES ,FOOD ALLERGY ,allergen immunotherapy ,allergy clinic ,anaphylaxis ,asthma ,clinical trials ,COVID-19 ,Position Paper ,psychological impact ,SARS-CoV-2 ,Allergists ,Health Personnel ,Humans ,Hypersensitivity ,Information Technology ,Patient Care Team ,Triage ,SARS‐CoV‐2 ,DESENSITIZATION ,0302 clinical medicine ,MESH: Patient Care Team ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,HDE ALER ,Pandemic ,Health care ,Immunology and Allergy ,ATOPIC-DERMATITIS ,MESH: COVID-19 ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,allergen immunotherapy (AIT) ,virus diseases ,DRUG HYPERSENSITIVITY REACTIONS ,3. Good health ,INFECTIONS ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,MESH: Triage ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,Allergen immunotherapy ,medicine.medical_specialty ,MESH: Information Technology ,MESH: Hypersensitivity ,Immunology ,education ,MEDLINE ,DIAGNOSIS ,psychological COVID ,03 medical and health sciences ,MESH: Allergists ,COVID‐19 ,medicine ,MESH: SARS-CoV-2 ,ddc:610 ,RHINOSINUSITIS ,MESH: Humans ,business.industry ,Clinical trial ,Coronavirus ,EXACERBATIONS ,030104 developmental biology ,030228 respiratory system ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Family medicine ,3121 General medicine, internal medicine and other clinical medicine ,Position paper ,MESH: Health Personnel ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
BackgroundThe Coronavirus disease 2019 (COVID‐19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.MethodThe scientific information on COVID‐19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet.ResultsBased on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic.
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- 2021
22. Pediatric idiopathic anaphylaxis: practical management from infants to adolescents.
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Mori F, Saretta F, Giovannini M, Gelsomino M, Liotti L, Barni S, Mastrorilli C, Pecoraro L, Castagnoli R, Arasi S, Caminiti L, Klain A, Miraglia Del Giudice M, and Novembre E
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- Humans, Child, Adolescent, Infant, Diagnosis, Differential, Child, Preschool, Algorithms, Anaphylaxis diagnosis, Anaphylaxis therapy, Anaphylaxis etiology, Anaphylaxis drug therapy
- Abstract
Idiopathic anaphylaxis (IA) remains a frustrating challenge for both patients and physicians. The aim of this paper is to focus on IA in pediatric ages and suggest possible diagnostic algorithms according to specific age ranges (infants, children, and adolescents). In fact, in a variable percentage of patients, despite extensive diagnostic tests, the cause of anaphylactic episodes cannot be identified. Moreover, the lack of a unanimous IA definition requires a careful and detailed diagnostic workup. Prompt recognition of signs and symptoms, especially in younger children, and an accurate clinical history often allow a choice of the most appropriate diagnostic tests and a correct differential diagnosis., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
23. Management of anaphylaxis due to COVID-19 vaccines in the elderly
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Paulo Augusto Moreira Camargos, Radolslaw Gawlik, Mirko Petrovic, Gunter J. Sturm, Kristof Nekam, Sergio Bonini, Zhanat Ispayeva, Marilyn Urrutia Pereira, Jean Bousquet, Antti Lauerma, Menachem Rottem, Arzu Yorgancioglu, Hubert Blain, Antonio Cherubini, Mário Morais-Almeida, Nathalie Salles, Charlotte G. Mortz, Sylwia Smolinska, Davor Plavec, A. Bedbrook, Torsten Zuberbier, Helga Kraxner, M. Beatrice Bilò, Sinthia Bosnic-Anticevich, Gaëtan Gavazzi, Finbarr C. Martin, Alvaro A. Cruz, K. S. Bennoor, Isabella Annesi-Maesano, Mohamed H. Shamji, Karin Hoffmann-Sommergruber, Marina Atanaskovic-Markovic, Carsten Bindslev-Jensen, Lan Tt Le, Isabel Skypala, Ana Todo-Bom, Vincenzo Patella, Lorenzo Cecchi, Charlotte Suppli Ulrik, Oscar Palomares, Joaquin Sastre, Hans Jürgen Hoffmann, Knut Brockow, Eva Untersmayr, Martin Hrubisko, Bernadette Eberlein, Aziz Sheikh, Milan Sova, Osman M. Yusuf, Violeta Kvedariene, G. Walter Canonica, Dana Wallace, Ioana Agache, Milena Sokolowska, Jos M. G. A. Schols, Susan Waserman, Stéphanie Miot, Carla Irani, Regina E Roller-Winsberger, Michael Levin, Yves Rolland, Emma Montella, Bilun Gemicioglu, Bolesław Samoliński, Stefano Del Giacco, Madda lenaIllario, Yehia El-Gamal, Olga Lourenço, Jean-Christoph Roger J-P Caubet, Luisa Brussino, Marysia Recto, De Yun Wang, Igor Kaidashev, Renaud Louis, Antonino Romano, Mario E. Zernotti, Jacques Reynes, Pedro Carreiro-Martins, Alexandra F. Santos, Marek Niedoszytko, M. Gotua, Musa Khaitov, Thomas B. Casale, Andrea Matucci, Bernardo Sousa-Pinto, Rafael Stelmach, Dejan Dokic, Joana Vitte, Motohiro Ebisawa, Maria Teresa Ventura, Joaquim Mullol, Tomas Chivato, Petr Panzner, Oliver Pfaar, Sanna Toppila-Salmi, Ioanna Tsiligianni, Wytske Fokkens, Alessandra Vultaggio, H. Neffen, Juan Carlos Ivancevich, Ya-dong Gao, Anna Sediva, Maja Hofmann, Ana Maria Carriazo, João Fonseca, Marek Jutel, A. Benetos, Nhân Pham-Thi, Mona Al-Ahmad, Arunas Valiulis, Mihaela Zidarn, Elizabeth Angier, Yoshitaka Okamoto, Montserrat Fernandez-Rivas, Cezmi A. Akdis, Philip W. Rouadi, Olivier Guérin, John Farrell, Mikaela Odemyr, George Christoff, Vera Mahler, Claus Bachert, Edward F. Knol, Wienczyslawa Czarlewski, Robyn E O'Hehir, Victoria Cardona, Ludger Klimek, Tari Haahtela, Vincent Le Moing, Branislava Milenkovic, Carmen Rondon, Kaja Julge, Jolanta Walusiak-Skorupa, Nikolaos G. Papadopoulos, Aslı Gelincik, Markus Ollert, Piotr Kuna, Leyla Namazova-Baranova, Margitta Worm, Annick Barbaud, Elena Camelia Berghea, Todor A. Popov, Derek K. Chu, María José Torres, Faradiba Sarquis Serpa, Nicola Scichilone, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Gianni Passalacqua, Humboldt-Universität zu Berlin, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Humboldt University Of Berlin, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Transylvania University, Wrocław Medical University, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Cagliari, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Università Politecnica delle Marche [Ancona] (UNIVPM), Medical Consulting Czarlewski, Universiti Putra Malaysia, University of Southampton, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Belgrade [Belgrade], Ghent University Hospital, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Dhaka Shishu Hospital [Bangladesh], University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Odense University Hospital (OUH), Italian National Research Council, National Research Council [Italy] (CNR), The University of Sydney, Technische Universität München = Technical University of Munich (TUM), Università degli studi di Torino = University of Turin (UNITO), Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil] (UFMG), IRCCS Research Hospital, Milan, Vall d'Hebron University Hospital [Barcelona], Centro Hospitalar de Lisboa Central E.P.E, University of South Florida [Tampa] (USF), Geneva University Hospital (HUG), Azienda Usl Toscana centro [Firenze], Софийски университет = Sofia University, McMaster University [Hamilton, Ontario], State University of Bahia, Institute of Public Health of Republic of North Macedonia [Skopje], Ain Shams University (ASU), Sagamihara National Hospital [Kanagawa, Japan], Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Amsterdam UMC - Amsterdam University Medical Center, Universidade do Porto = University of Porto, Wuhan University [China], CHU Grenoble, Silesian University of Medicine, Istanbul Faculty of Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Centre Hospitalier Universitaire de Nice (CHU Nice), Helsinki University Hospital [Helsinki, Finlande], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Medizinische Universität Wien = Medical University of Vienna, Aarhus University [Aarhus], Oncology Institute of St Elisabeth, University of Naples Federico II = Università degli studi di Napoli Federico II, St Joseph University, Hôtel-Dieu de France (HDF), Université Saint-Joseph de Beyrouth (USJ), Kazakh National Medical University, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Tartu University Institute of Clinical Medicine, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Federal Medicobiological Agency [Moscow, Russian Federation], University Medical Center [Utrecht], Semmelweis University [Budapest], Medical University of Łódź (MUL), Vilnius University [Vilnius], University of Medicine and Pharmacy (VIETNAM), University of Cape Town, CHU Sart Tilman, Université de Liège, University of Beira Interior [Portugal] (UBI), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), uBibliorum, Ear, Nose and Throat, AII - Inflammatory diseases, CHU Montpellier, Wroclaw Medical University [Wrocław, Pologne], University of Bari Aldo Moro (UNIBA), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sagamihara National Hospital, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Toulouse [Toulouse], RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Bousquet J., Agache I., Blain H., Jutel M., Ventura M.T., Worm M., Del Giacco S., Benetos A., Bilo B.M., Czarlewski W., Abdul Latiff A.H., Al-Ahmad M., Angier E., Annesi-Maesano I., Atanaskovic-Markovic M., Bachert C., Barbaud A., Bedbrook A., Bennoor K.S., Berghea E.C., Bindslev-Jensen C., Bonini S., Bosnic-Anticevich S., Brockow K., Brussino L., Camargos P., Canonica G.W., Cardona V., Carreiro-Martins P., Carriazo A., Casale T., Caubet J.-C., Cecchi L., Cherubini A., Christoff G., Chu D.K., Cruz A.A., Dokic D., El-Gamal Y., Ebisawa M., Eberlein B., Farrell J., Fernandez-Rivas M., Fokkens W.J., Fonseca J.A., Gao Y., Gavazzi G., Gawlik R., Gelincik A., Gemicioglu B., Gotua M., Guerin O., Haahtela T., Hoffmann-Sommergruber K., Hoffmann H.J., Hofmann M., Hrubisko M., Illario M., Irani C., Ispayeva Z., Ivancevich J.C., Julge K., Kaidashev I., Khaitov M., Knol E., Kraxner H., Kuna P., Kvedariene V., Lauerma A., Le L.T.T., Le Moing V., Levin M., Louis R., Lourenco O., Mahler V., Martin F.C., Matucci A., Milenkovic B., Miot S., Montella E., Morais-Almeida M., Mortz C.G., Mullol J., Namazova-Baranova L., Neffen H., Nekam K., Niedoszytko M., Odemyr M., O'Hehir R.E., Okamoto Y., Ollert M., Palomares O., Papadopoulos N.G., Panzner P., Passalacqua G., Patella V., Petrovic M., Pfaar O., Pham-Thi N., Plavec D., Popov T.A., Recto M.T., Regateiro F.S., Reynes J., Roller-Winsberger R.E., Rolland Y., Romano A., Rondon C., Rottem M., Rouadi P.W., Salles N., Samolinski B., Santos A.F., S Sarquis F., Sastre J., M. G. A. Schols J., Scichilone N., Sediva A., Shamji M.H., Sheikh A., Skypala I., Smolinska S., Sokolowska M., Sousa-Pinto B., Sova M., Stelmach R., Sturm G., Suppli Ulrik C., Todo-Bom A.M., Toppila-Salmi S., Tsiligianni I., Torres M., Untersmayr E., Urrutia Pereira M., Valiulis A., Vitte J., Vultaggio A., Wallace D., Walusiak-Skorupa J., Wang D.-Y., Waserman S., Yorgancioglu A., Yusuf O.M., Zernotti M., Zidarn M., Chivato T., Akdis C.A., Zuberbier T., Klimek L., HUS Inflammation Center, University of Helsinki, and Department of Dermatology, Allergology and Venereology
- Subjects
Male ,Allergy ,Pediatrics ,Eaaci Position Paper ,COVID-19 vaccines ,older (adults ,GUIDELINES ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Medicine and Health Sciences ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Geriatrics ,MESH: Aged ,RISK ,Vaccines ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,people) ,EPINEPHRINE ,Epinephrine ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,COVID -19 vaccines ,Anaphylaxis ,medicine.drug ,older (adults/people) ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,MESH: Covid-19 ,MESH: Epinephrine ,Immunology ,adrenaline ,anaphylaxis ,Aged ,COVID-19 Vaccines ,Humans ,SARS-CoV-2 ,COVID-19 ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Diabetes mellitus ,Anaphylaxis/etiology ,MESH: SARS-CoV-2 ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,COVID‐19 vaccines ,Older - Adults/people ,Asthma ,MESH: Humans ,business.industry ,adrenaline, anaphylaxis, COVID-19 vaccines, older (adults/people) ,medicine.disease ,Obesity ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,MESH: Male ,MESH: Anaphylaxis ,Older ,3121 General medicine, internal medicine and other clinical medicine ,business ,MESH: Covid-19 vaccines ,030215 immunology - Abstract
Submitted by (omml@ubi.pt) on 2021-07-05T10:47:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T10:49:11Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Rejected by Pessoa (pfep@ubi.pt), reason: Rever os nomes dos autores. Depois da correção é só voltar a submeter. on 2021-07-05T10:54:19Z (GMT) Submitted by (omml@ubi.pt) on 2021-07-05T11:52:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:34:51Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:35:49Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Made available in DSpace on 2021-07-05T13:35:49Z (GMT). No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Previous issue date: 2021-04-02 info:eu-repo/semantics/publishedVersion
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- 2021
24. EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID‐19 vaccines
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Thomas Eiwegger, Stefan Vieths, Kari C. Nadeau, Carmen Riggioni, Stefano Del Giacco, Mohamed H. Shamji, Milena Sokolowska, Marek Jutel, Oscar Palomares, Ioana Agache, María José Torres, Domingo Barber, Markus Ollert, Ronald L. Rabin, University of Zurich, Agache, Ioana, and Shamji, Mohamed H
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0301 basic medicine ,medicine.medical_specialty ,Allergy ,COVID-19 Vaccines ,Immunology ,Eaaci Position Paper ,610 Medicine & health ,Disease ,virus ,03 medical and health sciences ,0302 clinical medicine ,10183 Swiss Institute of Allergy and Asthma Research ,medicine ,media_common.cataloged_instance ,Immunology and Allergy ,Humans ,Dosing ,European union ,Intensive care medicine ,Contraindication ,BNT162 Vaccine ,media_common ,COVID ,2403 Immunology ,business.industry ,SARS-CoV-2 ,COVID-19 ,SARS-CoV ,medicine.disease ,United Kingdom ,Vaccination ,030104 developmental biology ,030228 respiratory system ,2723 Immunology and Allergy ,Position paper ,business ,Anaphylaxis - Abstract
The first approved COVID‐19 vaccines include Pfizer/BioNTech BNT162B2, Moderna mRNA‐1273 and AstraZeneca recombinant adenoviral ChAdOx1‐S. Soon after approval, severe allergic reactions to the mRNA‐based vaccines that resolved after treatment were reported. Regulatory agencies from the European Union, Unites States and the United Kingdom agree that vaccinations are contraindicated only when there is an allergy to one of the vaccine components or if there was a severe allergic reaction to the first dose. This position paper of the European Academy of Allergy and Clinical Immunology (EAACI) agrees with these recommendations and clarifies that there is no contraindication to administer these vaccines to allergic patients who do not have a history of an allergic reaction to any of the vaccine components. Importantly, as is the case for any medication, anaphylaxis may occur after vaccination in the absence of a history of allergic disease. Therefore, we provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres. We also describe potentially allergenic/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Close collaboration between academia, regulatory agencies and vaccine producers will facilitate approaches for patients at risks, such as incremental dosing of the second injection or desensitisation. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimise the risk of allergic reactions to COVID‐19 vaccines and to facilitate their broader and safer use.
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- 2021
25. COVID-19 vaccine-associated anaphylaxis: A statement of the World Allergy Organization Anaphylaxis Committee
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TURNER, Paul J., ANSOTEGUI, Ignacio J., CAMPBELL, Dianne E., CARDONA, Victoria, EBISAWA, Motohiro, EL-GAMAL, Yehia, FINEMAN, Stanley, GELLER, Mario, GONZALEZ-ESTRADA, Alexei, GREENBERGER, Paul A., LEUNG, Agnes S.Y., LEVIN, Michael E., MURARO, Antonella, BORGES, Mario SÁNCHEZ, SENNA, Gianenrico, TANNO, Luciana K., THONG, Bernard Yu-Hor, Margitta, WORM, Committee, WAO Anaphylaxis, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, The University of Sydney, Hospital Quirónsalud Bizkaia [Bilbao], DataLab Group [Montrouge], Vall d'Hebron University Hospital [Barcelona], Sagamihara National Hospital [Kanagawa, Japan], Ain Shams University (ASU), Emory University School of Medicine, Emory University [Atlanta, GA], Academia Nacional de Medicina, Mayo Clinic [Jacksonville], Northwestern University Feinberg School of Medicine, Prince of Wales Hospital, University of Cape Town, Food Allergy Referral Centre Veneto Region [Padua, Italy], Università degli Studi di Padova = University of Padua (Unipd), Centro Médico Docente La Trinidad, Università degli studi di Verona = University of Verona (UNIVR), Hospital Sírio-Libanês [São Paulo, Brazil], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Tan Tock Seng Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Salvy-Córdoba, Nathalie, Institut Català de la Salut, [Turner PJ] National Heart Lung Institute, Imperial College London, London, UK. Discipline of Paediatrics and Child Health, School of Medicine, University of Sydney, Sydney, Australia. [Ansotegui IJ] Dept. Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain. [Campbell DE] Discipline of Paediatrics and Child Health, School of Medicine, University of Sydney, Sydney, Australia. DBV Technologies, Montrouge, France. [Cardona V] Secció d’Al·lèrgia, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Ebisawa M] Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan. [El-Gamal Y] Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt, and Vall d'Hebron Barcelona Hospital Campus
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Allergy ,Immune System Diseases::Hypersensitivity::Hypersensitivity, Immediate::Anaphylaxis [DISEASES] ,Complex Mixtures::Biological Products::Vaccines::Viral Vaccines [CHEMICALS AND DRUGS] ,Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] ,0302 clinical medicine ,Pandemic ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Immunology and Allergy ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,030223 otorhinolaryngology ,Adverse event following immunization ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Anaphylaxis ,COVID-19 (Malaltia) - Vacunació ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,Pulmonary and Respiratory Medicine ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Polyethylene glycol ,Immunology ,Article ,03 medical and health sciences ,enfermedades del sistema inmune::hipersensibilidad::hipersensibilidad inmediata::anafilaxia [ENFERMEDADES] ,medicine ,Other subheadings::Other subheadings::/adverse effects [Other subheadings] ,Intensive care medicine ,Adverse effect ,business.industry ,Public health ,Medicaments - Efectes secundaris ,COVID-19 ,1103 Clinical Sciences ,medicine.disease ,Anafilaxi ,Coronavirus ,mezclas complejas::productos biológicos::vacunas::vacunas víricas [COMPUESTOS QUÍMICOS Y DROGAS] ,WAO Anaphylaxis Committee ,030228 respiratory system ,Immunization ,Vaccine ,Position paper ,Allergists ,business ,lcsh:RC581-607 - Abstract
Anafilaxi; COVID-19; Polietilenglicol Anafilaxia; COVID-19; Polietilenglicol Anaphylaxis; COVID-19; Polyethylene glycol Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Vaccines often cause adverse events; however, the vast majority of adverse events following immunization (AEFI) are a consequence of the vaccine stimulating a protective immune response, and not allergic in etiology. Anaphylaxis as an AEFI is uncommon, occurring at a rate of less than 1 per million doses for most vaccines. However, within the first days of initiating mass vaccination with the Pfizer-BioNTech COVID-19 vaccine BNT162b2, there were reports of anaphylaxis from the United Kingdom and United States. More recent data imply an incidence of anaphylaxis closer to 1:200,000 doses with respect to the Pfizer-BioNTech vaccine. In this position paper, we discuss the background to reactions to the current COVID-19 vaccines and relevant steps to mitigate against the risk of anaphylaxis as an AEFI. We propose a global surveillance strategy led by allergists in order to understand the potential risk and generate data to inform evidence-based guidance, and thus provide reassurance to public health bodies and members of the public.
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- 2021
26. First pediatric electronic algorithm to stratify risk of penicillin allergy.
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Roberts, Hannah, Soller, Lianne, Ng, Karen, Chan, Edmond S., Roberts, Ashley, Kang, Kristopher, Hildebrand, Kyla J., and Wong, Tiffany
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MEDICAL personnel ,CHILD patients ,ALGORITHMS ,PENICILLIN ,ALLERGIES - Abstract
Beta-lactam allergy is reported in 5–10% of children in North America, but up to 94–97% of patients are deemed not allergic after allergist assessment. The utility of standardized skin testing for penicillin allergy in the pediatric population has been recently questioned. Oral drug challenges when appropriate, are preferred over skin testing, and can definitively rule out immediate, IgE-mediated drug allergy. To our knowledge, this is the only pediatric study to assess the reliability of a penicillin allergy stratification tool using a paper and electronic clinical algorithm. By using an electronic algorithm, we identified 61 patients (of 95 deemed not allergic by gold standard allergist decision) as low risk for penicillin allergy, with no false negatives and without the need for allergist assessment or skin testing. In this study, we demonstrate that an electronic algorithm can be used by various pediatric clinicians when evaluating possible penicillin allergy to reliably identify low risk patients. We identified the electronic algorithm was superior to the paper version, capturing an even higher percentage of low risk patients than the paper version. By developing an electronic algorithm to accurately assess penicillin allergy risk based on appropriate history, without the need for diagnostic testing or allergist assessment, we can empower non-allergist health care professionals to safely de-label low risk pediatric patients and assist in alleviating subspecialty wait times for penicillin allergy assessment. [ABSTRACT FROM AUTHOR]
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- 2020
- Full Text
- View/download PDF
27. Selected allergic diseases of the gastrointestinal tract
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Zbigniew Bartuzi, Michał Przybyszewski, Andrzej Kuźmiński, Natalia Sokołowska-Ukleja, Alina Tomaszewska, Małgorzata Graczyk, and Magdalena Żbikowska-Gotz
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medicine.medical_specialty ,Gastroenterology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Internal medicine ,Eosinophilic ,Medicine ,Enteropathy ,Stomatitis ,Irritable bowel syndrome ,Enterocolitis ,Gastrointestinal tract ,Review Paper ,food allergy ,business.industry ,medicine.disease ,030211 gastroenterology & hepatology ,gastrointestinal tract ,medicine.symptom ,business ,Anaphylaxis - Abstract
Clinical symptoms of food allergy may affect not only the digestive tract, but also the respiratory system, skin, or cardiovascular system. They may manifest themselves as gastrointestinal problems, asthma attacks, hives, or anaphylactic shock. Allergic reactions of the gastrointestinal tract may be IgE-independent (oral anaphylaxis syndrome, acute gastrointestinal reactions), mixed (eosinophilic gastrointestinal disorders), or IgE-independent (food-induced enterocolitis, proctitis, or enteropathy). The most serious conditions in which allergic background plays or can play an important role are: oral anaphylaxis syndrome, aphthous stomatitis, reflux disease, acute and chronic allergic reactions of gastric mucosa, irritable bowel syndrome, and eosinophilic gastrointestinal disorders.
- Published
- 2019
28. Immunological characterization of onion (Allium cepa) allergy
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Marcello Albanesi, Danilo Di Bona, Luigi Macchia, Lucia Anna Giliberti, Maria Filomena Caiaffa, Carlo Pasculli, and Maria Pia Rossi
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Allergy ,lcsh:Internal medicine ,Dermatology ,Lymphocyte proliferation ,lymphocyte proliferation ,Immunoglobulin E ,lipid transfer proteins ,Peripheral blood mononuclear cell ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,medicine ,lcsh:Dermatology ,Immunology and Allergy ,lcsh:RC31-1245 ,Original Paper ,food allergy ,biology ,business.industry ,IgE-ELISA inhibition ,fungi ,food and beverages ,lcsh:RL1-803 ,medicine.disease ,biology.organism_classification ,Immunology ,biology.protein ,Allium ,business ,Contact dermatitis ,Anaphylaxis ,onion allergy - Abstract
Introduction Onion (Allium cepa) handling can induce contact dermatitis, rhinoconjunctivitis and asthma. However, only sporadic reports exist on allergic reactions to onion consumption. Aim We describe herein a case of a 35-year-old man who had an episode of anaphylaxis following cooked onion ingestion. We evaluated onion-specific IgE, the possible cross-reactivity between onion and peach and lymphocyte proliferation in response to onion. Material and methods Specific IgE was evaluated using two techniques: skin test and ImmunoCAP technology. Cross-reactivity between onion and peach was evaluated by IgE-ELISA inhibition test. As for lymphocyte proliferation, blood mononuclear cells were stained with CFSE dye and cultured with an in-house onion extract. Proliferation and phenotype was assessed by flow-cytometry. Results The skin test and ImmunoCAP confirmed the IgE-dependent response towards onion. The incubation of the patient serum with increasing concentrations of the peach extract reduced only scarcely (~30%) onion-specific IgE. Interestingly, B cells but not T cells showed proliferation in response to onion extract. Conclusions In conclusion, our report shows that cooked onion can induce severe allergic reactions, suggesting the presence of thermostable components. Moreover, we applied for the first time a B-cell-based approach to the diagnosis of food allergy. This latter approach might also be applied to other allergic conditions.
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- 2019
29. Is the clinical manifestation of anaphylaxis in children influenced by the trigger of reaction?
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Ewa Cichocka-Jarosz, Tomasz Tomasik, Urszula Jedynak-Wąsowicz, Grzegorz Lis, Piotr Brzyski, and Izabela Tarczoń
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medicine.medical_specialty ,Original Paper ,business.industry ,clinical manifestation ,Mean age ,Dermatology ,Clinical manifestation ,medicine.disease ,Cardiovascular symptoms ,Blood pressure ,children ,Internal medicine ,medicine ,Vomiting ,anaphylaxis ,Immunology and Allergy ,trigger of anaphylaxis ,Insect venom ,Respiratory system ,medicine.symptom ,business ,Anaphylaxis - Abstract
Introduction The number of anaphylaxis diagnoses in children is rising, being still based on the clinical picture. Aim To determine whether triggers of anaphylaxis influence its clinical characteristics in children and adolescents. Material and methods The study group included 114 children (5 months-17 years, mean age: 8.0 ±4.8 years), (66%: boys) with the episode of anaphylaxis up to 1 year back. Medical data were entered to the NORA Registry by means of a validated structured on-line questionnaire. Results Three most frequent triggers of anaphylaxis were: insect venom (47.4%), food (35.1%), drugs (5.3%), with a predominance of food (egg white, cow's milk, nuts and peanuts) in the 0-6 years age group, while insect venom (bee predominance) in the 7-17 years age group (p = 0.016). Clinical manifestations differed between food vs. venom allergic reactions and presented as gastro-intestinal (GI) (61.4%) (p = 0.004), respiratory (RS) (93.9%) (p = 0.036), and cardiovascular (CVS) (74.6%) (p = 0.022) symptoms. Among objective symptoms, vomiting was the most common symptom in the 0-2 years age group (47.1%) (p = 0.006), while hypotension in those aged 7-12 years (40%) (p = 0.010). Severity of symptoms evaluated as Mueller's grade (IV - 74.5%) and as Ring and Messmer's grade (III - 65.8%), depended on the trigger (p = 0.028, p = 0.029, respectively). Life-threatening symptoms occurred in 26 children (fall of the blood pressure - 22%, loss of consciousness - 4.4%). Conclusions The clinical manifestation of anaphylaxis in children is both trigger and age dependent, irrespective of the gender. A typical patient with food anaphylaxis was younger, presenting predominantly GI symptoms, while a typical patient with venom anaphylaxis was older, with mostly cardiovascular symptoms.
- Published
- 2021
30. Non-invasive and minimally-invasive techniques for the diagnosis and management of allergic diseases
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Adam Chaker, Carsten B. Schmidt-Weber, Stefanie Eyerich, Markus Ollert, Ralf Baumann, Marek L. Kowalski, Oliver Pfaar, Ulrich M. Zissler, Alkis Togias, Constanze A. Jakwerth, Tilo Biedermann, Trevor T. Hansel, Knut Brockow, Ryan S Thwaites, Ian M. Adcock, Eva Untersmayr, Holger Garn, and EIT
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Allergy ,medicine.medical_specialty ,Immunology ,Respiratory System ,Anaphylaxis ,Asthma ,Atopic Dermatitis ,Food Allergy ,Non-invasive Diagnosis ,Quality of life (healthcare) ,Health care ,anaphylaxis ,medicine ,Hypersensitivity ,Immunology and Allergy ,Humans ,Overdiagnosis ,Intensive care medicine ,Skin ,food allergy ,atopic dermatitis ,business.industry ,Atopic dermatitis ,asthma ,medicine.disease ,1107 Immunology ,Quality of Life ,Position paper ,noninvasive diagnosis ,business ,non-invasive diagnosis - Abstract
Allergy 76(4), 1010-1023 (2021). doi:10.1111/all.14645, Published by Wiley, Oxford
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- 2021
31. Peanut Allergy and Component-Resolved Diagnostics Possibilities-What Are the Benefits?
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Połomska J, Dydak P, Sozańska B, and Sikorska-Szaflik H
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- Child, Adult, Humans, Immunoglobulin E, Antigens, Plant, Allergens, Arachis, Peanut Hypersensitivity diagnosis, Anaphylaxis
- Abstract
Peanut allergy is a widespread and potentially life-threatening condition that affects both children and adults, with a growing incidence worldwide. It is estimated to affect around 1-2% of the population in several developed countries. Component-resolved diagnostics is a modern approach to allergy diagnosis that focuses on identifying specific allergenic proteins to provide precise diagnoses and personalized treatment plans. It is a technique that enables the analysis of specific IgE antibodies against tightly defined molecules (components) that constitute the allergen. Component-resolved diagnostics is particularly valuable in peanut allergy diagnosis, helping to determine allergen components associated with severe reactions. It also aids in predicting the course of the allergy and enables the development of personalized immunotherapy plans; however, the full application of it for these purposes still requires more precise studies. In this paper, we present the current knowledge about peanut allergy and component-resolved diagnostics possibilities. We discuss the possibilities of using molecular diagnostics in the diagnosis of peanut allergy. We focus on examining and predicting the development of peanut allergy, including the risk of anaphylaxis, and describe the latest data related to desensitization to peanuts.
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- 2023
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32. World allergy organization anaphylaxis guidance 2020
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Luciana Kase Tanno, Montserrat Fernandez Rivas, Alexei Gonzalez-Estrada, Aziz Sheikh, Stanley M. Fineman, Yehia El-Gamal, Ignacio J. Ansotegui, Victoria Cardona, Paul Turner, Motohiro Ebisawa, Mario Geller, Bernard Yu-Hor Thong, Paul A. Greenberger, Gianenrico Senna, Margitta Worm, Mario Sanchez Borges, Vall d'Hebron University Hospital [Barcelona], Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Hospital Quirónsalud Bizkaia [Bilbao], Sagamihara National Hospital [Kanagawa, Japan], Ain Shams University (ASU), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Emory University School of Medicine, Emory University [Atlanta, GA], Academia Nacional de Medicina, Mayo Clinic [Jacksonville], Northwestern University Feinberg School of Medicine, Centro Médico Docente La Trinidad, Clínica el Avila, Università degli studi di Verona = University of Verona (UNIVR), Usher Institute of Population Health Sciences and Informatics [Edinburgh, U.K.], University of Edinburgh, Hospital Sírio-Libanês [São Paulo, Brazil], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), INSERM-TRANSFERT [Paris] (IT), Institut National de la Santé et de la Recherche Médicale (INSERM), WHO-TDR Suisse, WHO-TDR Suisse-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Tan Tock Seng Hospital, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, School of Medicine [Western Sydney University], Western Sydney University, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], and Salvy-Córdoba, Nathalie
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Allergy ,0302 clinical medicine ,Immunology and Allergy ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,030223 otorhinolaryngology ,NSAIDs, nonsteroidal anti-inflammatory drugs ,IgE, immunoglobulin E ,CAST, cellular allergen stimulation test ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,BAT, basophil activation test ,EAI, epinephrine auto-injectors ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Acute systemic allergic reaction ,Epinephrine ,ACE - Angiotensin-converting enzyme ,MRGPRX2, Mas-related G-protein coupled receptor member X2 ,Guidance ,Position Paper ,Venom allergy ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,Anaphylaxis ,medicine.drug ,lcsh:Immunologic diseases. Allergy ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Immunology ,Drug allergy ,IgG, immunoglobulin G ,FcεRI, IgE high-affinity receptor ,Guidelines ,Adrenaline ,03 medical and health sciences ,Food allergy ,medicine ,Intensive care medicine ,Glucocorticoids ,Health professionals ,business.industry ,Cofactors ,1103 Clinical Sciences ,medicine.disease ,ACE, Angiotensin converting enzyme ,IgE - Immunoglobulin E ,030228 respiratory system ,Antihistamines ,lcsh:RC581-607 ,business - Abstract
International audience; Anaphylaxis is the most severe clinical presentation of acute systemic allergic reactions. The occurrence of anaphylaxis has increased in recent years, and subsequently, there is a need to continue disseminating knowledge on the diagnosis and management, so every healthcare professional is prepared to deal with such emergencies. The rationale of this updated position document is the need to keep guidance aligned with the current state of the art of knowledge in anaphylaxis management. The World Allergy Organization (WAO) anaphylaxis guidelines were published in 2011, and the current guidance adopts their major indications, incorporating some novel changes. Intramuscular epinephrine (adrenaline) continues to be the first-line treatment for anaphylaxis. Nevertheless, its use remains suboptimal. After an anaphylaxis occurrence, patients should be referred to a specialist to assess the potential cause and to be educated on prevention of recurrences and self-management. The limited availability of epinephrine auto-injectors remains a major problem in many countries, as well as their affordability for some patients.
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- 2020
33. Beliefs about food allergies in adolescents aged 11–19 years: A systematic review.
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Newman, Kristina L., Chater, Angel, and Knibb, Rebecca C.
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FOOD allergy ,TEENAGERS ,ALLERGIES ,THEMATIC analysis ,DATABASE searching ,RISK-taking behavior ,TEENAGE girls - Abstract
Aims: Research suggests of people with food allergy (FA), adolescents have the highest risk of fatal allergic reactions to food, yet understanding of this population and how they manage their condition is limited. Understanding beliefs and how they affect behaviour could inform ways to reduce risk taking behaviour and fatal reactions in adolescents. This systematic review aimed to explore beliefs adolescents hold about their FA, and how these may be associated with FA management. Demographics: Adolescents aged 11–19 years with FA. Methodology: A systematic search of seven databases was conducted. Papers of any design were included that reported on the beliefs about FA in adolescents aged 11–19 years. Data was systemised by narrative thematic analysis. Findings: 20 studies were included. Themes included navigating FA in different environments, carriage and use of adrenaline auto‐injectors, management of the risk of anaphylaxis, behaviour and understanding of others, and food‐allergic identity. Implications: Adolescents with FA hold a variety of condition beliefs; some beliefs were related to behaviour that could lead to an allergic reaction, while other beliefs were related to protective behaviours. Further research into understanding adolescent beliefs in order to inform clinical management and reduce the risk of potential fatal reactions is essential. [ABSTRACT FROM AUTHOR]
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- 2022
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34. An Immersive Multi-User Virtual Reality for Emergency Simulation Training: Usability Study
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Lerner, Dieter, Mohr, Stefan, Schild, Jonas, Göring, Martin, Luiz, Thomas, and Publica
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Original Paper ,simulation training ,Notfallmedizin ,education ,Übung ,training effectiveness ,Information technology ,004 Informatik ,T58.5-58.64 ,virtual emergency scenario ,educational virtual realities ,presence experience ,Virtuelle Realität ,head-mounted display ,emergency medicine ,anaphylaxis ,virtual reality ,immersive media ,virtual patient simulation ,Public aspects of medicine ,RA1-1270 ,ddc:004 ,Simulation - Abstract
BackgroundVirtual reality (VR) is increasingly used as simulation technology in emergency medicine education and training, in particular for training nontechnical skills. Experimental studies comparing teaching and learning in VR with traditional training media often demonstrate the equivalence or even superiority regarding particular variables of learning or training effectiveness. ObjectiveIn the EPICSAVE (Enhanced Paramedic Vocational Training with Serious Games and Virtual Environments) project, a highly immersive room-scaled multi-user 3-dimensional VR simulation environment was developed. In this feasibility study, we wanted to gain initial insights into the training effectiveness and media use factors influencing learning and training in VR. MethodsThe virtual emergency scenario was anaphylaxis grade III with shock, swelling of the upper and lower respiratory tract, as well as skin symptoms in a 5-year-old girl (virtual patient) visiting an indoor family amusement park with her grandfather (virtual agent). A cross-sectional, one-group pretest and posttest design was used to evaluate the training effectiveness and quality of the training execution. The sample included 18 active emergency physicians. ResultsThe 18 participants rated the VR simulation training positive in terms of training effectiveness and quality of the training execution. A strong, significant correlation (r=.53, P=.01) between experiencing presence and assessing training effectiveness was observed. Perceived limitations in usability and a relatively high extraneous cognitive load reduced this positive effect. ConclusionsThe training within the virtual simulation environment was rated as an effective educational approach. Specific media use factors appear to modulate training effectiveness (ie, improvement through “experience of presence” or reduction through perceived limitations in usability). These factors should be specific targets in the further development of this VR simulation training.
- Published
- 2020
35. Cutaneous mastocytosis treatment: strategies, limitations and perspectives
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Justyna Czarny, Hanna Ługowska-Umer, Magdalena Lange, and Roman Nowicki
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medicine.medical_specialty ,lcsh:Internal medicine ,Tryptase ,Dermatology ,Omalizumab ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine ,lcsh:Dermatology ,Immunology and Allergy ,Medical history ,Epinephrine autoinjector ,Systemic mastocytosis ,lcsh:RC31-1245 ,Review Paper ,mastocytosis ,biology ,treatment ,Cutaneous Mastocytosis ,business.industry ,lcsh:RL1-803 ,medicine.disease ,030228 respiratory system ,biology.protein ,prophylaxis ,business ,Infiltration (medical) ,Anaphylaxis ,medicine.drug - Abstract
Mastocytosis is a rare myeloproliferative disease, characterized by excessive proliferation and accumulation of mast cells in the tissues. In cutaneous mastocytosis (CM), mast cells infiltration is limited to the skin, whereas in systemic mastocytosis (SM) internal organs are involved. The first-line treatment in CM is antimediator therapy (mainly H1 and H2 antihistamines) and short-term topical corticosteroids. Phototherapy is the second-line therapy which may be considered when antihistamines do not produce the expected improvement. New therapeutic options include omalizumab and KIT-targeting agents. Although the disappearance of skin lesions has been reported as a result of cytoreductive therapies in SM, the use of potentially toxic drugs in CM is not recommended. In all adults with mastocytosis and in pediatric patients with severe CM, a persistently elevated serum tryptase level and anaphylaxis in medical history, equipping with epinephrine autoinjector for use in case of anaphylaxis is recommended.
- Published
- 2018
36. Anaphylaxis in Poland: the epidemiology and direct costs
- Author
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Filip Raciborski, Karina Jahnz-Różyk, Jarosław Pinkas, Anna Kłak, and Andrzej Śliwczyński
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medicine.medical_specialty ,lcsh:Internal medicine ,Prevalence ,costs ,Dermatology ,03 medical and health sciences ,Indirect costs ,0302 clinical medicine ,Environmental health ,Epidemiology ,Health care ,lcsh:Dermatology ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,lcsh:RC31-1245 ,National health ,anaphylaxis (anaphylactic shock) ,Original Paper ,business.industry ,lcsh:RL1-803 ,medicine.disease ,030228 respiratory system ,Anaphylactic shock ,epidemiology ,Allergists ,NHF (NFZ) ,business ,Anaphylaxis ,management - Abstract
Introduction : Epidemiological data on anaphylaxis have been underestimated both in Poland and worldwide. Aim : To evaluate the prevalence of anaphylaxis in Poland, including a classification by gender, age and residential region. Material and methods : The data used in the analysis were derived from two sources, the National Health Fund records of healthcare services for 2008–2015 (official statistics) and a questionnaire-based survey conducted in 2015 on a sample of 305 allergists practicing in different regions of Poland. Results : In 2015, 3144 people received treatment for anaphylactic shock (T78.0, T78.2, T80.5, T88.6) with an estimated prevalence rate of anaphylaxis of 8.2 per 100,000 (8.4 for females and 7.9 for males). The highest prevalence rate was found for women aged 50–54 years (14.5 per 100,000). There was a very large difference in the prevalence of anaphylaxis between rural and urban areas (13.1 vs. 0.8 per 100,000). In 2015, the Polish NHF spent PLN 3.5 million (EUR 835,000) on the management of anaphylaxis. Of the allergists surveyed, 73% had been currently managing patients who had experienced anaphylactic shock. The most common causes of anaphylaxis included insect venom (41.4%), food (29.8%) and drugs (17.4%). Conclusions : A central anaphylaxis registry should be established in Poland. This is the only approach that would allow collecting a wide range of reliable information on the cases, management and consequences of anaphylaxis. Ongoing management of patients who have experienced anaphylactic shock should be improved.
- Published
- 2017
37. Mast Cells and Basophils in IgE-Independent Anaphylaxis.
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Pałgan K
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- Humans, Mast Cells, Basophils, Immunoglobulin E, Anaphylaxis, Central Nervous System Stimulants
- Abstract
Anaphylaxis is a life-threatening or even fatal systemic hypersensitivity reaction. The incidence of anaphylaxis has risen at an alarming rate in the past decades in the majority of countries. Generally, the most common causes of severe or fatal anaphylaxis are medication, foods and Hymenoptera venoms. Anaphylactic reactions are characterized by the activation of mast cells and basophils and the release of mediators. These cells express a variety of receptors that enable them to respond to a wide range of stimulants. Most studies of anaphylaxis focus on IgE-dependent reactions. The mast cell has long been regarded as the main effector cell involved in IgE-mediated anaphylaxis. This paper reviews IgE-independent anaphylaxis, with special emphasis on mast cells, basophils, anaphylactic mediators, risk factors, triggers, and management.
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- 2023
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38. Empirical use of exclusion diets in chronic disorders: discussion paper.
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Hodson, A. H.
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ALLERGIES ,IMMUNE system ,ANAPHYLAXIS ,ENVIRONMENTAL medicine ,ENVIRONMENTAL health ,DRUG withdrawal symptoms ,PHYSIOLOGICAL therapeutics - Abstract
The article focuses on masking, the process where the clinical consequences of adverse immune reactions are removed but where the adverse reactions continue underground. Masking can go away when environmental stimuli are withheld from body contact for a short period. Patients can be reintroduced with abstained items to find the item responsible for the immune reaction. Withdrawal symptoms can occur when the masking is going away.
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- 1992
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39. Childrens' and Parents' Willingness to Join a Smartphone-Based Emergency Response Community for Anaphylaxis: Survey
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Tamar Silberg, Raphael Herbst, Michael Khalemsky, Eli Jaffe, David G. Schwartz, and Anna Khalemsky
- Subjects
Adult ,Male ,Parents ,medicine.medical_specialty ,Nonprofit organization ,media_common.quotation_subject ,Health Informatics ,Information technology ,030204 cardiovascular system & hematology ,volunteer ,smartphone ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Emergency medical services ,anaphylaxis ,Medicine ,Humans ,030212 general & internal medicine ,epinephrine ,Community Health Services ,Child ,mHealth ,media_common ,Original Paper ,Young child ,business.industry ,emergency ,Emergency Responders ,Patient Acceptance of Health Care ,T58.5-58.64 ,Emergency response ,Family medicine ,Join (sigma algebra) ,community ,Female ,Public aspects of medicine ,RA1-1270 ,business ,Autonomy ,First aid - Abstract
Background Medical emergencies such as anaphylaxis may require immediate use of emergency medication. Because of the low adherence of chronic patients (ie, carrying anti-anaphylactic medication) and the potentially long response time of emergency medical services (EMSs), alternative approaches to provide immediate first aid are required. A smartphone-based emergency response community (ERC) was established for patients with allergies to enable members to share their automatic adrenaline injector (AAI) with other patients who do not have their AAI at the onset of anaphylactic symptoms. The community is operated by a national EMS. In the first stage of the trial, children with food allergies and their parents were invited to join. Objective This study aimed to identify the factors that influence the willingness to join an ERC for a group of patients at risk of anaphylaxis. Methods The willingness to join an ERC was studied from different perspectives: the willingness of children with severe allergies to join an ERC, the willingness of their parents to join an ERC, the willingness of parents to enroll their children in an ERC, and the opinions of parents and children about the minimum age to join an ERC. Several types of independent variables were used: demographics, medical data, adherence, parenting style, and children's autonomy. A convenience sample of children and their parents who attended an annual meeting of a nonprofit organization for patients with food allergies was used. Results A total of 96 questionnaires, 73 by parents and 23 by children, were collected. Response rates were approximately 95%. Adherence was high: 22 out of 23 children (96%) and 22 out of 52 parents (42%) had their AAI when asked. Willingness to join the community was high among parents (95%) and among children (78%). Willingness of parents to enroll their children was 49% (36/73). The minimum age to join an ERC was 12.27 years (SD 3.02) in the parents’ opinion and 13.15 years (SD 3.44) in the children’s opinion. Conclusions Parents’ willingness to join an ERC was negatively correlated with parents’ age, child’s age, and parents’ adherence. This can be explained by the free-rider effect: parents who carried an AAI for their young child, but had low adherence, wanted to join the ERC to get an additional layer of emergency response. Children’s willingness to join the community was positively correlated with age and negatively correlated with the child’s emotional autonomy. Parents’ willingness to enroll their children in an ERC was positively correlated with child’s age and negatively correlated with parents’ adherence: again, this can be explained by the aforementioned free-rider effect. Parents’ and children’s opinions about the minimum age to join an ERC were negatively correlated with protective parenting style and positively correlated with monitoring parenting style.
- Published
- 2019
40. Venom allergy treatment practices in Poland in comparison to guidelines : next edition of the national audit
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Ewa Cichocka-Jarosz, Marcin Stobiecki, Marita Nittner-Marszalska, Urszula Jedynak-Wąsowicz, Piotr Brzyski, and Immunotherapy Section of the Polish Society of Allergology Working Group (PTA)
- Subjects
medicine.medical_specialty ,Allergy ,lcsh:Internal medicine ,Venom ,Dermatology ,010402 general chemistry ,01 natural sciences ,national survey ,Internal medicine ,medicine ,lcsh:Dermatology ,Immunology and Allergy ,National audit ,lcsh:RC31-1245 ,Response rate (survey) ,Original Paper ,010405 organic chemistry ,Maintenance dose ,business.industry ,lcsh:RL1-803 ,medicine.disease ,0104 chemical sciences ,Hymenoptera venom ,Sting ,immunotherapy ,Erratum ,business ,venom allergy ,Anaphylaxis - Abstract
Introduction: Venom immunotherapy treatment (VIT) is the only causal treatment of hymenoptera venom anaphylaxis, which aims to provide long-lasting immunoprotection against severe reactions to subsequent stings. Aim: To reassess the compliance of VIT procedures in the Polish allergy centres with the European guidelines. Material and methods: A structured questionnaire survey conducted in all 33 VIT-centres. The response rate was 94%. Results: The ultrarush initial protocol was the most common protocol (71%, n = 22), usually lasting for 3.5 h (50%, n = 7). The most frequent (36%, n = 11) time interval from the initial to the first maintenance dose (MD) was 14 days, ranging from 7 to 35 days. All centres used an MD of 100 \mug. The most frequent time interval between subsequent MDs was 4 weeks (58%, n = 18). Five years' of VIT was declared by 71% (n = 22). Before the termination of treatment, more than half of the centres (58%, n = 18) performed sIgE and almost half (42%, n = 13) performed skin tests. To confirm VIT efficacy, few centres (26%, n = 8) conducted the sting challenge. About half of centres provided the patients with an adrenalin auto-injector both at the time of initial diagnostics and at the end of treatment. More than half (55%, n = 17) used antihistamines in all patients. Almost half (45%, n = 14) declared to stop treatment with \beta-blockers and almost one fourth (23%, n = 7) discontinued angiotensin-converting-enzyme inhibitors. Conclusions: In the most important procedures, there is a very high compliance with the guidelines. In the areas where the guidelines are not precise, we observed a large spread of results.
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- 2019
41. Adrenaline auto injectors pharmacokinetic/pharmacodynamic studies and potential consequences for clinical practice.
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Worm, Margitta, Fox, Adam T., Wickman, Magnus, Ring, Johannes, Ebisawa, Motohiro, Pouessel, Guillaume, and Smith, Pete
- Subjects
ADRENALINE ,EPINEPHRINE autoinjectors ,PHARMACOKINETICS ,INJECTORS ,ALLERGIES ,ANAPHYLAXIS - Abstract
Background: Anaphylaxis is a sudden multisystem allergic reaction which may result in a fatal outcome if not treated promptly. Guidelines worldwide suggest intramuscular adrenaline as the first‐line treatment for anaphylaxis outside a perioperative reaction. Adrenaline autoinjectors (AAIs) are widely used self‐administrable devices, especially in community settings. Different commercial AAIs have been authorized to be marketed in Europe. For an AAI to be efficacious, a rapid adrenaline delivery in patients, including those who are overweight or obese, resulting in an optimal cardiovascular (CV) response, is a key feature. AAIs are designed to achieve this requirement, which is reflected in their differing functional properties such as primary container selection, drug delivery mechanism (cartridge‐or syringe‐based), needle length, needle gauge, and adrenaline dose (150 μg, 300 μg, or 500 μg). However, the differences in functional properties across these devices may play a critical role in achieving these requirements as well as the differences in ergonomics in the handling of these devices. The purpose of this review: Considering the dynamic pharmacokinetic/pharmacodynamic (PK/PD) profiles of different AAIs marketed in Europe and their effect on adrenaline delivery, the expert panel, also serving as author for this paper have carried out a detailed analysis of the PK/PD profiles of four AAIs, namely, Anapen, Emerade, EpiPen, and Jext, to delineate the adrenaline delivery and their subsequent physiological effects on the backdrop of device characteristics, dose strength, and the skin‐to‐muscle distances of the participants. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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42. Hypersensitivity reactions to folinic acid: mechanisms involved based on two case reports and a literature review.
- Author
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Apraxine, Matveï, Van den Eynde, Marc, De Cuyper, Astrid, and Pirson, Françoise
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FOLINIC acid ,IMMUNOGLOBULIN E ,G protein coupled receptors ,LUMBAR pain ,ALLERGIES ,FACIAL pain ,MILK allergy - Abstract
Background: Hypersensitivity reactions (HSR) to antineoplastic agents are an increasing problem, especially when they lead to treatment discontinuation, sometimes without any equivalent therapeutic option. HSR to folinic acid (FA), used particularly for the treatment of digestive carcinoma along with oxaliplatin and 5-fluorouracil, are rare. Only seven publications report HSR to FA, mainly confirmed by the disappearance of symptoms after the withdrawal of FA from chemotherapy. Only two papers describe allergy testing. Due to the difficult diagnosis, patients usually receive several further cycles of chemotherapy with progressively more intense symptoms before the withdrawal of FA. Case presentation: Here we document two cases of HSR to FA, initially misattributed to oxaliplatin. The first patient described successive cycles with first back muscle pain, then chills and facial oedema and finally diffuse erythema with labial edema despite premedication. The allergy assessment highlighted high acute tryptase levels and intradermal tests positive for FA, pointing to an immunoglobulin E (IgE)-mediated mechanism. The second patient also had lower back muscle pain and chills in addition to tachycardia and desaturation during the administration of FA. Skin tests were negative and tryptase levels normal. After withdrawing FA, the symptoms did not recur, thus allowing the patient to continue chemotherapy. The mechanism of FA hypersensitivity is still unclear. The chronology of symptoms suggests an IgE-mediated mechanism that was not documented in the allergy assessment. A non-IgE-mediated mast cell/basophil activation could be involved, through complement activation or through Mas-related G protein-coupled receptors X2 (MRGPRX2) particularly. Conclusions: These two cases of anaphylaxis to FA document the clinical manifestations associated with two different mechanisms of HSR. This paper provided the opportunity to review the limited literature on HSR to FA. Through these cases, we hope to draw the practitioner's attention to FA as a potential agent of severe hypersensitivity, especially if symptoms remain after withdrawing the most suspected chemotherapeutic agents. We want also to stress the importance of allergy testing. [ABSTRACT FROM AUTHOR]
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- 2022
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43. ROCK1 via LIM kinase regulates growth, maturation and actin based functions in mast cells
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Raghuveer Singh Mali, Reuben Kapur, Lei Wei, Veerendra Munugalavadla, Holly Martin, Jianjian Shi, Joydeep Ghosh, and Emily Sims
- Subjects
0301 basic medicine ,Stem cell factor ,mast cells ,LIMK1 ,Cell Degranulation ,Lim kinase ,03 medical and health sciences ,Mice ,0302 clinical medicine ,Cell Movement ,medicine ,anaphylaxis ,Cell Adhesion ,Hypersensitivity ,cell growth ,Animals ,ROCK1 ,Rho kinase ,Rho-associated protein kinase ,Protein kinase B ,Mice, Knockout ,rho-Associated Kinases ,business.industry ,Degranulation ,Lim Kinases ,Cell Differentiation ,Mast cell ,Actins ,3. Good health ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,Immunology ,Cancer research ,business ,LIM kinase ,030215 immunology ,Research Paper - Abstract
// Reuben Kapur 1, 2 , Jianjian Shi 1 , Joydeep Ghosh 2 , Veerendra Munugalavadla 3 , Emily Sims 1 , Holly Martin 1 , Lei Wei 1 , Raghuveer Singh Mali 1 1 Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA 2 Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA 3 Gilead Sciences, Inc., Foster City, CA, USA Correspondence to: Raghuveer Singh Mali, e-mail: rsmali@iupui.edu Keywords: mast cells, Rho kinase, LIM kinase, cell growth, anaphylaxis Received: October 21, 2015 Accepted: January 29, 2016 Published: March 02, 2016 ABSTRACT Understanding mast cell development is essential due to their critical role in regulating immunity and autoimmune diseases. Here, we show how Rho kinases (ROCK) regulate mast cell development and can function as therapeutic targets for treating allergic diseases. Rock1 deficiency results in delayed maturation of bone marrow derived mast cells (BMMCs) in response to IL-3 stimulation and reduced growth in response to stem cell factor (SCF) stimulation. Further, integrin-mediated adhesion and migration, and IgE-mediated degranulation are all impaired in Rock1-deficient BMMCs. To understand the mechanism behind altered mast cell development in Rock1−/− BMMCs, we analyzed the activation of ROCK and its downstream targets including LIM kinase (LIMK). We observed reduced activation of ROCK, LIMK, AKT and ERK1/2 in Rock1-deficient BMMCs in response to SCF stimulation. Further, loss of either Limk1 or Limk2 also demonstrated altered BMMC maturation and growth; combined deletion of both Limk1 and Limk2 resulted in further reduction in BMMC maturation and growth. In passive cutaneous anaphylaxis model, deficiency of Rock1 or treatment with ROCK inhibitor Fasudil protected mice against IgE-mediated challenge. Our results identify ROCK/LIMK pathway as a novel therapeutic target for treating allergic diseases involving mast cells.
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- 2016
44. Responding to COVID-19 vaccine-related safety events: WHO Western Pacific regional experience and lessons learned.
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Cho H, Amarasinghe A, and Takashima Y
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- Humans, COVID-19 Vaccines adverse effects, Vaccination, World Health Organization, Anaphylaxis etiology, Anaphylaxis chemically induced, COVID-19 epidemiology, COVID-19 prevention & control, Vaccines
- Abstract
Problem: Novel vaccines were developed in an unprecedentedly short time in response to the global coronavirus disease (COVID-19) pandemic, which triggered concerns about the safety profiles of the new vaccines. This paper describes the actions and outcomes of three major adverse events of special interest (AESIs) reported in the World Health Organization's (WHO's) Western Pacific Region: anaphylaxis, thrombosis with thrombocytopenia syndrome (TTS) and post-vaccination death., Context: During the large-scale introduction of various novel COVID-19 vaccines, robust monitoring of and response to COVID-19 vaccine safety events were critical., Action: We developed and disseminated information sheets about anaphylaxis and TTS; provided tailor-made training for anaphylaxis monitoring and response, webinars about TTS and AESIs, and an algorithm to support decision-making about AESIs following immunization; as well as provided country-specific technical support for causality assessments, including for possible vaccination-related deaths., Outcome: Each major vaccine event and situation of high concern was responded to appropriately and in a timely manner with comprehensive technical support from WHO. Our support activities have not only strengthened countries' capacities for vaccine safety surveillance and response, but also enabled countries to decrease the negative impact of these events on their immunization programmes and maintain the confidence of health-care professionals and the general population through proactive delivery of risk communications., Discussion: This paper summarizes selected, major AESIs following COVID-19 vaccination and responses made by WHO's Regional Office for the Western Pacific to support countries. The examples of responses to vaccine safety events during the pandemic and unprecedented mass vaccination campaigns could be useful for countries to adopt, where applicable, to enhance their preparation for activities related to monitoring vaccine safety., Competing Interests: The authors have no conflicts of interest to declare., ((c) 2023 The authors; licensee World Health Organization.)
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- 2023
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45. Validation of the Spanish Version of the Food Allergy Quality of Life Questionnaire-Adult Form (S-FAQLQ-AF)
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Quality of life ,EUROPREVALL ,EUROPE ,Questionnaire ,IMPACT ,Health-related quality of life ,CHILDREN ,INSTRUMENTS ,PREVALENCE ,DISEASES ,Food allergy ,PAPER ,Specific questionnaire ,VALIDITY ,HRQL ,Anaphylaxis ,METHODOLOGY - Abstract
Introduction: Specific food allergy quality of life questionnaires have been developed within the context of the EuroPrevall project. We aimed to adapt and validate the Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) in the Spanish language.Methods: The original English questionnaire was translated and culturally adapted into Spanish following World Health Organization guidelines. The final Spanish version of the FAQLQ-AF (S-FAQLQ-AF) was approved by the original authors. Consecutive patients (>= 18 years old) who fulfilled the following criteria were recruited: 1) diagnosis of food allergy defined as immediate allergic symptoms and a positive prick test or IgE against the culprit food(s) and 2) physician-assessed ability to complete the questionnaires. Patients completed the S-FAQLQ-AF and a Spanish version of the SF-12 questionnaire. Reliability was assessed 10 to 14 days after completion of the first questionnaire.Results: Eighty-two consecutive outpatients were recruited and cross-sectional validity was assessed based on the correlation between the S-FAQLQ-AF and the Food Allergy Independent Measure (FAIM) in this population (rho=0.83, PConclusion: The S-FAQLQ-AF is a valid, short, easy-to-use, and reliable instrument that discriminates between patients with different atopic phenotypes and is suitable for assessing the impact of IgE-mediated food allergy on patient quality of life.
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- 2015
46. Mental health problems associated with idiopathic anaphylaxis.
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Gardner, Logan S, Tan, Zihao, Brown, David, Gillis, David, Scott, James G., and Prentice, Roger
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MENTAL illness ,ANAPHYLAXIS ,PSYCHOLOGICAL factors ,SOCIAL norms ,AUSTRALIANS - Abstract
Background: Idiopathic Anaphylaxis (IA) is the most common anaphylactic syndrome in adults. Mental health problems associated with IA are not well recognised. We aimed to assess if patients diagnosed with IA were more likely to experience mental health problems compared to a normative Australian population. We additionally hypothesised that the number of anaphylactic episodes would correlate with symptoms of anxiety. Methods: A total of 34 patients with at least one episode of IA were recruited from an adult immunology clinic. Patients were recruited as part of a separate study evaluating alternative aetiologies in IA. Mental health problems were measured using the Depression, Anxiety and Stress Scale (DASS-21). An extension of the survey included questions specifically focused on the psychological impact of IA. Results: Compared to population norms, those with IA had significantly higher levels of mental health problems. Statistically significant DASS-21 scores were identified for depression 4.24 vs. 2.57 (p < 0.001), anxiety 4.76 vs. 1.74 (p < 0.012), stress 7.35 vs. 3.95 (p < 0.001) and total score 16.35 vs. 8.00 (p < 0.001). There was no association between two or more episodes of anaphylaxis and increased anxiety levels (β = 0.52, CI -2.59–3.62, p = 0.74). Conclusions: This is the first paper to demonstrate that patients living with idiopathic anaphylaxis are more symptomatic for mental illness than those in the community. Screening for mental illness and referral for psychological support should be undertaken in people with IA. [ABSTRACT FROM AUTHOR]
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- 2023
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47. Inhibition of Three Novel Radix Scutellariae Extracts on Immediate Hypersensitivity
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Lei Gao, Xueyan Wang, Jiangning Wang, Haiyun Shi, and Xiaorong Li
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Hypersensitivity, Immediate ,Male ,Ethyl acetate ,Aminopyridines ,Pharmacology ,Immunoglobulin E ,Plant Roots ,law.invention ,Radix Scutellariae, Ethanol extracts, Anti-allergic activity, PCA, IgE level ,Mice ,chemistry.chemical_compound ,law ,Edema ,Anti-Allergic Agents ,Drug Discovery ,medicine ,Animals ,Anaphylaxis ,Skin ,Ethanol ,Behavior, Animal ,biology ,business.industry ,Passive Cutaneous Anaphylaxis ,Ear ,medicine.disease ,Research Papers ,Complementary and alternative medicine ,chemistry ,Anesthesia ,biology.protein ,Female ,medicine.symptom ,Licking ,business ,Phytotherapy ,Histamine ,Drugs, Chinese Herbal ,Scutellaria baicalensis - Abstract
Background: Radix Scutellariae, a few papers reported its pharmacology activities including alleviate small intestines smooth muscles spasm,sedation, antihypertensive effect. However, the inhibition of its different organic extracts on immediate hypersensitivity has not bee researched.Materials and Methods: To investigate the anti-immediate hypersensitivity of three extracts including ethanol extracts, acetone extracts, ethylacetate extracts from Radix Scutellariae, four pharmacological screening model were chose, such as 4-Aminopyridine induced pruritus model,histamine-induced mouse paw edema model, PCA(passive cutaneous anaphylaxis) in ear of mouse, activie cutaneous anaphylaxismouse (mouse ear edema test), furthermore, total IgE level in the sensitized mice serum was evaluated deeply.Results: Ethanol group at 1.42g/kg and 0.71g/kg could greatly decrease the licking number to 1.2 and 12.7 respectively; also keep mice paw swelling at 0.29ml and 0.51ml at 15 min after injection of histamine. Both ear passive cutaneous allergic reaction and active cutaneous anaphylaxis-ear swelling test demonstrated that ethanol group exhibit great inhibition on immediate hypersensitivity. Low IgE level was found inethanol group, but high in other two groups.Conclusion: The ethanol extracts exhibits obvious strong inhibition, however, the acetone ones and ethyl acetate showed a little.Keywords: Radix Scutellariae, Ethanol extracts, Anti-allergic activity, PCA, IgE level
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- 2014
48. Hippobosca equina L. (Hippoboscidae: Hippobosca)-An Old Enemy as an Emerging Threat in the Palearctic Zone.
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Maślanko W, Szwaj E, Gazda M, and Bartosik K
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- Animals, Humans, Diptera microbiology, Anaphylaxis etiology
- Abstract
Arthropods of the Hippoboscoidea superfamily are parasites of animals from various systematic groups. Mass appearances of these insects and their attacks on people are increasingly being recorded. Their parasitism has a negative effect on host well-being, as it causes feelings of agitation and irritation as well as skin itching and damage. It may result in weight loss and development of diseases in the long-term perspective. Parasites can be a potential epidemiological threat for their hosts as well. One of such parasites is a cosmopolitan species of the Hippoboscinae subfamily- Hippobosca equina . Studies have confirmed the presence of Corynebacterium pseudotuberculosis equi , Bartonella spp., and Anaplasma spp. in the organism of these insects. The frequency of anaphylactic reactions caused by H. equina attacks has been increasing. The aim of the present paper was to summarize the up-to-date knowledge of Hippobosca equina Linnaeus, 1758 due to its significance in medical and veterinary sciences as a potential vector of pathogens. Given the increasing expansion of ectoparasites, mainly related to climate change, ensuring animal welfare and human health is a priority.
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- 2022
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49. Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels.
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Černiauskienė M, Bagdonaitė L, Karčiauskaitė D, and Kvedarienė V
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- Adult, Humans, Middle Aged, Tryptases, Prevalence, Immunoglobulin E, Allergens, Anaphylaxis, Mastocytosis
- Abstract
BACKGROUND In this paper we report on the link between increased tryptase levels and prevalence of allergen-specific immunoglobulin E (IgE) in patients with anaphylaxis. The main aim of the study was to assess the corelation between elevated tryptase levels and allergen-specific immunoglobulin E (IgE) in anaphylactic reactions, mastocytosis, and other types of allergic reactions. MATERIAL AND METHODS We enrolled 60 adult patients, aged 18-68 years (mean age 45±8 years). The subjects were divided into 3 groups (20 patients in each group) according to the serum tryptase changes: group 1 consisted of patients with anaphylaxis (serum tryptase level ≥11.4 µg/l), group 2 consisted of patients with mastocytosis (serum tryptase level ≥20.0 µg/l), and group 3 consisted of patients with other allergic reactions with no anaphylaxis as an atopic control group (serum tryptase level <11.4 µg/l). The test material was venous blood serum samples. The allergen-specific IgE assay was carried out by immunoblot. Tryptase concentration was determined by immunoenzymatic assay. RESULTS Allergen-specific IgE was found in 73% of all subjects: 75% in the anaphylactic group, 55% in the mastocytosis group, and 90% in the atopic control group. Polysensitization was common and was significantly different among groups. In the atopic group, there were more patients allergic to 4-7 allergens (P<0.05). CONCLUSIONS We did not find a strong correlation between allergen-specific IgE levels and elevated tryptase levels.
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- 2022
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50. Anemoside B4 protects against IgE-dependent allergic responses by suppressing the PLC/IP3 and JAK/STAT3 pathways.
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Chang Y, Fan T, and Huang J
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- Animals, Calcium metabolism, Cell Degranulation, Congenital Disorders of Glycosylation, Cytokines metabolism, Immunoglobulin E metabolism, Mast Cells, Mice, Ovalbumin pharmacology, Passive Cutaneous Anaphylaxis, Saponins, Tumor Necrosis Factor-alpha metabolism, Anaphylaxis, Anti-Allergic Agents pharmacology, Anti-Allergic Agents therapeutic use, Hypersensitivity drug therapy, Hypersensitivity pathology, Triterpenes pharmacology
- Abstract
Anemoside B4 (AB4) is a natural triterpenoid abundant in the roots of Pulsatilla chinensis. Although various biological activities have been widely attributed to AB4, few studies have focused on its antiallergic effects. In this study the inhibitory effects of AB4 on immunoglobulin E (IgE)-mediated allergic responses were investigated, both in vitro and in vivo, and the mechanism of its effects. IgE-mediated passive cutaneous anaphylaxis was used to elucidate the antiallergic effects of AB4 in vivo. The degranulation assay, calcium imaging, and cytokine and chemokine release in the laboratory of allergic disease 2 (LAD2) cell line were used to evaluate the antiallergic effect of AB4 in vitro. Pathological staining was performed to analyze angiectasis. Western blot analysis was performed to investigate the downstream signaling pathways. AB4 dose-dependently attenuated ovalbumin/IgE-induced paw swelling in mice, and reduced the serum concentrations of tumor necrosis factor-alpha and C-C motif chemokine 2. In addition, AB4 suppressed IgE-mediated LAD2 cell degranulation, calcium influx, and PLC/IP3 and JAK/STAT3 phosphorylation. Our results suggest that AB4 inhibits allergic reactions through the PLC/IP3 and JAK/STAT3 pathways., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that may appear to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2022
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