27 results on '"Wedi, Bettina"'
Search Results
2. Prospective, monocentric, observational study of the long-term effectiveness of omalizumab in chronic urticaria
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Traidl, Stephan, primary and Wedi, Bettina, additional
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- 2023
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3. Diagnosis and treatment of Hymenoptera venom allergy
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Ruëff, Franziska, primary, Bauer, Andrea, additional, Becker, Sven, additional, Brehler, Randolf, additional, Brockow, Knut, additional, Chaker, Adam M., additional, Darsow, Ulf, additional, Fischer, Jörg, additional, Fuchs, Thomas, additional, Gerstlauer, Michael, additional, Gernert, Sunhild, additional, Hamelmann, Eckard, additional, Hötzenecker, Wolfram, additional, Klimek, Ludger, additional, Lange, Lars, additional, Merk, Hans, additional, Mülleneisen, Norbert K., additional, Neustädter, Irena, additional, Pfützner, Wolfgang, additional, Sieber, Wolfgang, additional, Sitter, Helmut, additional, Skudlik, Christoph, additional, Treudler, Regina, additional, Wedi, Bettina, additional, Wöhrl, Stefan, additional, Worm, Margitta, additional, and Jakob, Thilo, additional
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- 2023
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4. DGAKI and PEI in dialogue 2023: Diagnostics and allergen immunotherapy
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Pfaar, Oliver, primary, Hamelmann, Eckard, additional, Taube, Christian, additional, Wagenmann, Martin, additional, Wedi, Bettina, additional, Werfel, Thomas, additional, Bartel, Detlef, additional, Bonertz, Andreas, additional, Hartenstein, Diana, additional, Kaul, Susanne, additional, Mahler, Vera, additional, and Worm, Margitta, additional
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- 2023
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5. Guideline for allergological diagnosis of drug hypersensitivity reactions
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Brockow, Knut, primary, Wurpts, Gerda, additional, Trautmann, Axel, additional, Pfützner, Wolfgang, additional, Treudler, Regina, additional, Bircher, Andreas J., additional, Brehler, Randolf, additional, Buhl, Timo, additional, Dickel, Heinrich, additional, Fuchs, Thomas, additional, Jakob, Thilo, additional, Kurz, Julia, additional, Kreft, Burkhard, additional, Lange, Lars, additional, Merk, Hans F., additional, Mockenhaupt, Maja, additional, Mülleneisen, Norbert, additional, Ott, Hagen, additional, Ring, Johannes, additional, Ruëff, Franziska, additional, Sachs, Bernhardt, additional, Sitter, Helmut, additional, Wedi, Bettina, additional, Wöhrl, Stefan, additional, Worm, Margitta, additional, and Zuberbier, Torsten, additional
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- 2023
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6. The global impact of the COVID-19 pandemic on the management and course of chronic urticaria
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Kocatürk, Emek, Salman, Andaç, Cherrez-Ojeda, Ivan, Criado, Paulo Ricardo, Peter, Jonny, Comert-Ozer, Elif, Abuzakouk, Mohamed, Câmara Agondi, Rosana, Al-Ahmad, Mona, Altrichter, Sabine, Arnaout, Rand, Arruda, Luisa Karla, Asero, Riccardo, Bauer, Andrea, Ben-Shoshan, Moshe, Bernstein, Jonathan, Bizjak, Mojca, Boccon-Gibod, Isabelle, Bonnekoh, Hanna, Bouillet, Laurence, Brzoza, Zenon, Busse, Paula, Campos, Regis A., Carne, Emily, Conlon, Niall, Criado, Roberta Fachini Jardim, De Souza Lima, Eduardo Magalhães, Demir, Semra, Dissemond, Joachim, Doğan Günaydın, Sibel, Dorofeeva, Irina, Ensina, Luis Felipe, Ertaş, Ragip, Ferrucci, Silvia Mariel, Figueras-Nart, Ignasi, Fomina, Daria, Franken, Sylvie M., Fukunaga, Atsushi, Giménez Arnau, Ana M, Godse, Kiran, Gonçalo, Margarida, Gotua, Maia, Grattan, Clive, Guillet, Carole, Inomata, Naoko, Jakob, Thilo, Karakaya, Gul, Kasperska-Zając, Alicja, Katelaris, Constance H., Košnik, Mitja, Krasowska, Dorota, Kulthanan, Kanokvalai, Kumaran, M.Sendhil, Lang, Claudia, Larco-Sousa, José Ignacio, Lazaridou, Elisavet, Leslie, Tabi Anika, Lippert, Undine, Calderón llosa, Oscar, Makris, Michael, Marsland, Alexander, Medina, Iris V., Meshkova, Raisa, Bastos Palitot, Esther, Parisi, Claudio A.S., Pickert, Julia, Ramon, Germán D., Rodríguez-Gonzalez, Mónica, Rosario, Nelson, Rudenko, Michael, Rutkowski, Krzysztof, Sánchez Caraballo, Jorge Mario, Schliemann, Sibylle, Sekerel, Bulent Enis, Serpa, Faradiba S., Serra-Baldrich, E, Song, Zhiqiang, Soria, Angèle, Staevska, Maria, Staubach, Petra, Tagka, Anna, Takahagi, Shunsuke, Thomsen, Simon Francis, Treudler, Regina, Vadasz, Zahava, Rodrigues Valle, Solange Oliveira, Van Doorn, Martijn B.A., Vestergaard, Christian, Wagner, Nicola, Wang, Dahu, Wang, Liangchun, Wedi, Bettina, Xepapadaki, Paraskevi, Yücel, Esra, Zalewska-Janowska, Anna, Zhao, Zuotao, Zuberbier, Torsten, Maurer, Marcus, Universitat Autònoma de Barcelona, Dermatology, Göncü, Özgür Emek Kocatürk (ORCID 0000-0003-2801-0959 & YÖK ID 217219), Salman, A., Cherrez-Ojeda, I., Criado, P. R., Peter, J., Comert-Ozer, E., Abuzakouk, M., Agondi, R. C., Al-Ahmad, M., Altrichter, S., Arnaout, R., Arruda, L. K., Asero, R., Bauer, A., Ben-Shoshan, M., Bernstein, J. A., Bizjak, M., Boccon-Gibod, I., Bonnekoh, H., Bouillet, L., Brzoza, Z., Busse, P., Campos, R. A., Carne, E., Conlon, N., Criado, R. F., Lima, E. M. D., Demir, S., Dissemond, J., Gunaydin, S. D., Dorofeeva, I., Ensina, L. F., Ertas, R., Ferrucci, S. M., Figueras-Nart, I., Fomina, D., Franken, S. M., Fukunaga, A., Gimenez-Arnau, A. M., Godse, K., Goncalo, M., Gotua, M., Grattan, C., Guillet, C., Inomata, N., Jakob, T., Karakaya, G., Kasperska-Zajac, A., Katelaris, C. H., Kosnik, M., Krasowska, D., Kulthanan, K., Kumaran, M. S., Lang, C., Larco-Sousa, J. I., Lazaridou, E., Leslie, T. A., Lippert, U., Llosa, O. C., Makris, M., Marsland, A., Medina, I. V., Meshkova, R., Palitot, E. B., Parisi, C. A. S., Pickert, J., Ramon, G. D., Rodriguez-Gonzalez, M., Rosario, N., Rudenko, M., Rutkowski, K., Sanchez, J., Schliemann, S., Sekerel, B. E., Serpa, F. S., Serra-Baldrich, E., Song, Z. Q., Soria, A., Staevska, M., Staubach, P., Tagka, A., Takahagi, S., Thomsen, S. F., Treudler, R., Vadasz, Z., Valle, S. O. R., Van Doorn, M. B. A., Vestergaard, C., Wagner, N., Wang, D. H., Wang, L. C., Wedi, B., Xepapadaki, P., Yücel, E., Zalewska-Janowska, A., Zhao, Z. T., Zuberbier, T., Maurer, M., School of Medicine, AII - Infectious diseases, Kocaturk, Emek, Salman, Andac, Cherrez-Ojeda, Ivan, Criado, Paulo Ricardo, Peter, Jonny, Comert-Ozer, Elif, Abuzakouk, Mohamed, Agondi, Rosana Camara, Al-Ahmad, Mona, Altrichter, Sabine, Arnaout, Rand, Arruda, Luisa Karla, Asero, Riccardo, Bauer, Andrea, Ben-Shoshan, Moshe, Bernstein, Jonathan A., Bizjak, Mojca, Boccon-Gibod, Isabelle, Bonnekoh, Hanna, Bouillet, Laurence, Brzoza, Zenon, Busse, Paula, Campos, Regis A., Carne, Emily, Conlon, Niall, Criado, Roberta F., de Souza Lima, Eduardo M., Demir, Semra, Dissemond, Joachim, Gunaydin, Sibel Dogan, Dorofeeva, Irina, Ensina, Luis Felipe, Ertas, Ragip, Ferrucci, Silvia Mariel, Figueras-Nart, Ignasi, Fomina, Daria, Franken, Sylvie M., Fukunaga, Atsushi, Gimenez-Arnau, Ana M., Godse, Kiran, Goncalo, Margarida, Gotua, Maia, Grattan, Clive, Guillet, Carole, Inomata, Naoko, Jakob, Thilo, Karakaya, Gul, Kasperska-Zajac, Alicja, Katelaris, Constance H., Kosnik, Mitja, Krasowska, Dorota, Kulthanan, Kanokvalai, Kumaran, M. Sendhil, Lang, Claudia, Ignacio Larco-Sousa, Jose, Lazaridou, Elisavet, Leslie, Tabi Anika, Lippert, Undine, Llosa, Oscar Calderon, Makris, Michael, Marsland, Alexander, Medina, Iris, V, Meshkova, Raisa, Palitot, Esther Bastos, Parisi, Claudio A. S., Pickert, Julia, Ramon, German D., Rodriguez-Gonzalez, Monica, Rosario, Nelson, Rudenko, Michael, Rutkowski, Krzysztof, Sanchez, Jorge, Schliemann, Sibylle, Sekerel, Bulent Enis, Serpa, Faradiba S., Serra-Baldrich, Esther, Song, Zhiqiang, Soria, Angele, Staevska, Maria, Staubach, Petra, Tagka, Anna, Takahagi, Shunsuke, Thomsen, Simon Francis, Treudler, Regina, Vadasz, Zahava, Rodrigues Valle, Solange Oliveira, Van Doorn, Martijn B. A., Vestergaard, Christian, Wagner, Nicola, Wang, Dahu, Wang, Liangchun, Wedi, Bettina, Xepapadaki, Paraskevi, Yucel, Esra, Zalewska-Janowska, Anna, Zhao, Zuotao, Zuberbier, Torsten, and Maurer, Marcus
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Male ,0301 basic medicine ,STRESS ,Exacerbation ,UCARE ,pandemije ,Medizin ,Omalizumab ,SERUM ,chronic urticaria ,0302 clinical medicine ,Pandemic ,Health care ,Immunology and Allergy ,Chronic Urticaria ,treatment ,Chronic urticaria ,COVID-19 ,Cyclosporine ,SARS-CoV-2 ,Treatment ,zdravljenje ,ASSOCIATION ,Middle Aged ,cyclosporine ,omalizumab ,pandemic ,kronična urtikarija ,INFECTIONS ,GA(2)LEN ,Female ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,Immunology ,udc:616-097 ,pandemics ,ciklosporin ,Young Adult ,03 medical and health sciences ,Patient referral ,medicine ,Humans ,In patient ,Patient Reported Outcome Measures ,Aged ,Internet ,business.industry ,DEFINITION ,Medicine ,Allergy ,Cross-Sectional Studies ,030104 developmental biology ,030228 respiratory system ,Emergency medicine ,business - Abstract
Introduction: the COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. Aim: to understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. Materials and methods: our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. Results: the COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. Conclusions: the COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation., Novartis; Sanofi; Menarini Universidad Espiritu Santo; Takeda; Allakos; AstraZeneca; CSL Behring; Genentech; Pharming; GSK; Shire/Takada; BioCryst; ResTORbio; Pearl Therapeutics, CVS Health; Law offices of Levin; Riback; Adelman; Flangel; Vedder Price; Fresenius; Taiho; Kyowa Kirin; Tanabe; Korin; Uriach Pharma; Instituto Carlos III FEDER; Menarini; Amgen; Thermo Fisher; Avene; ALK‐Abello; Bencard/Allergy Therapeutics; Celgene; Allergopharma; Faes Farma; AbbVie; Janssen; Leo Pharma; Lilly; Roche; Genesis; Menlo Therapeutics; UCB; Pfizer; Almirall; Galderma; Allergika; Beiersdorf; Biocryst; Biogen Idec; BMS; Boehringer‐Ingelheim; Eli‐Lilly; Galderma; Hexal; Klosterfrau; LEO‐Pharma; LETI‐Pharma; L´Oreal; Medice; Octapharma; Pflüger; Pharming; Regeneron; Shire; ALK‐Abello; Fraunhofer‐IZI Leipzig; Hautnetz Leipzig/Westsachsen; MSD; HAL‐Allergy; Bencard; Nestle; Nutricia; Bayer Health Care; FAES; Henkel; Allakos; Argenx; Genentech Menarini; Moxie; Aralez; Celldex
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- 2021
7. Molecular Genetic Screening in Patients With ACE Inhibitor/Angiotensin Receptor Blocker-Induced Angioedema to Explore the Role of Hereditary Angioedema Genes
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Mathey, Carina M., primary, Maj, Carlo, additional, Scheer, Annika B., additional, Fazaal, Julia, additional, Wedi, Bettina, additional, Wieczorek, Dorothea, additional, Amann, Philipp M., additional, Löffler, Harald, additional, Koch, Lukas, additional, Schöffl, Clemens, additional, Dickel, Heinrich, additional, Ganjuur, Nomun, additional, Hornung, Thorsten, additional, Forkel, Susann, additional, Greve, Jens, additional, Wurpts, Gerda, additional, Hallberg, Pär, additional, Bygum, Anette, additional, Von Buchwald, Christian, additional, Karawajczyk, Malgorzata, additional, Steffens, Michael, additional, Stingl, Julia, additional, Hoffmann, Per, additional, Heilmann-Heimbach, Stefanie, additional, Mangold, Elisabeth, additional, Ludwig, Kerstin U., additional, Rasmussen, Eva R., additional, Wadelius, Mia, additional, Sachs, Bernhardt, additional, Nöthen, Markus M., additional, and Forstner, Andreas J., additional
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- 2022
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8. Guideline on allergen immunotherapy in IgE-mediated allergic diseases: S2K Guideline of the German Society of Allergology and Clinical Immunology (DGAKI), Society of Pediatric Allergology and Environmental Medicine (GPA), Medical Association of German Allergologists (AeDA), Austrian Society of Allergology and Immunology (ÖGAI), Swiss Society for Allergology and Immunology (SSAI), German Dermatological Society (DDG), German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), German Society of Pediatrics and Adolescent Medicine (DGKJ), Society of Pediatric Pulmonology (GPP), German Respiratory Society (DGP), German Professional Association of Otolaryngologists (BVHNO), German Association of Paediatric and Adolescent Care Specialists (BVKJ), Federal Association of Pneumologists, Sleep and Respiratory Physicians (BdP), Professional Association of German Dermatologists (BVDD)
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Pfaar, Oliver, Ankermann, Tobias, Augustin, Matthias, Bubel, Petra, Boing, Sebastian, Brehler, Randolf, Eng, Peter A, Fischer, Peter J, Gerstlauer, Michael, Hamelmann, Eckard, Jakob, Thilo, Kleine-Tebbe, Jorg, Kopp, Matthias Volkmar, Lau, Susanne, Mulleneisen, Norbert, Muller, Christoph, Nemat, Katja, Pfutzner, Wolfgang, Saloga, Joachim, Stromer, Klaus, Schmid-Grendelmeier, Peter, Schuster, Antje, Sturm, Gunter Johannes, Taube, Christian, Szepfalusi, Zsolt, Vogelberg, Christian, Wagenmann, Martin, Wehrmann, Wolfgang, Werfel, Thomas, Wohrl, Stefan, Worm, Margitta, Wedi, Bettina, Kaul, Susanne, Mahler, Vera, and Schwalfenberg, Anja
- Abstract
Not available. © Dustri-Verlag Dr. K. Feistle.
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- 2022
9. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria
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Zuberbier, Torsten, Abdul Latiff, Amir Hamzah, Abuzakouk, Mohamed, Aquilina, Susan, Asero, Riccardo, Baker, Diane, Ballmer-Weber, Barbara, Bangert, Christine, Ben-Shoshan, Moshe, Bernstein, Jonathan A., Bindslev-Jensen, Carsten, Brockow, Knut, Brzoza, Zenon, Chong Neto, Herberto Jose, Church, Martin K., Criado, Paulo R., Danilycheva, Inna V., Dressler, Corinna, Ensina, Luis Felipe, Fonacier, Luz, Gaskins, Matthew, Gáspár, Krisztian, Gelincik, Aslı, Giménez-Arnau, Ana, Godse, Kiran, Gonçalo, Margarida, Grattan, Clive, Grosber, Martine, Hamelmann, Eckard, Hébert, Jacques, Hide, Michihiro, Kaplan, Allen, Kapp, Alexander, Kessel, Aharon, Kocatürk, Emek, Kulthanan, Kanokvalai, Larenas-Linnemann, Désirée, Lauerma, Antti, Leslie, Tabi A., Magerl, Markus, Makris, Michael, Meshkova, Raisa Y., Metz, Martin, Micallef, Daniel, Mortz, Charlotte G., Nast, Alexander, Oude-Elberink, Hanneke, Pawankar, Ruby, Pigatto, Paolo D., Ratti Sisa, Hector, Rojo Gutiérrez, María Isabel, Saini, Sarbjit S., Schmid-Grendelmeier, Peter, Sekerel, Bulent E., Siebenhaar, Frank, Siiskonen, Hanna, Soria, Angele, Staubach-Renz, Petra, Stingeni, Luca, Sussman, Gordon, Szegedi, Andrea, Thomsen, Simon Francis, Vadasz, Zahava, Vestergaard, Christian, Wedi, Bettina, Zhao, Zuotao, Maurer, Marcus, Department of Dermatology, Allergology and Venereology, University Management, and HUS Inflammation Center
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hives ,angioedema ,RESISTANT CHRONIC URTICARIA ,CHRONIC IDIOPATHIC/SPONTANEOUS URTICARIA ,DELAYED PRESSURE URTICARIA ,DISEASE-ACTIVITY ,urticaria ,DOUBLE-BLIND ,consensus ,evidence-based ,QUALITY-OF-LIFE ,3121 General medicine, internal medicine and other clinical medicine ,itch ,ULTRAVIOLET-B PHOTOTHERAPY ,NONSEDATING ANTIHISTAMINES ,mast cell ,wheal ,CHRONIC IDIOPATHIC URTICARIA ,DOSE INTRAVENOUS IMMUNOGLOBULIN - Abstract
Publisher Copyright: © 2021 GA²LEN. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This update and revision of the international guideline for urticaria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
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- 2022
10. Potent Anti-Inflammatory Effects of Tetracyclines on Human Eosinophils
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Gehring, Manuela, primary, Wieczorek, Dorothea, additional, Kapp, Alexander, additional, and Wedi, Bettina, additional
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- 2021
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11. Anti-IgE for the Treatment of Chronic Urticaria
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Wedi,Bettina and Traidl,Stephan
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ImmunoTargets and Therapy - Abstract
Bettina Wedi, Stephan Traidl Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, GermanyCorrespondence: Bettina Wedi Email wedi.bettina@mh-hannover.deAbstract: Urticaria and angioedema are very common. Management of chronic urticaria subtypes, which usually persist for many years, is challenging. Recent years have demonstrated that targeting IgE with antibodies provides a safe and efficient treatment approach. Whilst several anti-IgE antibodies have been developed, omalizumab is currently the only one approved for use. International and national guidelines recommend its use after failure of antihistamines at standard and increased dose. Whilst not yet approved, many new anti-IgE approaches are currently being investigated in pre-clinical studies or clinical trials. This non-systematic focused review summarizes current knowledge of omalizumab and other anti-IgE biologics in chronic urticaria using data extracted from PubMed, Google Scholar and clinical trial databases, clinicaltrials.gov and clinicaltrials.eu. For adults, there is good evidence from randomized clinical trials and real-world data that symptomatic treatment with omalizumab is efficacious and safe in chronic spontaneous urticaria (CSU), whereas evidence in chronic inducible urticaria (CINDU) and special populations is limited. Easy-to-use tools to identify non-responders and predict the required duration of treatment have not been established yet. Phase 2 b results of ligelizumab have not only demonstrated efficacy and safety but also superiority to omalizumab. Indeed, there is preliminary evidence that omalizumab non- or partial responders benefit from ligelizumab. Whereas further development of quilizumab was discontinued, other approaches, eg UB-221 or DARPins are under investigation. Anti-IgE treatment with omalizumab represents a landmark in the treatment of chronic urticaria, with and without angioedema, and there is light on the horizon suggesting success may come with various next-generation anti-IgE approaches.Keywords: anti-IgE therapy, ligelizumab, monoclonal antibody, omalizumab, quilizumab, UB-221, urticaria
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- 2021
12. Molecular Genetic Screening in Patients With ACE Inhibitor/ Angiotensin Receptor Blocker-Induced Angioedema to Explore the Role of Hereditary Angioedema Genes.
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Mathey, Carina M., Maj, Carlo, Scheer, Annika B., Fazaal, Julia, Wedi, Bettina, Wieczorek, Dorothea, Amann, Philipp M., Löffler, Harald, Koch, Lukas, Schöffl, Clemens, Dickel, Heinrich, Ganjuur, Nomun, Hornung, Thorsten, Forkel, Susann, Greve, Jens, Wurpts, Gerda, Hallberg, Pär, Bygum, Anette, Buchwald, Christian Von, and Karawajczyk, Malgorzata
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ANGIOTENSIN receptors ,GENETIC testing ,ANGIONEUROTIC edema ,PLASMIN ,LISINOPRIL ,ACE inhibitors ,ANGIOTENSIN-receptor blockers ,FISHER exact test - Abstract
Angioedema is a relatively rare but potentially life-threatening adverse reaction to angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs). As with hereditary forms of angioedema (HAE), this adverse reaction is mediated by bradykinin. Research suggests that ACEi/ARB-induced angioedema has a multifactorial etiology. In addition, recent case reports suggest that some ACEi/ARBinduced angioedema patients may carry pathogenic HAE variants. The aim of the present study was to investigate the possible association between ACEi/ARB-induced angioedema and HAE genes via systematic molecular genetic screening in a large cohort of ACEi/ARB-induced angioedema cases. Targeted re-sequencing of five HAEassociated genes (SERPING1, F12, PLG, ANGPT1, and KNG1) was performed in 212 ACEi/ARB-induced angioedema patients recruited in Germany/Austria, Sweden, and Denmark, and in 352 controls from a German cohort. Among patients, none of the identified variants represented a known pathogenic variant for HAE. Moreover, no significant association with ACEi/ARB-induced angioedema was found for any of the identified common [minor allele frequency (MAF) >5%] or rare (MAF < 5%) variants. However, several non-significant trends suggestive of possible protective effects were observed. The lowest p-value for an individual variant was found in PLG (rs4252129, p.R523W, p = 0.057, p.adjust > 0.999, Fisher’s exact test). Variant p.R523W was found exclusively in controls and has previously been associated with decreased levels of plasminogen, a precursor of plasmin which is part of a pathway directly involved in bradykinin production. In addition, rare, potentially functional variants (MAF < 5%, Phredscaled combined annotation dependent depletion score >10) showed a nominally significant enrichment in controls both: 1) across all five genes; and 2) in the F12 gene alone. However, these results did not withstand correction for multiple testing. In conclusion, our results suggest that HAE-associated mutations are, at best, a rare cause of ACEi/ARB-induced angioedema. Furthermore, we were unable to identify a significant association between ACEi/ARB-induced angioedema and other variants in the investigated genes. Further studies with larger sample sizes are warranted to draw more definite conclusions concerning variants with limited effect sizes, including protective variants. [ABSTRACT FROM AUTHOR]
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- 2022
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13. Contemporary Grand Challenges and Opportunities in Skin Allergies
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Wedi, Bettina, primary
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- 2021
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14. COVID-19-Impfung: Risikoabschätzung aus allergologischer Sicht
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Worm, Margitta, primary, Bauer, Andrea, additional, Wedi, Bettina, additional, Treudler, Regina, additional, Pfützner, Wolfgang, additional, and Brockow, Knut, additional
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- 2021
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15. Practical recommendations for the allergological risk assessment of the COVID-19 vaccination – a harmonized statement of allergy centers in Germany
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Worm, Margitta, primary, Bauer, Andrea, additional, Wedi, Bettina, additional, Treudler, Regina, additional, Pfuetzner, Wolfgang, additional, Brockow, Knut, additional, Buhl, Timo, additional, Zuberbier, Torsten, additional, Fluhr, Joachim, additional, Wurpts, Gerda, additional, Klimek, Ludger, additional, Jacob, Thilo, additional, Merk, Hans F., additional, Mülleneisen, Norbert, additional, Roeseler, Stefani, additional, Dickel, Heinrich, additional, Raap, Ulrike, additional, and Kleine-Tebbe, Jörg, additional
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- 2021
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16. Induction of penicillin tolerance during pregnancy: Allergological opinion on the recommendation of the current AWMF Guidelines on Diagnosis and Treatment of Syphilis (AWMF Registry No. 059-002)
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Wedi, Bettina, primary, Aberer, Werner, additional, Brockow, Knut, additional, Dickel, Heinrich, additional, Brehler, Randolf, additional, Jakob, Thilo, additional, Kreft, Burkhard, additional, Mahler, Vera, additional, Merk, Hans F., additional, Mülleneisen, Norbert, additional, Ott, Hagen, additional, Pfützner, Wolfgang, additional, Röseler, Stefani, additional, Ruëff, Franziska, additional, Sunderkötter, Cord, additional, Trautmann, Axel, additional, Treudler, Regina, additional, Worm, Margitta, additional, and Wurpts, Gerda, additional
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- 2021
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17. Secondary prevention measures in anaphylaxis patients: Data from the anaphylaxis registry
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Kraft, Magdalena, Knop, Macarena Pia, Renaudin, Jean-Marie, Scherer Hofmeier, Kathrin, Pföhler, Claudia, Bilò, Maria Beatrice, Lang, Roland, Treudler, Regina, Wagner, Nicola, Spindler, Thomas, Hourihane, Jonathan O'B, Maris, Ioana, Koehli, Alice, Bauer, Andrea, Lange, Lars, Müller, Sabine, Papadopoulos, Nikolaos G, Wedi, Bettina, Moeser, Anne, Ensina, Luis F, Fernandez-Rivas, Montserrat, Cichocka-Jarosz, Ewa, Christoff, George, Garcia, Blanca E, Poziomkowska-Gęsicka, Iwona, Cardona, Victoria, Mustakov, Tihomir B, Rabe, Uta, Mahler, Vera, Grabenhenrich, Linus, et al, and University of Zurich
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2403 Immunology ,10036 Medical Clinic ,2723 Immunology and Allergy ,610 Medicine & health - Published
- 2020
18. Secondary prevention measures in anaphylaxis patients: Data from the anaphylaxis registry
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Kraft, Magdalena, Knop, Macarena Pia, Renaudin, Jean-Marie, Scherer Hofmeier, Kathrin, Pföhler, Claudia, Bilò, Maria Beatrice, Lang, Roland, Treudler, Regina, Wagner, Nicola, Spindler, Thomas, O'B Hourihane, Jonathan, Maris, Ioana, Koehli, Alice, Bauer, Andrea, Lange, Lars, Müller, Sabine, Papadopoulos, Nikolaos G., Wedi, Bettina, Moeser, Anne, Ensina, Luis F., Fernandez-Rivas, Montserrat, Cichocka-Jarosz, Ewa, Christoff, George, Garcia, Blanca E., Poziomkowska-Gęsicka, Iwona, Cardona, Victoria, Mustakov, Tihomir B., Rabe, Uta, Mahler, Vera, Grabenhenrich, Linus, Dölle-Bierke, Sabine, Worm, Margitta, and The Network for Online Registration of Anaphylaxis (NORA)
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epinephrine autoinjector ,adrenaline autoinjector ,anaphylaxis ,ddc:610 ,610 Medizin und Gesundheit ,secondary prevention ,anaphylactic reaction - Abstract
Background Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction. Methods Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anaphylaxis. Our analysis included 7788 cases from 10 European countries and Brazil. Results The secondary prevention measures offered varied across the elicitors. A remarkable discrepancy was observed between prevention measures offered in specialized allergy centers (84% of patients were prescribed adrenaline autoinjectors following EAACI guidelines) and outside the centers: Here, EAACI guideline adherence was only 37%. In the multivariate analysis, the elicitor of the reaction, age of the patient, mastocytosis as comorbidity, severity of the reaction, and reimbursement/availability of the autoinjector influence physician's decision to prescribe one. Conclusions Based on the low implementation of guidelines concerning secondary prevention measures outside of specialized allergy centers, our findings highlight the importance of these specialized centers and the requirement of better education for primary healthcare and emergency physicians.
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- 2019
19. Guideline on diagnostic procedures for suspected hypersensitivity to beta-lactam antibiotics
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Wurpts, Gerda, primary, Aberer, Werner, additional, Dickel, Heinrich, additional, Brehler, Randolf, additional, Jakob, Thilo, additional, Kreft, Burkhard, additional, Mahler, Vera, additional, Merk, Hans F., additional, Mülleneisen, Norbert, additional, Ott, Hagen, additional, Pfützner, Wolfgang, additional, Röseler, Stefani, additional, Ruëff, Franziska, additional, Sitter, Helmut, additional, Sunderkötter, Cord, additional, Trautmann, Axel, additional, Treudler, Regina, additional, Wedi, Bettina, additional, Worm, Margitta, additional, and Brockow, Knut, additional
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- 2020
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20. Urticaria and infections
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Wedi Bettina, Raap Ulrike, Wieczorek Dorothea, and Kapp Alexander
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Urticaria is a group of diseases that share a distinct skin reaction pattern. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. In spontaneous acute urticaria there is no doubt for a causal relationship to infections and all chronic urticaria must have started as acute. Whereas in physical or distinct urticaria subtypes the evidence for infections is sparse, remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Current summarizing available studies that evaluated the course of the chronic urticaria after proven Helicobacter eradication demonstrate a statistically significant benefit compared to untreated patients or Helicobacter-negative controls without urticaria (p < 0.001). Since infections can be easily treated some diagnostic procedures should be included in the routine work-up, especially the search for Helicobacter pylori. This review will update the reader regarding the role of infections in different urticaria subtypes.
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- 2009
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21. Guideline for the diagnosis of drug hypersensitivity reactions
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Brockow, Knut, Przybilla, Bernhard, Aberer, Werner, Bircher, Andreas J., Brehler, Randolf, Dickel, Heinrich, Fuchs, Thomas, Jakob, Thilo, Lange, Lars, Pfützner, Wolfgang, Mockenhaupt, Maja, Ott, Hagen, Pfaar, Oliver, Ring, Johannes, Sachs, Bernhardt, Sitter, Helmut, Trautmann, Axel, Treudler, Regina, Wedi, Bettina, Worm, Margitta, Wurpts, Gerda, Zuberbier, Torsten, and Merk, Hans F.
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in vitro test ,diagnosis ,provocation test ,skin test ,Guideline ,drug hypersensitivity - Abstract
Drug hypersensitivity reactions are unpredictable adverse drug reactions. They manifest either within 1-6 h following drug intake (immediate reactions) with mild to life-threatening symptoms of anaphylaxis, or several hours to days later (delayed reactions), primarily as exanthematous eruptions. It is not always possible to detect involvement of the immune system (allergy). Waiving diagnostic tests can result in severe reactions on renewed exposure on the one hand, and to unjustified treatment restrictions on the other. With this guideline, experts from various specialist societies and institutions have formulated recommendations and an algorithm for the diagnosis of allergies. The key principles of diagnosing allergic/hypersensitivity drug reactions are presented. Where possible, the objective is to perform allergy diagnostics within 4 weeks-6 months following the reaction. A clinical classification of symptoms based on the morphology and time course of the reaction is required in order to plan a diagnostic work-up. In the case of typical symptoms of a drug hypersensitivity reaction and unequivocal findings from validated skin and/or laboratory tests, a reaction can be attributed to a trigger with sufficient confidence. However, skin and laboratory tests are often negative or insufficiently reliable. In such cases, controlled provocation testing is required to clarify drug reactions. This method is reliable and safe when attention is paid to indications and contraindications and performed under appropriate medical supervision. The results of the overall assessment are discussed with the patient and documented in an "allergy passport" in order to ensure targeted avoidance in the future and allow the use of alternative drugs where possible.
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- 2015
22. Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases
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Pfaar, Oliver, Bachert, Claus, Bufe, Albrecht, Buhl, Roland, Ebner, Christof, Eng, Peter, Friedrichs, Frank, Fuchs, Thomas, Hamelmann, Eckard, Hartwig-Bade, Doris, Hering, Thomas, Huttegger, Isidor, Jung, Kirsten, Klimek, Ludger, Kopp, Matthias Volkmar, Merk, Hans, Rabe, Uta, Saloga, Joachim, Schmid-Grendelmeier, Peter, Schuster, Antje, Schwerk, Nicolaus, Sitter, Helmut, Umpfenbach, Ulrich, Wedi, Bettina, Wöhrl, Stefan, Worm, Margitta, Kleine-Tebbe, Jörg, Kaul, Susanne, and Schwalfenberg, Anja
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Hyposensitization ,allergic disease ,allergic rhinitis ,allergen extract ,AIT ,Guideline_AIT-Guideline ,allergen-specific immunotherapy ,guideline ,allergic asthma ,allergen - Abstract
Summary The present guideline (S2k) on allergen-specific immunotherapy (AIT) was established by the German, Austrian and Swiss professional associations for allergy in consensus with the scientific specialist societies and professional associations in the fields of otolaryngology, dermatology and venereology, pediatric and adolescent medicine, pneumology as well as a German patient organization (German Allergy and Asthma Association; Deutscher Allergie- und Asthmabund, DAAB) according to the criteria of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). AIT is a therapy with disease-modifying effects. By administering allergen extracts, specific blocking antibodies, toler-ance-inducing cells and mediators are activated. These prevent further exacerbation of the allergen-triggered immune response, block the specific immune response and attenuate the inflammatory response in tissue. Products for SCIT or SLIT cannot be compared at present due to their heterogeneous composition, nor can allergen concentrations given by different manufacturers be compared meaningfully due to the varying methods used to measure their active ingredients. Non-modified allergens are used for SCIT in the form of aqueous or physically adsorbed (depot) extracts, as well as chemically modified allergens (allergoids) as depot extracts. Allergen extracts for SLIT are used in the form of aqueous solutions or tablets. The clinical efficacy of AIT is measured using various scores as primary and secondary study endpoints. The EMA stipulates combined symptom and medication scores as primary endpoint. A harmonization of clinical endpoints, e. g., by using the combined symptom and medication scores (CSMS) recommended by the EAACI, is desirable in the future in order to permit the comparison of results from different studies. The current CONSORT recommendations from the ARIA/GA2LEN group specify standards for the evaluation, presentation and publication of study results. According to the Therapy allergen ordinance (TAV), preparations containing common allergen sources (pollen from grasses, birch, alder, hazel, house dust mites, as well as bee and wasp venom) need a marketing authorization in Germany. During the marketing authorization process, these preparations are examined regarding quality, safety and efficacy. In the opinion of the authors, authorized allergen preparations with documented efficacy and safety, or preparations tradeable under the TAV for which efficacy and safety have already been documented in clinical trials meeting WAO or EMA standards, should be preferentially used. Individual formulations (NPP) enable the prescription of rare allergen sources (e.g., pollen from ash, mugwort or ambrosia, mold Alternaria, animal allergens) for specific immunotherapy. Mixing these allergens with TAV allergens is not permitted. Allergic rhinitis and its associated co-morbidities (e. g., bronchial asthma) generate substantial direct and indirect costs. Treatment options, in particular AIT, are therefore evaluated using cost-benefit and cost-effectiveness analyses. From a long-term perspective, AIT is considered to be significantly more cost effective in allergic rhinitis and allergic asthma than pharmacotherapy, but is heavily dependent on patient compliance. Meta-analyses provide unequivocal evidence of the efficacy of SCIT and SLIT for certain allergen sources and age groups. Data from controlled studies differ in terms of scope, quality and dosing regimens and require product-specific evaluation. Therefore, evaluating individual preparations according to clearly defined criteria is recommended. A broad transfer of the efficacy of certain preparations to all preparations administered in the same way is not endorsed. The website of the German Society for Allergology and Clinical Immunology (www.dgaki.de/leitlinien/s2k-leitlinie-sit; DGAKI: Deutsche Gesellschaft für Allergologie und klinische Immunologie) provides tables with specific information on available products for AIT in Germany, Switzerland and Austria. The tables contain the number of clinical studies per product in adults and children, the year of market authorization, underlying scoring systems, number of randomized and analyzed subjects and the method of evaluation (ITT, FAS, PP), separately given for grass pollen, birch pollen and house dust mite allergens, and the status of approval for the conduct of clinical studies with these products. Strong evidence of the efficacy of SCIT in pollen allergy-induced allergic rhinoconjunctivitis in adulthood is well-documented in numerous trials and, in childhood and adolescence, in a few trials. Efficacy in house dust mite allergy is documented by a number of controlled trials in adults and few controlled trials in children. Only a few controlled trials, independent of age, are available for mold allergy (in particular Alternaria). With regard to animal dander allergies (primarily to cat allergens), only small studies, some with methodological deficiencies are available. Only a moderate and inconsistent therapeutic effect in atopic dermatitis has been observed in the quite heterogeneous studies conducted to date. SCIT has been well investigated for individual preparations in controlled bronchial asthma as defined by the Global Initiative for Asthma (GINA) 2007 and intermittent and mild persistent asthma (GINA 2005) and it is recommended as a treatment option, in addition to allergen avoidance and pharmacotherapy, provided there is a clear causal link between respiratory symptoms and the relevant allergen. The efficacy of SLIT in grass pollen-induced allergic rhinoconjunctivitis is extensively documented in adults and children, whilst its efficacy in tree pollen allergy has only been shown in adults. New controlled trials (some with high patient numbers) on house dust mite allergy provide evidence of efficacy of SLIT in adults. Compared with allergic rhinoconjunctivitis, there are only few studies on the efficacy of SLIT in allergic asthma. In this context, newer studies show an efficacy for SLIT on asthma symptoms in the subgroup of grass pollen allergic children, adolescents and adults with asthma and efficacy in primary house dust mite allergy-induced asthma in adolescents aged from 14 years and in adults. Aspects of secondary prevention, in particular the reduction of new sensitizations and reduced asthma risk, are important rationales for choosing to initiate treatment early in childhood and adolescence. In this context, those products for which the appropriate effects have been demonstrated should be considered. SCIT or SLIT with pollen or mite allergens can be performed in patients with allergic rhinoconjunctivitis using allergen extracts that have been proven to be effective in at least one double-blind placebo-controlled (DBPC) study. At present, clinical trials are underway for the indication in asthma due to house dust mite allergy, some of the results of which have already been published, whilst others are still awaited (see the DGAKI table “Approved/potentially completed studies” via www.dgaki.de/Leitlinien/s2k-Leitlinie-sit (according to www.clinicaltrialsregister.eu)). When establishing the indication for AIT, factors that favour clinical efficacy should be taken into consideration. Differences between SCIT and SLIT are to be considered primarily in terms of contraindications. In individual cases, AIT may be justifiably indicated despite the presence of contraindications. SCIT injections and the initiation of SLIT are performed by a physician experienced in this type of treatment and who is able to administer emergency treatment in the case of an allergic reaction. Patients must be fully informed about the procedure and risks of possible adverse events, and the details of this process must be documented (see “Treatment information sheet”; available as a handout via www.dgaki.de/Leitlinien/s2k-Leitlinie-sit). Treatment should be performed according to the manufacturer‘s product information leaflet. In cases where AIT is to be performed or continued by a different physician to the one who established the indication, close cooperation is required in order to ensure that treatment is implemented consistently and at low risk. In general, it is recommended that SCIT and SLIT should only be performed using preparations for which adequate proof of efficacy is available from clinical trials. Treatment adherence among AIT patients is lower than assumed by physicians, irrespective of the form of administration. Clearly, adherence is of vital importance for treatment success. Improving AIT adherence is one of the most important future goals, in order to ensure efficacy of the therapy. Severe, potentially life-threatening systemic reactions during SCIT are possible, but – providing all safety measures are adhered to – these events are very rare. Most adverse events are mild to moderate and can be treated well. Dose-dependent adverse local reactions occur frequently in the mouth and throat in SLIT. Systemic reactions have been described in SLIT, but are seen far less often than with SCIT. In terms of anaphylaxis and other severe systemic reactions, SLIT has a better safety profile than SCIT. The risk and effects of adverse systemic reactions in the setting of AIT can be effectively reduced by training of personnel, adhering to safety standards and prompt use of emergency measures, including early administration of i. m. epinephrine. Details on the acute management of anaphylactic reactions can be found in the current S2 guideline on anaphylaxis issued by the AWMF (S2-AWMF-LL Registry Number 061-025). AIT is undergoing some innovative developments in many areas (e. g., allergen characterization, new administration routes, adjuvants, faster and safer dose escalation protocols), some of which are already being investigated in clinical trials. Cite this as Pfaar O, Bachert C, Bufe A, Buhl R, Ebner C, Eng P, Friedrichs F, Fuchs T, Hamelmann E, Hartwig-Bade D, Hering T, Huttegger I, Jung K, Klimek L, Kopp MV, Merk H, Rabe U, Saloga J, Schmid-Grendelmeier P, Schuster A, Schwerk N, Sitter H, Umpfenbach U, Wedi B, Wöhrl S, Worm M, Kleine-Tebbe J. Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases – S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD). Allergo J Int 2014;23:282–319
- Published
- 2014
23. Eosinophil Apoptosis Is Mediated by Stimulators of Cellular Oxidative Metabolisms and Inhibited by Antioxidants: Involvement of a Thiol-Sensitive Redox Regulation in Eosinophil Cell Death
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Wedi, Bettina, Straede, Julia, Wieland, Britta, and Kapp, Alexander
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- 1999
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24. Management of childhood urticaria
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Pite, Helena, Wedi, Bettina, Borrego, Luís Miguel, Kapp, Alexander, Raap, Ulrike, and Centro de Estudos de Doenças Crónicas (CEDOC)
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Urticaria ,immune system diseases ,Pruritus ,Diagnosis ,Disease management ,Antihistamines ,Therapy ,Dermatology ,Children - Abstract
Urticaria, defined by the presence of wheals and/or angio edema, is a common condition in children, prompting parents to consult physicians. For its successful management, paediatric-specific features must be taken into account, regarding the identifcation of eliciting triggers and pharmacological therapy. This review systematically discusses the current best-available evidence on spontaneous acute and chronic urticaria as well as physical and other urticaria types in children. Potential underlying causes, namely infections, food and drug hypersensitivity, autoreactivity and autoimmune or other conditions, and eliciting stimuli are considered, with practical recommendations for specific diagnostic approaches. Second-generation antihistamines are the mainstay of pharmacological treatment aimed at relief of symptoms, which require dose adjustment for pae diatric use. Other therapeutic interventions are also discussed. In addition, unmet needs are highlighted, aiming to promote research into the paediatric population, ultimately aiming at the effective management of childhood urticaria. publishersversion published
- Published
- 2013
25. Management of Childhood Urticaria: Current Knowledge and Practical Recommendations.
- Author
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PITE, Helena, WEDI, Bettina, BORREGO, Luís Miguel, KAPP, Alexander, and RAAP, Ulrike
- Subjects
- *
URTICARIA , *ANGIONEUROTIC edema , *SKIN inflammation , *SKIN diseases , *PEDIATRIC dermatology - Abstract
Urticaria, defined by the presence of wheals and/or angioedema, is a common condition in children, prompting parents to consult physicians. For its successful management, paediatric-specific features must be taken into account, regarding the identification of eliciting triggers and pharmacological therapy. This review systematically discusses the current best-available evidence on spontaneous acute and chronic urticaria as well as physical and other urticaria types in children. Potential underlying causes, namely infections, food and drug hypersensitivity, autoreactivity and autoimmune or other conditions, and eliciting stimuli are considered, with practical recommendations for specific diagnostic approaches. Second-generation antihistamines are the mainstay of pharmacological treatment aimed at relief of symptoms, which require dose adjustment for paediatric use. Other therapeutic interventions are also discussed. In addition, unmet needs are highlighted, aiming to promote research into the paediatric population, ultimately aiming at the effective management of childhood urticaria. [ABSTRACT FROM AUTHOR]
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- 2013
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26. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria
- Author
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Göncü, Özgür Emek Kocatürk (ORCID 0000-0003-2801-0959 & YÖK ID 217219), Zuberbier, Torsten, Abdul Latiff, Amir Hamzah, Abuzakouk, Mohamed, Aquilina, Susan, Asero, Riccardo, Baker, Diane, Ballmer-Weber, Barbara, Bangert, Christine, Ben-Shoshan, Moshe, Bernstein, Jonathan A., Bindslev-Jensen, Carsten, Brockow, Knut, Brzoza, Zenon, Chong Neto, Herberto Jose, Church, Martin K., Criado, Paulo R., Danilycheva, Inna V., Dressler, Corinna, Ensina, Luis Felipe, Fonacier, Luz, Gaskins, Matthew, Gaspar, Krisztian, Gelincik, Asli, Gimenez-Arnau, Ana, Godse, Kiran, Goncalo, Margarida, Grattan, Clive, Grosber, Martine, Hamelmann, Eckard, Hebert, Jacques, Hide, Michihiro, Kaplan, Allen, Kapp, Alexander, Kessel, Aharon, Kulthanan, Kanokvalai, Larenas-Linnemann, Desiree, Lauerma, Antti, Leslie, Tabi A., Magerl, Markus, Makris, Michael, Meshkova, Raisa Y., Metz, Martin, Micallef, Daniel, Mortz, Charlotte G., Nast, Alexander, Oude-Elberink, Hanneke, Pawankar, Ruby, Pigatto, Paolo D., Ratti Sisa, Hector, Rojo Gutierrez, Maria Isabel, Saini, Sarbjit S., Schmid-Grendelmeier, Peter, Sekerel, Bulent E., Siebenhaar, Frank, Siiskonen, Hanna, Soria, Angele, Staubach-Renz, Petra, Stingeni, Luca, Sussman, Gordon, Szegedi, Andrea, Thomsen, Simon Francis, Vadasz, Zahava, Vestergaard, Christian, Wedi, Bettina, Zhao, Zuotao, Maurer, Marcus, and School of Medicine
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Angioedema ,Consensus ,Evidence-based ,Hives ,Itch ,Mast cell ,Urticaria ,Wheal ,Allergy ,Immunology - Abstract
This update and revision of the international guideline for urticaria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the Global Allergy and Asthma European Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible urticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria., Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs); European Union (EU); 6th Framework Programme; Global Allergy and Asthma European Network (GA2LEN); European Academy of Allergology and Clinical Immunology (EAACI); Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI); European Dermatology Forum (EDF)
- Published
- 2021
27. "Delabeling" by direct provocation testing in children and adolescents with a suspected history of a delayed reaction to β-lactam antibiotics: Consensus paper of Gesellschaft für pädiatrische Allergologie und Umweltmedizin (GPAU), Deutsche Gesellschaft für Allergologie und klinische Immunologie (DGAKI), and Ärzteverband deutscher Allergologen (ÄDA).
- Author
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Neustädter I, Blatt S, Wurpts G, Dickel H, Walter C, Aberer W, Bode S, Buhl T, Gernert S, Harner S, Heine G, Kerzel S, Köhler M, Lange L, List J, Merk HF, Nüßlein T, Ott H, Sattler F, Schuster A, Straube H, Wedi B, Zuberbier T, and Brockow K
- Abstract
Background: Approximately 10% of European children are classified as allergic to drugs. In the majority of these children, no allergy to β-lactam antibiotics (BLA) can be found. In most cases, the exanthema is caused by the infection., Materials and Methods: The objective of this paper is to describe the causes and consequences of a misdiagnosis of drug allergy. We propose a method for establishing a correct diagnosis in the case of a history of a delayed reaction during treatment with a BLA. For this purpose, a proposal was discussed via e-mail communication, and consensus was reached among the members of the drug allergy working groups of the participating medical societies., Results: The suspicion of a BLA allergy based on the medical history alone can have a negative impact on future antibiotic treatment. Exanthema associated with febrile infections not related to drug administration is a frequent finding in children. This makes it all the more important to be able to recommend a standardized procedure for clarification in children and adolescents with suspected hypersensitivity reactions. The medical history should be the basis on which to diagnose either a drug allergy or another possible differential diagnosis. A mild maculopapular exanthema (MPE) can be an expression of a drug allergy or a nonspecific viral exanthema. Uncomplicated MPE is not associated with significant systemic involvement, and there is no involvement of the mucous membranes or cutaneous blistering. Only a small number of children with uncomplicated MPE show positive skin tests and only ~ 7 - 16% of suspected BLA diagnoses can be confirmed by provocation tests. Thus, in children with uncomplicated MPE, drug provocation can be performed in an outpatient setting even without prior skin testing. This paper presents a 3-day outpatient direct provocation scheme for BLA delabeling in children with uncomplicated MPE., Conclusion: Many children and adolescents are unnecessarily denied treatment with BLA after an uncomplicated MPE while being treated with a BLA., Competing Interests: The author declared no potential conflict of interest with respect to the research, authorship, and/or publication of this article. Table 1.Warning signs of β-lactam allergy, modified according to [1, 12]. Immediate reactionDelayed reactionConjunctival erythemaPronounced facial edemaShock symptoms (arterial hypotension/dizziness)Atypical target lesions, bullous lesionsCoughing, sneezing, wheezing ErythrodermaDyspneaHemorrhagic and necrotic lesionsHoarsenessPainful skin, mucous membrane involvementDysphagiaGeneralized lymphadenopathyPathological laboratory findings (e.g., liver enzyme elevation, impaired renal function) Table 2.Provocation regime [6, 8, 15]. Day 1 (practice/clinic)Day 2 (at home)Day 3 (at home)1 single doseDaily dose distributed in 2 – 3 doses (depending on the antibiotic)Daily dose distributed in 2 – 3 doses (depending on the antibiotic)Monitoring for 1 hourStart ~ 24 hours after the first dose day 1**Wash-out period should be ~ 24 hours so that delayed reactions can be recorded after the 1st dose during the time interval between reaching the therapeutic dose and the subsequent dose. Figure 1Estimates on the likelihood of allergic cross-reactions between the various β-lactam antibiotics ([14])., (© Dustri-Verlag Dr. K. Feistle.)
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- 2024
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- View/download PDF
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