Search

Background: Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases., Methods: A modified Delphi process was used. The ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold and allergic rhinitis., Results: Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA revealed significant differences in the symptom intensity between the three diseases (p < .001)., Conclusions: This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID-19, the common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire., (© 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed., (© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)

Background: Hypersensitivity reactions (HR) are common in mastocytosis. However, little is known about triggers and risk factors. The registry of the European Competence Network on Mastocytosis (ECNM) enables reliable studies in a larger cohort of mastocytosis patients. We assessed prevalence, triggers and risk factors of HR in adults with mastocytosis in the ECNM registry., Methods: Data were collected in 27 ECNM centers. We analyzed potential triggers (Hymenoptera venoms, food, drug, inhalant and others) and risk factors at diagnosis and during follow-up. The study group consisted of 2485 adults with mastocytosis, 1379 women (55.5%) and 1106 men (44.5%). Median age was 48.2 years (range 18-91 years)., Results: Nine hundred and forty eight patients (38.1%) reported one or more HR`. Most common triggers were Hymenoptera venoms in cutaneous mastocytosis (CM) and indolent systemic mastocytosis (ISM), whereas in advanced SM (advSM), most common elicitors were drugs, including nonsteroidal anti-inflammatory agents and penicillin. In multivariate analyses, tryptase level < 90 ng/mL, <15% infiltration by mast cells in bone marrow biopsy-sections, and diagnosis of ISM were identified as independent risk factors for HR. For drug-induced HR, prominent risk factors were advSM and high tryptase levels. New reactions were observed in 4.8% of all patients during 4 years follow-up., Conclusions: HR are mainly triggered by Hymenoptera venoms in patients with CM and ISM and by drugs in patients with advSM. Tryptase levels <90 ng/mL, mast cell bone marrow infiltration <15%, and WHO category ISM are predictors of HR. New HR occur in 4.8% of all patients within 4 years., (© 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Background: Anaphylaxis to insect venom (Hymenoptera) is most severe in patients with mastocytosis and may even lead to death. However, not all patients with mastocytosis suffer from anaphylaxis. The aim of the study was to analyze differences in gene expression between patients with indolent systemic mastocytosis (ISM) and a history of insect venom anaphylaxis (IVA) compared to those patients without a history of anaphylaxis, and to determine the predictive use of gene expression profiling. Methods: Whole-genome gene expression analysis was performed in peripheral blood cells. Results: Twenty-two adults with ISM were included: 12 with a history of IVA and 10 without a history of anaphylaxis of any kind. Significant differences in single gene expression corrected for multiple testing were found for 104 transcripts (P < 0.05). Gene ontology analysis revealed that the differentially expressed genes were involved in pathways responsible for the development of cancer and focal and cell adhesion suggesting that the expression of genes related to the differentiation state of cells is higher in patients with a history of anaphylaxis. Based on the gene expression profiles, a naïve Bayes prediction model was built identifying patients with IVA. Conclusions: In ISM, gene expression profiles are different between patients with a history of IVA and those without. These findings might reflect a more pronounced mast cells dysfunction in patients without a history of anaphylaxis. Gene expression profiling might be a useful tool to predict the risk of anaphylaxis on insect venom in patients with ISM. Prospective studies are needed to substantiate any conclusions. [ABSTRACT FROM AUTHOR]

Background: Mastocytosis is an uncommon disease resulting from proliferation of abnormal mast cells infiltrating skin, bone marrow, liver, and other tissues. The aim of this study was to find differences in gene expression in peripheral blood cells of patients with indolent systemic mastocytosis compared to healthy controls. The second aim was to define a specific gene expression profile in patients with mastocytosis. Methods: Twenty-two patients with indolent systemic mastocytosis and 43 healthy controls were studied. Whole genome gene expression analysis was performed on RNA samples isolated from the peripheral blood. For amplification and labelling of the RNA, the Illumina TotalPrep 96 RNA Amplification Kit was used. Human HT-12_V3_expression arrays were processed. Data analysis was performed using GeneSpring, Genecodis, and Transcriptional System Regulators. Results: Comparison of gene expression between patients and controls revealed a significant difference (P < 0.05 corrected for multiple testing) and the fold change difference >2 in gene expression in 2303 of the 48.794 analysed transcripts. Functional annotation indicated that the main pathways in which the differently expressed genes were involved are ubiquitin-mediated proteolysis, MAPK signalling pathway, pathways in cancer, and Jak-STAT signalling. The expression distributions for both groups did not overlap at all, indicating that many genes are highly differentially expressed in both groups. Conclusion: We were able to find abnormalities in gene expression in peripheral blood cells of patients with indolent systemic mastocytosis and to construct a gene expression profile which may be useful in clinical practice to predict the presence of mastocytosis and in further research of novel drugs. [ABSTRACT FROM AUTHOR]

Atopy has been long used as the screening method for airway allergy. Nevertheless, aeroallergens can trigger respiratory symptoms not only in atopic patients (atopic respiratory allergy, ARA), but also in non‐atopic subjects (local respiratory allergy, LRA). Moreover, ARA and LRA can coexist in the same patient, and this clinical scenario has been called dual respiratory allergy (DRA). When the clinical history cannot determine the relevance of sensitizations in ARA patients, nasal, conjunctival or bronchial allergen challenges (NAC, CAC, and BAC, respectively) should be conducted. Moreover, these tests are required to identify patients with LRA and DRA. The clarification of the allergic triggers of airway diseases has a profound impact on the management strategies the patients can be offered. Importantly, allergen immunotherapy (AIT) remains as the only disease‐modifying intervention for ARA. Recent data indicate that AIT might have a similar effect on LRA patients. Nevertheless, AIT success relies largely on the correct phenotyping of allergic individuals, and NAC, CAC, and BAC are very helpful tools in this regard. In this review, we will summarize the main indications and methodology of CAC, NAC, and BAC. Importantly, the clinical implementation of these tests might translate into precision medicine approaches and better health outcomes for patients with airway allergy. [ABSTRACT FROM AUTHOR]

Hymenoptera venom allergy ranks among the top three causes of anaphylaxis worldwide, and approximately one‐quarter of sting‐induced reactions are classified as severe. Fatal sting reactions are exceedingly rare, but certain factors may entail a considerably higher risk. Delayed administration of epinephrine and upright posture are situational risk factors which may determine an unfavorable outcome of the acute anaphylactic episode and should be addressed during individual patient education. Systemic mastocytosis and senior age are major, unmodifiable long‐term risk factors and thus reinforce the indication for venom immunotherapy. Vespid venom allergy and male sex likewise augment the risk of severe or even fatal reactions. Further studies are required to assess the impact of specific cardiovascular comorbidities. Available data regarding potential effects of beta‐blockers and/or ACE inhibitors in coexisting venom allergy are inconclusive and do not justify recommendations to discontinue guideline‐directed antihypertensive treatment. The absence of urticaria/angioedema during sting‐induced anaphylaxis is indicative of a severe reaction, serum tryptase elevation, and mast cell clonality. Determination of basal serum tryptase levels is an established diagnostic tool for risk assessment in Hymenoptera venom‐allergic patients. Measurement of platelet‐activating factor acetylhydrolase activity represents a complementary approach but is not available for routine diagnostic use. [ABSTRACT FROM AUTHOR]

B Background: b The aim of this study was to investigate the serum lipid metabolomic differences between patients with allergic asthma and healthy controls, and analysis of changes in serum arachidonic acid metabolism in allergic asthma patients with conventional drug therapy and specific immunotherapy respectively. Among those, there were 54 (4.5%) children without physician-diagnosed asthma at enrollment, but with physician-diagnosed asthma at follow-up, defined as incidence of physician-diagnosed asthma; 113 (9.3%) children with physician-diagnosed asthma at both enrollment and follow-up, defined as persistence of physician-diagnosed asthma; and 165 (13.6%) children with physician-diagnosed asthma at enrollment, but without physician-diagnosed asthma at follow-up, defined as remission of physician-diagnosed asthma. 31 patients suffered from allergic asthma and 13 patients from non-allergic asthma. The inflammatory process is increased among non-allergic asthma patients in comparison to allergic asthma patients. [Extracted from the article]

Conjunctival allergen provocation test ( CAPT) reproduces the events occurring by instilling an allergen on the ocular surface. This paper is the compilation of a task force focussed on practical aspects of this technique based on the analysis of 131 papers. Main mechanisms involved are reviewed. Indications are diagnosing the allergen(s)-triggering symptoms in IgE-mediated ocular allergy in seasonal, acute or perennial forms of allergic conjunctivitis, especially when the relevance of the allergen is not obvious or in polysensitized patients. Contraindications are limited to ongoing systemic severe pathology, asthma and eye diseases. CAPT should be delayed if receiving systemic steroids or antihistamines. Local treatment should be interrupted according to the half-life of each drug. Prerequisites are as follows: obtaining informed consent; evidencing of an allergen by skin prick tests and/or serum-specific IgE dosages; being able to deal with an unlikely event such as acute asthma exacerbation, urticaria or anaphylaxis, or an exacerbation of allergic conjunctivitis. Allergen extracts should be diluted locally prior to administration. Positive criteria are based on itching or quoted according to a composite score. An alternative scoring is based on itching. CAPT remains underused in daily practice, although it is a safe and simple procedure which can provide valuable clinical information. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical research studies which include Group 2 innate lymphoid cells (ILC2s) in the house dust mite (HDM) allergic rhinitis (AR) patients, differentiation of dendritic cells, and remodeling of the chronic murine model for allergic rhinitis.

The article presents abstracts on medical topics which include the use of immunomodulatory molecules for the prevention of allergy, hypoallergenic birch pollen allergy immunotherapy (AIT) vaccine, and effect of parietaria carbamylated allergoid extract.

The article presents abstracts on medical research studies which include the drug trial of omalizumab for atopic asthmatic patients, effects of omalizumab for obese asthmatic patients, and powder inhaler for asthmatic patients.

An author index for the European Academy of Allergy and Clinical Immunology (EAACI) 2016 is presented.

An anaphylactic reaction due to a Hymenoptera sting is a clinical emergency, and patients, their caregivers as well as all healthcare professionals should be familiar with its recognition and acute management. This consensus report has been prepared by a European expert panel of the EAACI Interest Group of Insect Venom Hypersensitivity. It is targeted at allergists, clinical immunologists, internal medicine specialists, pediatricians, general practitioners, emergency department doctors, and any other healthcare professional involved. The aim was to report the scientific evidence on self-medication of anaphylactic reactions due to Hymenoptera stings, to inform healthcare staff about appropriate patient self-management of sting reactions, to propose indications for the prescription of an adrenaline auto-injector ( AAI), and to discuss other forms of medication. First-line treatment for Hymenoptera sting anaphylaxis is intramuscular adrenaline. Prescription of AAIs is mandatory in the case of venom-allergic patients who suffer from mast cell diseases or with an elevated baseline serum tryptase level and in untreated patients with a history of a systemic reaction involving at least two different organ systems. AAI prescription should also be considered in other specific situations before, during, and after stopping venom immunotherapy. [ABSTRACT FROM AUTHOR]

Background Anaphylaxis caused by hymenoptera venom allergy is associated with elevation of baseline serum tryptase ( sBT) and/or mastocytosis in about 5% of patients. Up to now, no information has become available on single venom allergen sIgE reactivity and the usefulness of component-resolved approaches to diagnose this high-risk patient group. To address the component-resolved sIgE sensitization pattern and diagnostic sensitivity in hymenoptera venom-allergic patients with elevated sBT levels and/or mastocytosis, a panel of yellow jacket and honeybee venom allergens was applied on a widely used IgE immunoassay platform. Methods Fifty-three patients with mastocytosis and/or elevated sBT tryptase level and systemic reactions to hymenoptera venoms were analyzed for their IgE reactivity to recombinant yellow jacket and honeybee venom allergens by Immulite3 g. Results sIgE reactivity to Ves v 1, Ves v 5, Api m 1 to Api m 4 and Api m 10 was found at a similar frequency in hymenoptera venom-allergic patients with and without elevated sBT levels and/or mastocytosis. However, the use of the recombinant allergens and a diagnostic cutoff of 0.1 kUA/L allowed the diagnosis of patients with otherwise undetectable IgE to venom extract. The diagnostic sensitivity of yellow jacket venom allergy using the combination of Ves v 1 and Ves v 5 was 100%. Conclusions In high-risk patients with elevated sBT levels and/or mastocytosis, the use of molecular components and decreasing the threshold sIgE level to 0.1 kUA/L may be needed to avoid otherwise undetectable IgE to hymenoptera venom extracts in about 8% of such patients. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include functional genomics in immunology and allergy; urticaria-angioedema due to tranexamic acid; and diagnosis of drug allergy to chlorhexidine in a national survey of Great Britain.

The article presents abstracts on medical topics which include the effects of daily dietary intake of fibres on immune functioning in young adults; hand-foot-mouth disease in an adolescent; and drug rash with eosinophilia and systemic symptoms syndrome in a pediatric patient.

The article presents abstracts on allergy and immunology which include the indices of innate immunity in children with recurrent wheezing, the predictive factors of tumor infiltrating neutrophils in patients with colorectal cancer, and the role of interleukin-10 (IL-10) in dengue infections.

The article lists the authors who have submitted their abstracts in the journal including W. Aberer, J. Arnolds, and S. Baos.

The article presents abstract on allergy which include the etiology of hypereosinophilia, the clinical features and long-term prognosis of Churg-Strauss syndrome, and the pathogenesis of respiratory diseases in frequently ill children.

Mast cell activation ( MCA) occurs in a number of different clinical conditions, including Ig E-dependent allergies, other inflammatory reactions, and mastocytosis. MCA-related symptoms may be mild, moderate, severe, or even life-threatening. The severity of MCA depends on a number of different factors, including genetic predisposition, the number and releasability of mast cells involved in the reaction, the type of allergen, presence of specific Ig E, and presence of certain comorbidities. In severe reactions, MCA can be documented by a substantial increase in the serum tryptase level above baseline. When symptoms are recurrent, are accompanied by an increase in mast cell-derived mediators in biological fluids, and are responsive to treatment with mast cell-stabilizing or mediator-targeting drugs, the diagnosis of mast cell activation syndrome ( MCAS) is appropriate. Based on the underlying condition, these patients can further be classified into i) primary MCAS where KIT-mutated, clonal mast cells are detected, ii) secondary MCAS where an underlying inflammatory disease, often in the form of an Ig E-dependent allergy, but no KIT-mutated mast cells, is found, and iii) idiopathic MCAS, where neither an allergy or other underlying disease, nor KIT-mutated mast cells are detectable. It is important to note that in many patients with MCAS, several different factors act together to lead to severe or even life-threatening anaphylaxis. Detailed knowledge about the pathogenesis and complexity of MCAS, and thus establishing the exact final diagnosis, may greatly help in the management and therapy of these patients. [ABSTRACT FROM AUTHOR]

An author index for the 2012 issue of "Allergy: European Journal of Allergy and Clinical Immunology," is presented.

Background There is no in vitro test to predict the induction of long-term tolerance in patients treated with venom immunotherapy ( VIT). The aim of this study was to investigate whether immunotherapy-induced changes in basophil responsiveness reflect a state of protection and the induction of a tolerance. Methods Twenty-three patients with allergic reaction after Hymenoptera sting (11 wasp and 12 honeybee) were treated with VIT. In all patients, a CD63 basophil activation test was performed before the beginning of immunotherapy, after 1 year and after completing 4-6.5 years of immunotherapy (approximately 1 year after stopping). The tolerance was then evaluated by a sting challenge test. The basophil activation test was repeated 3-6 months after the challenge. Results Twenty-two subjects showed a negative sting challenge, and one subject, a positive sting challenge. Allergen-specific basophil response remained unchanged after 1 year of immunotherapy. However, after immunotherapy, a significant and approximately fourfold decrease was demonstrated in all tolerant subjects mainly in response to submaximal 0.1 μg/ml allergen concentration. This depression was sustained and did not change with the sting challenge test. In a nontolerant patient with a positive sting challenge, basophil response did not change. Conclusions Our results suggest that the depression of allergen-specific basophil response seems to be associated with the induction of a tolerance after completing a course of VIT. [ABSTRACT FROM AUTHOR]

An author index for the June 2011 issue of the journal "Allergy," is presented.

The article presents abstracts on research papers which include evaluation and comparison of commercially available latex extracts for skin prick tests, enzymatic activity characterisation in commercial mite extracts and isolation and characterisation of wheat flour allergens, to be presented at poster session on allergy diagnosis to be held on June 6, 2011.

The article presents abstracts on research papers which include climate change and aeroallergens, atopy and sensitisation rates to aeroallergens in children and teenagers in Jeju, Korea and allergic sensitisation to ornamental plants in patients with allergic rhinitis and asthma, to be presented at poster session on Aerobiology to be held on June 5, 2011.

The article presents abstracts on medical topics which include the evaluation of the health-related-quality-of life (HRQOL) in adolescents with asthma, the association of not controlled asthma with overweight and obesity in male adults, and the ecological relationship between the prevalence of asthma and the exposure to house dust mite.

The article presents abstracts on medical topics which include "Environmental tobacco smoke makes allergy symptoms stronger," by Z. Wawrzyniak and colleagues, "Association of allergy with chronic sinusitis in children," by Y. Rha and colleagues, and "Occupational asthma induced by common spider Holocnemus pluchei," by I. Bobolea and colleagues.

The article presents abstracts on medical topics which include "Exhaled nitric oxide and respiratory symptoms in the diagnosis of atopic asthma," by N. Mgaloblishvili and colleagues, "Early experiences of infants with IgE mediated cow's milk allergy," by A. Santos and colleagues, and "Investigating serum levels of heavy metals in childhood eczema," by K. Hon and colleagues.

An author index for the 2009 issue of "The Authors Journal Compilation" is presented.

An author index for the June 2007 issue of "Allergy" is presented.

Hymenoptera venom allergy occasionally causes fatal reactions. The prevalence of systemic reactions (SRs) is 0.3-8.9%, with anaphylaxis in 0.3-42.8% of cases. Factors contributing to reaction severity include older age, insect type, a previous less severe SR, preexisting diseases, concomitant treatments, mast cell diseases and elevated baseline tryptase serum concentration. Venom immunotherapy (VIT) is highly effective, as shown by sting challenge and spontaneous field stings. Indications for VIT are based on history of an SR, positive diagnostic tests, natural history and established risk factors for a severe outcome. Current strategies for reducing adverse reactions include anti-IgE monoclonal antibody pretreatment, and purified aqueous and purified aluminium hydroxide adsorbed preparations. New strategies for VIT, mostly using recombinant allergen, are in development. Further improvements will increase the safety and efficacy of VIT. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Mastocytosis and Insect Venom Allergy: Diagnosis, Safety and Efficacy of Venom Immunotherapy," by M. Niedoszytko that was published in a previous issue.