438 results on '"Julie Wang"'
Search Results
2. <scp>DOAC</scp> ‐stop can remove direct oral anticoagulants and allow analysis by global coagulation assays
- Author
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Julie Wang, Hui Yin Lim, Harshal Nandurkar, and Prahlad Ho
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Biochemistry (medical) ,Clinical Biochemistry ,Hematology ,General Medicine - Published
- 2023
3. Cancer risk with topical calcineurin inhibitors, pimecrolimus and tacrolimus, for atopic dermatitis: a systematic review and meta-analysis
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Niveditha Devasenapathy, Alexandro Chu, Melanie Wong, Archita Srivastava, Renata Ceccacci, Clement Lin, Margaret MacDonald, Aaron Wen, Jeremy Steen, Mitchell Levine, Lonnie Pyne, Lynda Schneider, Derek K Chu, Rachel Netahe Asiniwasis, Mark Boguniewicz, Lina Chen, Anna De Benedetto, Winfred T Frazier, Matthew Greenhawt, Joey Huynh, Elaine Kim, Jennifer LeBovidge, Mary Laura Lind, Peter A Lio, Stephen A Martin, Monica O'Brien, Peck Y Ong, Jonathan I Silverberg, Jonathan M Spergel, and Julie Wang
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Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology - Abstract
Atopic dermatitis is a prevalent condition in children and can be effectively managed with medications such as topical calcineurin inhibitors (pimecrolimus or tacrolimus). A key unresolved safety concern is whether use of topical calcineurin inhibitors is associated with cancer. We systematically reviewed the risk of cancer in patients with atopic dermatitis exposed to topical calcineurin inhibitors.As part of the 2022 American Academy of Allergy, Asthma and Immunology and American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters atopic dermatitis guidelines, we searched MEDLINE, Embase, the Latin American and Caribbean Health Sciences Literature database, the Índice Bibliográfico Espanhol de Ciências da Saúde database, the Global Resource of Eczema Trials database, WHO's International Clinical Trials Registry Platform, the US Food and Drug Administration database, the European Medicines Agency database, company registers, and relevant citations from inception to June 6, 2022. We included randomised controlled trials and comparative and non-comparative non-randomised studies in any language addressing cancer risk in patients with atopic dermatitis using topical calcineurin inhibitors. We excluded split-body studies and studies with less than 3 weeks of follow-up. Paired reviewers independently screened records, extracted data, and assessed risk of bias in duplicate. We used Bayesian models to estimate the probability for cancer due to topical calcineurin inhibitor exposure and the GRADE approach to determine the certainty of the evidence. Patients, advocacy groups, and care providers set a priori thresholds of important effects. This study is registered with Open Science Framework, https://osf.io/v4bfc.We identified and analysed 110 unique studies (52 randomised controlled trials and 69 non-randomised studies [11 were non-randomised study extensions of randomised controlled trials]) including 3·4 million patients followed up for a mean of 11 months (range 0·7-120). The absolute risk of any cancer with topical calcineurin inhibitor exposure was not different from controls (absolute risk 4·70 per 1000 with topical calcineurin inhibitors vs 4·56 per 1000 without; odds ratio 1·03 [95% credible interval 0·94-1·11]; moderate certainty). For all age groups and using data from observational studies and randomised controlled trials, the use of pimecrolimus (OR 1·05 [95% credible interval 0·94-1·15]) or tacrolimus (0·99 [0·89-1·09]) is likely to have had little to no association with cancer compared with no topical calcineurin inhibitor exposure. For pimecrolimus versus tacrolimus, the finding was similar (0·95 [95% credible interval 0·83-1·07]). Findings were similar in infants, children, and adults, and robust to trial sequential, subgroup, and sensitivity analyses.Among individuals with atopic dermatitis, moderate-certainty evidence shows that topical calcineurin inhibitors do not increase the risk of cancer. These findings support the safe use of topical calcineurin inhibitors in the optimal treatment of patients with atopic dermatitis.American Academy of Allergy, Asthma and Immunology and American College of Allergy, Asthma and Immunology via the Joint Task Force on Practice Parameters.
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- 2023
4. Topical corticosteroids for chronic rhinosinusitis with nasal polyposis: GRADE systematic review and network meta-analysis
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Antonio Bognanni, Derek K. Chu, Matthew A. Rank, Jonathan Bernstein, Anne K. Ellis, David Golden, Matthew Greenhawt, John B. Hagan, Caroline C. Horner, Dennis K. Ledford, Jay Lieberman, Amber U. Luong, Lisa A. Marks, Richard R. Orlandi, Shefali A. Samant, Marcus Shaker, Zachary M. Soler, Whitney W. Stevens, David R. Stukus, Julie Wang, and Anju T. Peters
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Nasal Polyps ,Adrenal Cortex Hormones ,Immunology ,Humans ,Immunology and Allergy ,Sinusitis ,Rhinitis - Abstract
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is associated with a significant disease burden. The optimal use of and administration route for intranasal corticosteroids (INCS) when managing CRSwNP are unclear.We systematically synthesized the evidence addressing INCS for CRSwNP.We searched studies archived in Medline, Embase, and Central from database inception until September 1, 2021, for randomized controlled trials comparing INCS using any delivery method to placebo or other INCS administration types. Paired reviewers screened records, abstracted data, and rated risk of bias (CLARITY revision of Cochrane Risk of Bias version 1 tool) independently and in duplicate. We synthesized the evidence for each outcome using random effects network meta-analyses. We critically appraised the evidence following the GRADE (Grades of Recommendation Assessment, Development, and Evaluation) approach.We analyzed 61 randomized controlled trials (7176 participants, 8 interventions). Sinusitis-related quality of life might improve with INCS rinse (mean difference [MD] -6.83, 95% confidence interval [CI] -11.94 to -1.71) and exhalation delivery system (EDS) (MD -7.86, 95% CI -14.64 to -1.08) compared to placebo (both low certainty evidence). Nasal obstruction symptoms are likely improved when receiving INCS via stent/dressing (MD -0.31, 95% CI -0.54 to -0.08), spray (MD -0.51, 95% CI -0.61 to -0.41), and EDS (MD -0.35, 95% CI -0.51 to -0.18) (all moderate to high certainty) compared to placebo. We found no important differences in adverse effects among interventions (moderate certainty for INCS spray, very low to low certainty for others).Multiple delivery forms of INCS are viable therapeutic options for CRSwNP, resulting in improvement of patient-important outcomes. INCS via stent, spray, and EDS appear to be beneficial across the widest range of considered outcomes.
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- 2022
5. Disparities in the Diagnosis and Management of Anaphylaxis
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Brit, Trogen, Samantha, Jacobs, and Julie, Wang
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Pulmonary and Respiratory Medicine ,Immunology ,Immunology and Allergy - Abstract
The goal of this review is to characterize health disparities impacting the recognition and treatment of anaphylaxis.Previous research has identified major health disparities related to atopic conditions including asthma, atopic dermatitis, and food allergies (FA); however, disparities related to anaphylaxis have yet to be examined in depth. We found widespread health disparities in the incidence and severity of anaphylaxis, as well as in the management of allergies (particularly food allergies) that place individuals at risk of anaphylaxis. Sociodemographic factors are associated with numerous negative health outcomes related to anaphylaxis. We highlight several key steps that must be taken to address these disparities.
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- 2022
6. Drug allergy: A 2022 practice parameter update
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David A, Khan, Aleena, Banerji, Kimberly G, Blumenthal, Elizabeth J, Phillips, Roland, Solensky, Andrew A, White, Jonathan A, Bernstein, Derek K, Chu, Anne K, Ellis, David B K, Golden, Matthew J, Greenhawt, Caroline C, Horner, Dennis, Ledford, Jay A, Lieberman, John, Oppenheimer, Matthew A, Rank, Marcus S, Shaker, David R, Stukus, Dana, Wallace, Julie, Wang, and Marcus, Shaker
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Immunology ,Immunology and Allergy - Published
- 2022
7. College mathematics instructor professional development providers: Who are they?
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Sean P. Yee, Shandy Hauk, Tuto Lopez Gonzalez, and Julie Wang
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Mathematics (miscellaneous) ,History and Philosophy of Science ,Physics and Astronomy (miscellaneous) ,Engineering (miscellaneous) ,Education - Published
- 2023
8. Acute At-Home Management of Anaphylaxis: 911: What Is the Emergency?
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Thomas B, Casale, Julie, Wang, John, Oppenheimer, and Anna, Nowak-Wegrzyn
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Emergency Medical Services ,Epinephrine ,Risk Factors ,Humans ,Immunology and Allergy ,Health Care Costs ,Emergency Service, Hospital ,Anaphylaxis - Abstract
The appropriate at-home management of anaphylaxis begins with patient education on recognition and treatment, especially when and how to use epinephrine. Delayed administration of epinephrine as well as having severe symptoms and needing multiple doses of epinephrine to treat symptoms are risk factors for biphasic anaphylaxis. The successful implementation of at-home management of anaphylaxis requires appropriate patient selection and an algorithmic approach that recommends activation of emergency medical services (EMS) when the patient does not adequately respond to at-home administration of epinephrine or there are extenuating patient-related circumstances. Fortunately, approximately 98% of anaphylactic episodes respond to 2 or fewer doses of epinephrine, the standard prescription used for epinephrine autoinjectors; fatal anaphylaxis is very rare, as low as 0.002 deaths/million person-years; and biphasic reactions are uncommon (∼5%), and only extremely rarely lethal. Thus, most common concerns leading to recommended EMS activation and emergency department visits after epinephrine administration are generally unsubstantiated. Furthermore, emergency department visits do not always lead to better treatment and drive health care costs higher. Open communications with patients and families regarding risks and benefits of at-home management and observation versus EMS activation and emergency department evaluation after epinephrine administration for anaphylaxis are essential. However, we believe the data indicate that it is time to reconsider the often used and taught approach that recommends EMS activation whenever epinephrine is used.
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- 2022
9. A review of the safety of oral immunotherapy in clinical trial and real-world studies
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Stephanie Leeds, John K. Kuster, and Julie Wang
- Abstract
Safety concerns are a barrier to oral immunotherapy (OIT). This review aims to describe OIT safety events and explore potential risk factors and mitigating factors. Published clinical and real-world OIT studies were reviewed for data on safety outcomes in OIT. Gastrointestinal symptoms are one of the most common adverse reactions associated with OIT, and persistent symptoms can be associated with an eosinophilic response. Allergic reactions are increased in OIT compared with avoidance; however, these symptoms tend not to be severe and to decrease over time. Despite OIT, epinephrine usage persists in studies and life-threatening reactions (though rare) have occurred. High baseline food specific immunoglobulin E levels, aggressive dosing, uncontrolled atopic comorbidities, and poor adherence to protocols may contribute to the severity of adverse events. OIT remains a shared decision that incorporates best medical evidence and appropriate patient selection. It requires individualized care and action plans to ensure safe outcomes.
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- 2022
10. How to define severity: a review of allergic reaction severity scoring systems
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Ami Shah, Timothy E. Dribin, and Julie Wang
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Pulmonary and Respiratory Medicine ,Immunology ,Immunology and Allergy - Published
- 2023
11. Underground Energy Storage Utilizing Concrete Building Foundation: Experimental and Numerical Approach
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M. Z. Saghir, Seth Dworkin, Julie Wang, Ayman M. Bayomy, and Magdy M. Mousa
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7. Clean energy - Abstract
Space heating and cooling represents 63% of total building energy demand. In the present study, the concept of concrete foundation piles was used as an underground storage medium. This system requires no additional drilling costs or space, unlike conventional boreholes. A lab-scaled experiment facility was designed to experimentally investigate the thermal response of a concrete pile during the charging and discharging processes. The amount of energy stored and released during each process was evaluated. A flow rate parametric study was also conducted to explore the effect of the laminar and turbulent flow behaviour. In order to complement the experimental study, an extensive CFD model was developed and compared with the experimental data. There was good agreement between the numerical and experimental results for each process at different flow rates. The results revealed that increasing the flow rate increases not only the heat rejection and extraction but also the storage efficiency. Keywords: borehole, energy pile, thermal storage, thermal response, ground source heat pump
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- 2023
12. Double-Blind, Placebo-Controlled Study of E-B-FAHF-2 in Combination With Omalizumab-Facilitated Multiallergen Oral Immunotherapy
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Julie Wang, Robert A. Wood, Samantha Raymond, Mayte Suárez-Fariñas, Nan Yang, Scott H. Sicherer, Hugh A. Sampson, and Xiu-Min Li
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Immunology and Allergy - Published
- 2023
13. Deconstructing the Way We Use Pulmonary Function Test Race-Based Adjustments
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Nicole B. Ramsey, Andrea J. Apter, Elliot Israel, Margee Louisias, Lenora M. Noroski, Sharmilee M. Nyenhuis, Princess U. Ogbogu, Tamara T. Perry, Julie Wang, and Carla M. Davis
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Immunology and Allergy - Published
- 2022
14. Distinct trajectories distinguish antigen-specific T cells in peanut-allergic individuals undergoing oral immunotherapy
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Justine Calise, Hannah DeBerg, Nahir Garabatos, Sugandhika Khosa, Veronique Bajzik, Lorena Botero Calderon, Kelly Aldridge, Mario Rosasco, Brian C. Ferslew, Tong Zhu, Ronald Smulders, Lisa M. Wheatley, Tanya M. Laidlaw, Tielin Qin, Gurunadh R. Chichili, Daniel C. Adelman, Mary Farrington, David Robinson, David Jeong, Stacie M. Jones, Srinath Sanda, David Larson, William W. Kwok, Carolyn Baloh, Gerald T. Nepom, Erik Wambre, Edwin H. Kim, Kari C. Nadeau, Anna Nowak-Wegrzyn, Robert A. Wood, Hugh A. Sampson, Amy M. Scurlock, Sharon Chinthrajah, Julie Wang, Robert D. Pesek, Sayantani B. Sindher, Mike Kulis, Jacqueline Johnson, Katharine Spain, Denise C. Babineau, Hyunsook Chin, Joy Laurienzo-Panza, null Rachel Yan, null Tielin Qin, Don Whitehouse, Michelle L. Sever, Marshall Plaut, A. Wesley Burks, Gina Marchesini, Kavitha Gilroy, Sylvia Posso, Sabrina Skiba, Thien-Son Nguyen, Adam Wojno, Tuan Nguyen, Vivian Gersuk, Quynh-Anh Nguyen, Jessica Garber, Kimberly O’Brien, Brandon Larson, C. Cousens-Jacobs, and Alex Hu
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Immunology ,Immunology and Allergy - Published
- 2023
15. 321 Cancer risk with topical pimecrolimus and tacrolimus for atopic dermatitis: systematic review and Bayesian meta-analysis
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Alexandro W L Chu, Niveditha Devasenapathy, Melanie Wong, Archita Srivastava, Renata Ceccacci, Clement Lin, Margaret MacDonald, Aaron Wen, Jeremy Steen, Mitchell Levine, Lonnie Pyne, Julie Wang, Jonathan M Spergel, Jonathan I Silverberg, Peck Y Ong, Monica O’Brien, Stephan A Martin, Peter A Lio, Mary Laura Lind, Jennifer LeBovidge, Elaine Kim, Joey Huynh, Matthew Greenhawt, Winfred T Frazier, Lina Chen, Anna De Benedetto, Mark Boguniewicz, Rachel N Asiniwasis, Lynda Schneider, and Derek K Chu
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Dermatology - Abstract
Atopic dermatitis affects millions worldwide and is effectively managed by topical treatments, including topical calcineurin inhibitors, pimecrolimus and tacrolimus. In 2005 and 2011, the FDA released reviews associating topical calcineurin inhibitors with a theoretical cancer risk, albeit an uncertain association. We systematically reviewed the risk of cancer in patients with atopic dermatitis exposed to topical calcineurin inhibitors. We systematically identified randomized controlled trials, comparative, and non-comparative non-randomized studies from database inception to 6 June 2022, from MEDLINE, EMBASE, GREAT, LILACS, ICTRP, FDA, EMA, company registers and relevant citations. We included studies in any language addressing the risk of cancer in patients with atopic dermatitis exposed to topical calcineurin inhibitors for greater than 3 weeks. We excluded split-body studies. We conducted a Bayesian meta-analysis and used the GRADE approach to determine the certainty of the evidence. A multidisciplinary panel including patients, advocacy groups and care providers, set an a priori threshold of 1 in 1000 risk difference as a clinically important effect. We analysed 121 studies (52 randomized controlled trials and 69 non-randomized studies) including 3.4 million patents followed for a mean of 11 months (range: 0.7–120). The absolute risk of any cancer with topical calcineurin inhibitor exposure was neither different from controls (absolute risk 4.70 per 1000 with topical calcineurin inhibitor exposure vs. 4.56 per 1000 without; odds ratio 1.03 [95% credible interval 0.94–1.11], moderate-certainty evidence) nor the general US population (4.6 per 1000). Findings were similar in infants, children, and adults, and were robust to trial sequential, subgroup and sensitivity analyses. Among infants, children and adults with atopic dermatitis, moderate-certainty evidence shows that topical calcineurin inhibitors do not increase the risk of cancer. These findings support the safe use of topical calcineurin inhibitors in the management of patients with atopic dermatitis. Our findings provide actional information to inform updated clinical practice guidelines, product labels and continuing education for care providers, to clarify the safe usage of topical calcineurin inhibitors.
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- 2023
16. Single-type Psychedelic Use and Major Depressive Episode in the National Survey on Drug Use and Health, 2017-2019
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Wilder, Julie Wang
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major depressive disorder ,psychedelic-assisted therapy ,depression ,Medicine and Health Sciences ,hallucinogens ,psychedelics ,peyote ,nsduh - Abstract
Cross-sectional analysis using data from the National Survey on Drug Use and Health (NSDUH) (2017-2019) to examine single-type psychedelic use and past year Major Depressive Episode (MDE).
- Published
- 2023
- Full Text
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17. Anaphylaxis knowledge gaps and future research priorities: A consensus report
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Lynda C. Schneider, Ronna L. Campbell, Yin Zhang, Amal Assa'ad, Hugh A. Sampson, David B.K. Golden, Kimberly A. Risma, Jonathan M. Spergel, Rakesh D. Mistry, Paul Turner, Susan A. Rudders, Kenneth A. Michelson, Carlos A. Camargo, Marcus Shaker, Brad Sobolewski, Julie Wang, David Schnadower, Peter Capucilli, Mark I. Neuman, Mariana Castells, David C. Brousseau, John K. Witry, Timothy E. Dribin, David Vyles, Michael Pistiner, Dianne E. Campbell, Margitta Worm, and Juhee Lee
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Allergen immunotherapy ,medicine.medical_specialty ,Consensus ,Allergy ,emergency department ,translational science ,Best practice ,Immunology ,Population ,basic science ,Article ,population science ,Multidisciplinary approach ,Surveys and Questionnaires ,Humans ,Immunology and Allergy ,Medicine ,education ,Anaphylaxis ,education.field_of_study ,business.industry ,Research ,Emergency department ,Hospitalization ,1107 Immunology ,Scale (social sciences) ,Family medicine ,impact ,Translational science ,business ,Predictive modelling ,feasibility - Abstract
Background Despite a better understanding of the epidemiology, pathogenesis, and management of patients with anaphylaxis, there remain knowledge gaps. Enumerating and prioritizing these gaps would allow limited scientific resources to be directed more effectively. Objective We sought to systematically describe and appraise anaphylaxis knowledge gaps and future research priorities based on their potential impact and feasibility. Methods We convened a 25-member multidisciplinary panel of anaphylaxis experts. Panelists formulated knowledge gaps/research priority statements in an anonymous electronic survey. Four anaphylaxis themed writing groups were formed to refine statements: (1) Population Science, (2) Basic and Translational Sciences, (3) Emergency Department Care/Acute Management, and (4) Long-Term Management Strategies and Prevention. Revised statements were incorporated into an anonymous electronic survey, and panelists were asked to rate the impact and feasibility of addressing statements on a continuous 0 to 100 scale. Results The panel generated 98 statements across the 4 anaphylaxis themes: Population Science (29), Basic and Translational Sciences (27), Emergency Department Care/Acute Management (24), and Long-Term Management Strategies and Prevention (18). Median scores for impact and feasibility ranged from 50.0 to 95.0 and from 40.0 to 90.0, respectively. Key statements based on median rating for impact/feasibility included the need to refine anaphylaxis diagnostic criteria, identify reliable diagnostic, predictive, and prognostic anaphylaxis bioassays, develop clinical prediction models to standardize postanaphylaxis observation periods and hospitalization criteria, and determine immunotherapy best practices. Conclusions We identified and systematically appraised anaphylaxis knowledge gaps and future research priorities. This study reinforces the need to harmonize scientific pursuits to optimize the outcomes of patients with and at risk of anaphylaxis.
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- 2022
18. Management of Anaphylaxis in Infants and Toddlers
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Julie Wang and Nicole B. Ramsey
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INSECT BITES ,Allergy ,Pediatrics ,medicine.medical_specialty ,business.industry ,digestive, oral, and skin physiology ,Immunology ,Infant ,Insect Bites and Stings ,Allergens ,medicine.disease ,Food ,Food allergy ,Child, Preschool ,medicine ,Humans ,Immunology and Allergy ,Epinephrine autoinjector ,Toddler ,Medical prescription ,Differential diagnosis ,business ,Anaphylaxis ,Food Hypersensitivity - Abstract
Anaphylaxis is a systemic allergic reaction that can be caused by food, drugs, insect bites, or unknown triggers in infants and toddlers. Anaphylaxis rates are increasing. Infants and toddlers may have increased exposure to known and unknown allergens, decreased ability to describe their symptoms, and an expanded differential diagnosis for consideration on presentation. The most common symptoms in these age groups are cutaneous and gastrointestinal. Age-specific language may be helpful for caregivers to identify and describe the symptoms of anaphylaxis in infants and toddlers. Long-term management of anaphylaxis includes allergy evaluation to guide avoidance and assess prognosis and education on allergic reaction management; this incorporates the prescription of epinephrine autoinjector and provision of an allergy emergency plan.
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- 2022
19. Children and caregiver proxy quality of life from peanut oral immunotherapy trials
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Audrey Dunn Galvin, Andrea Vereda, Pablo Rodríguez del Río, Antonella Muraro, Carla Jones, Robert Ryan, David Norval, Jennifer Jobrack, Aikaterini Anagnostou, and Julie Wang
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Pulmonary and Respiratory Medicine ,Immunology ,Immunology and Allergy - Abstract
Health-related quality of life (HRQoL) is significantly and substantially reduced in individuals with peanut allergy due to many factors associated with unanticipated or potentially fatal reactions. Further insight on the impact of peanut oral immunotherapy in managing peanut allergy on HRQoL is needed. The aim of this analysis was to assess effects of peanut (Arachis hypogaea) allergen powder-dnfp (PTAH), a biologic drug for peanut oral immunotherapy, on HRQoL from three phase 3 and two follow-on trials of PTAH.HRQoL assessments from participants aged 4-17 in the PALISADE (ARC003), ARC004 (PALISADE follow-on), ARTEMIS (ARC010), RAMSES (ARC007), and ARC011 (RAMSES follow-on) trials were included in this analysis. Responses on the Food Allergy Quality of Life Questionnaire (FAQLQ) and Food Allergy Independent Measure (FAIM) were evaluated by age group and respondent (self or caregiver proxy). Data were analyzed with descriptive statistics and Student t tests.Baseline FAQLQ and FAIM total scores appeared comparable between PTAH- and placebo-treated participants. Self and caregiver proxy-reported total scores on the FAQLQ for PTAH-treated participants generally improved at trial exit versus baseline; FAIM total scores improved throughout all trials. The tendency for improvement in FAQLQ total scores from baseline for PTAH appeared larger in self versus caregiver proxy-reports. Between treatment groups, PTAH was generally favored in the PALISADE and ARTEMIS trials; differences varied in the RAMSES trial based on age and respondent types.PTAH for the management of peanut allergy in children appeared to have a beneficial effect on HRQoL in trials. Improvements were seen despite rigors of trial participation.
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- 2022
20. The Joint Task Force on Practice Parameters GRADE Guidelines for the Medical Management of Chronic Rhinosinusitis with Nasal Polyposis
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Matthew A. Rank, Derek K. Chu, Antonio Bognanni, Paul Oykhman, Jonathan A. Bernstein, Anne K. Ellis, David B.K. Golden, Matthew Greenhawt, Caroline C. Horner, Dennis K. Ledford, Jay Lieberman, Amber U. Luong, Richard R. Orlandi, Shefali A. Samant, Marcus S. Shaker, Zachary M. Soler, Whitney W. Stevens, David R. Stukus, Julie Wang, and Anju T. Peters
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Immunology ,Immunology and Allergy - Abstract
These evidence-based guidelines support patients, clinicians, and other stakeholders in decisions about the use of intranasal corticosteroids (INCS), biologics, and aspirin therapy after desensitization (ATAD) for the management of chronic rhinosinusitis with nasal polyposis (CRSwNP). It is important to note that the current evidence on surgery for CRSwNP was not assessed for this guideline, nor were management options other than INCS, biologics, and ATAD. The Allergy-Immunology Joint Task Force on Practice Parameters formed a multidisciplinary guideline panel balanced to include the views of multiple stakeholders and to minimize potential biases. Systematic reviews for each management option informed the guideline. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to inform and develop recommendations. The guideline panel reached consensus on the following statements: (1) In people with CRSwNP, the guideline panel suggests INCS rather than no INCS (conditional recommendation, low certainty of evidence) (2) In people with CRSwNP, the guideline panel suggests biologics rather than no biologics (conditional recommendation, moderate certainty of evidence) (3) In people with aspirin (nonsteroidal anti-inflammatory drug) exacerbated respiratory disease, the guideline panel suggests ATAD rather than no ATAD (conditional recommendation, moderate certainty of evidence). The conditions for each recommendation are discussed in the guideline.
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- 2022
21. TGF-β-induced CD4+ FoxP3+ regulatory T cell-derived extracellular vesicles modulate Notch1 signaling through miR-449a and prevent collagen-induced arthritis in a murine model
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Julie Wang, Feng Huang, Xiaorong Lin, Yuluan Hou, Rongzhen Liang, Xiaojiang Hu, Nancy J. Olsen, Song Guo Zheng, Jingrong Chen, and Jun Zhao
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Regulatory T cell ,Immunology ,Arthritis ,medicine.disease_cause ,T-Lymphocytes, Regulatory ,Article ,Autoimmunity ,Arthritis, Rheumatoid ,Immunomodulation ,Extracellular Vesicles ,Mice ,Transforming Growth Factor beta ,In vivo ,medicine ,Animals ,Immunology and Allergy ,Receptor, Notch1 ,Gene knockdown ,Effector ,Chemistry ,FOXP3 ,Forkhead Transcription Factors ,medicine.disease ,Arthritis, Experimental ,In vitro ,Cell biology ,Mice, Inbred C57BL ,Disease Models, Animal ,MicroRNAs ,Infectious Diseases ,medicine.anatomical_structure ,Mice, Inbred DBA ,CD4 Antigens ,Signal Transduction - Abstract
CD4(+)FOXP3(+) Treg cells are central to the maintenance of self-tolerance and can be defective in autoimmunity. In autoimmune rheumatic diseases, dysfunctional self-tolerance, is to a large extent, caused by insufficient Treg-cell activity. Although nTregs have therapeutic effects in vivo, their relative scarcity and slow rate of in vitro expansion hinder the application of nTreg therapy. It was previously reported that EVs contribute significantly to the suppressive function of FOXP3(+) Treg cells. Considering that the stability and plasticity of nTregs remain major challenges in vivo, we established EVs derived from in vitro TGF-β-induced Treg cells (iTreg-EVs) and assessed their functions in a murine model of autoimmune arthritis. The results demonstrated that iTreg-EVs preferentially homed to the pathological joint and efficiently prevented the imbalance in Th17/Treg cells in arthritic mice. Furthermore, we found that miR-449a-5p mediated Notch1 expression modulation and that miR-449a-5p knockdown abolished the effects of iTreg-EVs on effector T cells and regulatory T cells in vitro and in vivo. Taken together, our results show that iTreg-EVs control the inflammatory responses of recipient T cells through miR-449a-5p-dependent modulation of Notch1 and ameliorate the development and severity of arthritis, which may provide a potential cell-free strategy based on manipulating iTreg-EVs to prevent autoimmune arthritis.
- Published
- 2021
22. Invasion theory as a management tool for increasing native biodiversity in urban ecosystems
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Luke J. Potgieter, J. Scott MacIvor, Marc W. Cadotte, and Chih Julie Wang
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0106 biological sciences ,Geography ,Ecology ,business.industry ,010604 marine biology & hydrobiology ,Environmental resource management ,Biodiversity ,Urban ecosystem ,business ,010603 evolutionary biology ,01 natural sciences ,Novel ecosystem ,Management tool - Published
- 2021
23. Air quality and children allergic diseases and neurodevelopmental disorders - A nationwide birth cohort follow-up approach
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Shu-Li (Julie) Wang, Chong-Shiow Wang, Tsung Lin Tsai, and Chih-Da Wu
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General Earth and Planetary Sciences ,General Environmental Science - Published
- 2022
24. Sex-specific associations between prenatal exposure to phthalates and neurocognitive development in Taiwanese children: Application of environmental mixture methods to small study sample
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Juwel Rana, Stefano Renzetti, Shu-Li (Julie) Wang, Alexander Keil, and Youssef Oulhote
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General Earth and Planetary Sciences ,General Environmental Science - Published
- 2022
25. Diversity, Equity, and Inclusion: A Decade of Progress?
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Bridgette L. Jones, Melody C. Carter, Carla M. Davis, and Julie Wang
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Immunology and Allergy - Abstract
The concepts of diversity, equity, and inclusion are fundamental and more recently heavily discussed within medicine, research, and the larger society. There is increasing awareness that diversity of thoughts, perspectives, and backgrounds yields stronger teams and more effective results. There is also increasing awareness that stark inequities from systemic, institutional, and individual levels exist that limit the baseline opportunities for many populations. To close disparity gaps, broad aspects of diversity and promoting equity are required and efforts must be inclusive of those most marginalized. In this Clinical Commentary, we discuss, "How and If progress has been made in Diversity, Equity, Inclusion within the field of Allergy/Asthma/Immunology in the past decade?" We discuss the current state of clinical practice and what has been revealed over the past 10 years; describe our current workforce and what progress has or has not occurred there; and finally, review the state of scientific and medical research.
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- 2022
26. Durvalumab plus Gemcitabine and Cisplatin in Advanced Biliary Tract Cancer
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Do-Youn Oh, Aiwu Ruth He, Shukui Qin, Li-Tzong Chen, Takuji Okusaka, Arndt Vogel, Jin Won Kim, Thatthan Suksombooncharoen, Myung Ah Lee, Masayuki Kitano, Howard Burris, Mohamed Bouattour, Suebpong Tanasanvimon, Mairéad G. McNamara, Renata Zaucha, Antonio Avallone, Benjamin Tan, Juan Cundom, Choong-kun Lee, Hidenori Takahashi, Masafumi Ikeda, Jen-Shi Chen, Julie Wang, Mallory Makowsky, Nana Rokutanda, Philip He, John F. Kurland, Gordon Cohen, and Juan W. Valle
- Published
- 2022
27. Overall haemostatic potential (OHP) assay can risk stratify for venous thromboembolism recurrence in anticoagulated patients
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Julie Wang, Hui Yin Lim, Rowena Brook, Jeffrey Lai, Harshal Nandurkar, and Prahlad Ho
- Subjects
Hematology ,Cardiology and Cardiovascular Medicine - Abstract
Assessing the risk of recurrent venous thromboembolism (VTE), particularly when patients are anticoagulated, remains a major challenge largely due to the lack of biomarkers. Blood was sampled from adult VTE patients recruited between January 2018 and September 2020, while receiving therapeutic anticoagulation. Results were compared to 144 healthy subjects (34.7% male, median age 42 years). Overall haemostatic potential (OHP) assay, a spectrophotometric assay, was performed on platelet-poor plasma, in which fibrin formation (triggered by small amounts of thrombin (overall coagulation potential, OCP)) and fibrinolysis (by the addition of thrombin and tissue plasminogen activator (OHP)) are simultaneously measured. Results were obtained from 196 patients (52.6% male, mean age 57.1 years). Compared to healthy subjects, VTE patients displayed significantly higher OCP (39.6 vs 34.5 units, p th percentile (recurrence rate 4.32/100 patient-years (100PY), 95% confidence interval (CI) 2.39–7.80, p = 0.002). Of 97 patients who subsequently discontinued anticoagulation, all unprovoked VTE recurrences (n = 9) occurred above the 40th OCP percentile (recurrence rate 9.10/100PY, 95% CI 4.74–17.49, p = 0.005) and the 40th OHP percentile (recurrence rate 8.46/100PY, 95% CI 4.40–16.25, p = 0.009). Our pilot study demonstrates that the OHP assay can detect a hypercoagulable and hypofibrinolytic state in anticoagulated VTE patients and may be able to risk stratify VTE recurrence, allowing for more individualised decision on long-term anticoagulation. Further larger prospective studies are required.
- Published
- 2022
28. Conducting Polymer-Coated Carbon Cloth Captures and Releases Extracellular Vesicles by a Rapid and Controlled Redox Process
- Author
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Jesna Ashraf, Alireza Akbarinejad, Colin L. Hisey, Devon T. Bryant, Julie Wang, Bicheng Zhu, Clive W. Evans, David E. Williams, Lawrence W. Chamley, David Barker, Lisa I. Pilkington, and Jadranka Travas-Sejdic
- Subjects
General Materials Science - Abstract
Electrochemical techniques offer great opportunities for the capture of chemical and biological entities from complex mixtures and their subsequent release into clean buffers for analysis. Such methods are clean, robust, rapid, and compatible with a wide range of biological fluids. Here, we designed an electrochemically addressable system, based on a conducting terpolymer [P(EDOT
- Published
- 2022
29. Reply to 'How to deconstruct 'race' and spirometry'
- Author
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Nicole B. Ramsey, Andrea J. Apter, Elliot Israel, Margee M. Louisias, Lenora M. Noroski, Sharmilee M. Nyenhuis, Princess U. Ogbogu, Tamara T. Perry, Julie Wang, and Carla M. Davis
- Subjects
Spirometry ,Forced Expiratory Volume ,Immunology and Allergy ,Humans - Published
- 2022
30. Health disparities in allergic and immunologic conditions in racial and ethnic underserved populations: A Work Group Report of the AAAAI Committee on the Underserved
- Author
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Elsie C. Morris, Michael B. Foggs, Andrea J. Apter, Carla M. Davis, Anil Nanda, Cheryl Lynn Walker-McGill, Tamara T. Perry, Princess U. Ogbogu, Julie Wang, Adrian Casillas, Michael R. Nelson, and Margee Louisias
- Subjects
medicine.medical_specialty ,education ,Immunology ,Ethnic group ,Health Services Accessibility ,03 medical and health sciences ,Underserved Population ,0302 clinical medicine ,Quality of life (healthcare) ,030225 pediatrics ,parasitic diseases ,Health care ,Ethnicity ,Hypersensitivity ,Humans ,Immunology and Allergy ,Medicine ,Social determinants of health ,Healthcare Disparities ,Socioeconomic status ,business.industry ,Health Status Disparities ,United States ,Health equity ,030228 respiratory system ,Family medicine ,business ,Patient education - Abstract
Health disparities are health differences linked with economic, social, and environmental disadvantage. They adversely affect groups that have systematically experienced greater social or economic obstacles to health. Renewed efforts are needed to reduced health disparities in the United States, highlighted by the disparate impact on racial minorities during the coronavirus pandemic. Institutional or systemic patterns of racism are promoted and legitimated through accepted societal standards, and organizational processes within the field of medicine, and contribute to health disparities. Herein, we review current evidence regarding health disparities in allergic rhinitis, asthma, atopic dermatitis, food allergy, drug allergy, and primary immune deficiency disease in racial and ethnic underserved populations. Best practices to address these disparities involve addressing social determinants of health and adopting policies to improve access to specialty care and treatment for the underserved through telemedicine and community partnerships, cross-cultural provider training to reduce implicit bias, inclusion of underserved patients in research, implementation of culturally competent patient education, and recruitment and training of health care providers from underserved communities. Addressing health disparities requires a multilevel approach involving patients, health providers, local agencies, professional societies, and national governmental agencies.
- Published
- 2021
31. Prevention and management of allergic reactions to food in child care centers and schools: Practice guidelines
- Author
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Jonathan O'b Hourihane, Richard Loh, Carlos A. Cuello-Garcia, Jan Brozek, Derek K. Chu, Lana Rosenfield, Lisa Galloway, David Fahmy, Greg Gartrell, Brenda Weitzner, Kyla J. Hildebrand, Susan Waserman, Michael Langlois, Nicola Hamilton, David Fleischer, Mimi L.K. Tang, Theresa Bingemann, Douglas G. Mack, Julie Wang, Sally Schoessler, Heather Cruickshank, Motohiro Ebisawa, Antonella Muraro, Laura Bantock, and Matthew Greenhawt
- Subjects
medicine.medical_specialty ,Child care ,business.industry ,media_common.quotation_subject ,Selected interventions ,Immunology ,Psychological intervention ,medicine.disease ,Health equity ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Food allergy ,Family medicine ,medicine ,Immunology and Allergy ,Health education ,Quality (business) ,030212 general & internal medicine ,business ,Grading (education) ,media_common - Abstract
Food allergy management in child care centers and schools is a controversial topic, for which evidence-based guidance is needed. Following the Grading of Recommendations Assessment, Development, and Evaluation approach, we conducted systematic literature reviews of the anticipated health effects of selected interventions for managing food allergy in child care centers and schools; we compiled data about the costs, feasibility, acceptability, and effects on health equity of the selected interventions; and we developed the following conditional recommendations: we suggest that child care centers and schools implement allergy training and action plans; we suggest that they use epinephrine (adrenaline) to treat suspected anaphylaxis; we suggest that they stock unassigned epinephrine autoinjectors, instead of requiring students to supply their own personal autoinjectors to be stored on site for designated at-school use; and we suggest that they do not implement site-wide food prohibitions (eg, "nut-free" schools) or allergen-restricted zones (eg, "milk-free" tables), except in the special circumstances identified in this document. The recommendations are labeled "conditional" due to the low quality of available evidence. More research is needed to determine with greater certainty which interventions are likely to be the most beneficial. Policymakers might need to adapt the recommendations to fit local circumstances.
- Published
- 2021
32. Assessment of Maternal and Neonatal Cord Blood SARS-CoV-2 Antibodies and Placental Transfer Ratios
- Author
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Shouling Zhang and Julie Wang
- Subjects
Pediatrics, Perinatology and Child Health - Published
- 2022
33. A Synopsis of the Synopses, 2021–2022
- Author
-
Julie Wang
- Subjects
Pediatrics, Perinatology and Child Health - Published
- 2022
34. Laboratory markers of severity across three COVID-19 outbreaks in Australia: has Omicron and vaccinations changed disease presentation?
- Author
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Julie Wang, Kay Weng Choy, Hui Yin Lim, and Prahlad Ho
- Subjects
Emergency Medicine ,Internal Medicine - Abstract
COVID-19 has rapidly evolved since it was first discovered in December 2019. We aimed to retrospectively review our experience with COVID-19 infection across 2020–2022, focusing on differences in laboratory markers at presentation. Consecutive adult patients admitted to hospital with confirmed COVID-19 infection were retrospectively reviewed across three periods (29/3/2020–29/9/2020, 16/8/2021–13/10/2021 and 1/1/2022–31/1/2022), correlating with the lineages B.1.338, Delta (B.1.617.2) and Omicron (B.1.1.159), respectively. Laboratory findings of the first requested blood test within 24 h of presentation were recorded and correlated with patient outcome. The primary outcome was requirement for oxygen therapy at any point. Inflammatory markers, namely serum ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP) were significantly lower on presentation during 2022 compared to 2021, corresponding to a milder disease course. More than 80% of 2022 patients had received 2 or more vaccine doses and fully vaccinated patients displayed significantly lower inflammatory markers at presentation. Using 2022 data, a multivariate prediction model was constructed to predict for oxygen requirement, with c-statistic 0.86. Patients in 2022, corresponding with the Omicron variant, displayed a milder disease course, even in hospitalised patients, with the majority not requiring oxygen and lower inflammatory markers. We constructed a simple-to-use risk prediction model with c-statistic 0.86 which may identify individuals who can be safely managed as outpatients in the era of highly transmissible variants.
- Published
- 2022
35. Allergen recognition by specific effector Th2 cells enables IL-2-dependent activation of regulatory T cell responses in humans
- Author
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Daniel Lozano‐Ojalvo, Scott R. Tyler, Carlos J. Aranda, Julie Wang, Scott Sicherer, Hugh A. Sampson, Robert A. Wood, A. Wesley Burks, Stacie M. Jones, Donald Y. M. Leung, Maria Curotto de Lafaille, M. Cecilia Berin, and National Institutes of Health (US)
- Subjects
Immunology ,Immunology and Allergy - Abstract
medRxiv preprint, Type 2 allergen-specific T cells are essential for the induction and maintenance of allergies to foods, and Tregs specific for these allergens are assumed to be involved in their resolution. However, it has not been convincingly demonstrated whether allergen-specific Treg responses are responsible for the generation of oral tolerance in humans. We observed that sustained food allergen exposure in the form of oral immunotherapy resulted in increased frequency of Tregs only in individuals with lasting clinical tolerance. We sought to identify regulatory components of the CD4+ T-cell response to food allergens by studying their functional activation over time in vitro and in vivo. Two subsets of Tregs expressing CD137 or CD25/OX40 were identified with a delayed kinetics of activation compared with clonally enriched pathogenic effector Th2 cells. Treg activation was dependent on IL-2 derived from effector T cells. In vivo exposure to peanut in the form of an oral food challenge of allergic subjects induced a delayed and persistent activation of Tregs after initiation of the allergen-specific Th2 response. The novel finding of our work is that a sustained wave of Treg activation is induced by the release of IL-2 from Th2 effector cells, with the implication that therapeutic administration of IL-2 could improve current OIT approaches., We thank A. Grishin and M. Masilamani for their leadership of laboratory studies of CoFAR7. We thank the staff of the clinical research units at each participating center, the Statistical and Clinical Coordinating Center, and K. Peyton, the SACCC Project Manager. We thank J. Poyser, Project Manager for CoFAR7 Program (National Institutes of Health [NIH]/National Institute of Allergy and Infectious Diseases [NIAID]). Finally, we thank the families who kindly participated.
- Published
- 2022
36. Neuropilin-1 Identifies a New Subpopulation of TGF-β-Induced Foxp3+ Regulatory T Cells With Potent Suppressive Function and Enhanced Stability During Inflammation
- Author
-
Weiqian Chen, Weishan Huang, Youqiu Xue, Ye Chen, Wenbin Qian, Jilin Ma, Avery August, Julie Wang, Song Guo Zheng, and Jin Lin
- Subjects
Immunology ,Immunology and Allergy - Abstract
CD4+Foxp3+ regulatory T cells (Tregs) play a crucial role in preventing autoimmunity and inflammation. There are naturally-derived in the thymus (tTreg), generated extrathymically in the periphery (pTreg), and induced in vitro culture (iTreg) with different characteristics of suppressiveness, stability, and plasticity. There is an abundance of published data on neuropilin-1 (Nrp-1) as a tTreg marker, but little data exist on iTreg. The fidelity of Nrp-1 as a tTreg marker and its role in iTreg remains to be explored. This study found that Nrp-1 was expressed by a subset of Foxp3+CD4+T cells in the central and peripheral lymphoid organs in intact mice, as well as in iTreg. Nrp-1+iTreg and Nrp-1-iTreg were adoptively transferred into a T cell-mediated colitis model to determine their ability to suppress inflammation. Differences in gene expression between Nrp-1+ and Nrp-1-iTreg were analyzed by RNA sequencing. We demonstrated that the Nrp-1+ subset of the iTreg exhibited enhanced suppressive function and stability compared to the Nrp-1- counterpart both in vivo and in vitro, partly depending on IL-10. We found that Nrp-1 is not an exclusive marker of tTreg, however, it is a biomarker identifying a new subset of iTreg with enhanced suppressive function, implicating a potential for Nrp-1+iTreg cell therapy for autoimmune and inflammatory diseases.
- Published
- 2022
37. Allergen immunotherapy for atopic dermatitis: Systematic review and meta-analysis of benefits and harms
- Author
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Juan José Yepes-Nuñez, Gordon H. Guyatt, Luis Guillermo Gómez-Escobar, Lucia C. Pérez-Herrera, Alexandro W.L. Chu, Renata Ceccaci, Ana Sofía Acosta-Madiedo, Aaron Wen, Sergio Moreno-López, Margaret MacDonald, Mónica Barrios, Xiajing Chu, Nazmul Islam, Ya Gao, Melanie M. Wong, Rachel Couban, Elizabeth Garcia, Edgardo Chapman, Paul Oykhman, Lina Chen, Tonya Winders, Rachel Netahe Asiniwasis, Mark Boguniewicz, Anna De Benedetto, Kathy Ellison, Winfred T. Frazier, Matthew Greenhawt, Joey Huynh, Elaine Kim, Jennifer LeBovidge, Mary Laura Lind, Peter Lio, Stephen A. Martin, Monica O’Brien, Peck Y. Ong, Jonathan I. Silverberg, Jonathan Spergel, Julie Wang, Kathryn E. Wheeler, Lynda Schneider, and Derek K. Chu
- Subjects
Immunology ,Immunology and Allergy - Abstract
Atopic dermatitis (AD, eczema) is driven by a combination of skin barrier defects, immune dysregulation, and extrinsic stimuli such as allergens, irritants, and microbes. The role of environmental allergens (aeroallergens) in triggering AD remains unclear.We systematically synthesized evidence regarding the benefits and harms of allergen immunotherapy (AIT) for AD.As part of the 2022 American Academy of Allergy, AsthmaImmunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters AD Guideline update, we searched the MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Global Resource for Eczema Trials, and Web of Science databases from inception to December 2021 for randomized controlled trials comparing subcutaneous immunotherapy (SCIT), sublingual immunotherapy (SLIT), and/or no AIT (placebo or standard care) for guideline panel-defined patient-important outcomes: AD severity, itch, AD-related quality of life (QoL), flares, and adverse events. Raters independently screened, extracted data, and assessed risk of bias in duplicate. We synthesized intervention effects using frequentist and Bayesian random-effects models. The GRADE approach determined the quality of evidence.Twenty-three randomized controlled trials including 1957 adult and pediatric patients sensitized primarily to house dust mite showed that add-on SCIT and SLIT have similar relative and absolute effects and likely result in important improvements in AD severity, defined as a 50% reduction in SCORing Atopic Dermatitis (risk ratio [95% confidence interval] 1.53 [1.31-1.78]; 26% vs 40%, absolute difference 14%) and QoL, defined as an improvement in Dermatology Life Quality Index by 4 points or more (risk ratio [95% confidence interval] 1.44 [1.03-2.01]; 39% vs 56%, absolute difference 17%; both outcomes moderate certainty). Both routes of AIT increased adverse events (risk ratio [95% confidence interval] 1.61 [1.44-1.79]; 66% with SCIT vs 41% with placebo; 13% with SLIT vs 8% with placebo; high certainty). AIT's effect on sleep disturbance and eczema flares was very uncertain. Subgroup and sensitivity analyses were consistent with the main findings.SCIT and SLIT to aeroallergens, particularly house dust mite, can similarly and importantly improve AD severity and QoL. SCIT increases adverse effects more than SLIT. These findings support a multidisciplinary and shared decision-making approach to optimally managing AD.
- Published
- 2022
38. Individualised Risk Assessments for Recurrent Venous Thromboembolism: New Frontiers in the Era of Direct Oral Anticoagulants
- Author
-
Prahlad Ho, Hui Yin Lim, and Julie Wang
- Subjects
medicine.medical_specialty ,business.industry ,030204 cardiovascular system & hematology ,equipment and supplies ,Individual level ,Recurrence risk ,03 medical and health sciences ,Safety profile ,0302 clinical medicine ,Anticoagulant therapy ,030220 oncology & carcinogenesis ,Medicine ,cardiovascular diseases ,business ,Intensive care medicine ,Risk assessment ,Venous thromboembolism - Abstract
Venous thromboembolism (VTE) is a leading cause of morbidity and mortality and is associated with high recurrence rates. The introduction of direct oral anticoagulants (DOACs) in the 2010s has changed the landscape of VTE management. DOACs have become the preferred anticoagulant therapy for their ease of use, predictable pharmacokinetics, and improved safety profile. Increasingly, guidelines have recommended long term anticoagulation for some indications such as following first unprovoked major VTE, although an objective individualised risk assessment for VTE recurrence remains elusive. The balance of preventing VTE recurrence needs to be weighed against the not insignificant bleeding risk, which is cumulative with prolonged use. Hence, there is a need for an individualised, targeted approach for assessing the risk of VTE recurrence, especially in those patients in whom the balance between benefit and risk of long-term anticoagulation is not clear. Clinical factors alone do not provide the level of discrimination required on an individual level. Laboratory data from global coagulation assays and biomarkers may provide enhanced risk assessment ability and are an active area of research. A review of the prediction models and biomarkers for assessing VTE recurrence risk is provided, with an emphasis on contemporary developments in the era of DOACs and global coagulation assays.
- Published
- 2021
39. Food-Induced Anaphylaxis in Infants: Can New Evidence Assist with Implementation of Food Allergy Prevention and Treatment?
- Author
-
Angela Tsuang, Edmond S. Chan, and Julie Wang
- Subjects
medicine.medical_specialty ,Allergy ,business.industry ,Oral food challenge ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Food allergy ,Immunology and Allergy ,Medicine ,Anxiety ,Observational study ,Epinephrine autoinjector ,030212 general & internal medicine ,medicine.symptom ,business ,Intensive care medicine ,Psychosocial ,Anaphylaxis - Abstract
Previous guidance on infant anaphylaxis largely relied on data from older children and adults. Infants are a unique subgroup, which presents specific challenges because infants are unable to verbalize symptoms, although the magnitude of underrecognition is not well studied. Data show that strict avoidance of allergens is difficult to achieve in the infant age group and a source of stress and anxiety for their caregivers. Recent studies suggest that infant anaphylaxis is less severe than in older children, which could greatly assist with implementation of food allergy prevention and treatment. New evidence from clinical trials and observational and real-world studies show that infant anaphylaxis is rare on first ingestion of a new food and typically not severe when it occurs, which parents may not be aware of when preparing to introduce peanut or other common food allergens to infants for the purpose of prevention. The better safety and efficacy of oral immunotherapy in infants and preschoolers could help prevent undesired psychosocial consequences of longstanding food allergy such as anxiety, bullying, and poor quality of life. Evidence from recent years on the lower risk of infant anaphylaxis and its severity could move allergy practice toward the confidence that regular, long-term ingestion provides.
- Published
- 2021
40. Values and Preferences of Patients and Caregivers Regarding Treatment of Atopic Dermatitis (Eczema)
- Author
-
Keon Andre Maleki-Yazdi, Anja Fog Heen, Irene X. Zhao, Gordon H. Guyatt, Erica A. Suzumura, Nima Makhdami, Lina Chen, Tonya Winders, Kathryn E. Wheeler, Julie Wang, Jonathan Spergel, Jonathan I. Silverberg, Peck Y. Ong, Monica O’Brien, Stephen A. Martin, Peter A. Lio, Mary Laura Lind, Jennifer LeBovidge, Elaine Kim, Joey Huynh, Matthew Greenhawt, Winfred T. Frazier, Kathy Ellison, Korey Capozza, Anna De Benedetto, Mark Boguniewicz, Wendy Smith Begolka, Rachel Netahe Asiniwasis, Lynda C. Schneider, and Derek K. Chu
- Subjects
Dermatology - Abstract
ImportancePatient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available.ObjectiveTo inform American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters AD guideline development, patient and caregiver values and preferences in the management of AD were systematically synthesized.Evidence ReviewPaired reviewers independently screened MEDLINE, Embase, PsycINFO, and CINAHL databases from inception until March 20, 2022, for studies of patients with AD or their caregivers, eliciting values and preferences about treatment, rated risk of bias, and extracted data. Thematic and inductive content analysis to qualitatively synthesize the findings was used. Patients, caregivers, and clinical experts provided triangulation. The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative Research) informed rating of the quality of evidence.FindingsA total of 7780 studies were identified, of which 62 proved eligible (n = 19 442; median age across studies [range], 15 years [3-44]; 59% female participants). High certainty evidence showed that patients and caregivers preferred to start with nonmedical treatments and to step up therapy with increasing AD severity. Moderate certainty evidence showed that adverse effects from treatment were a substantial concern. Low certainty evidence showed that patients and caregivers preferred odorless treatments that are not visible and have a minimal effect on daily life. Patients valued treatments capable of relieving itching and burning skin and preferred to apply topical corticosteroids sparingly. Patients valued a strong patient-clinician relationship. Some studies presented varied perspectives and 18 were at high risk for industry sponsorship bias.Conclusions and RelevanceIn the first systematic review to address patient values and preferences in management of AD to our knowledge, 6 key themes that may inform optimal clinical care, practice guidelines, and future research have been identified.
- Published
- 2023
41. Inhibition of Pathologic Immunoglobulin E In Food Allergy by EBF2 and Active Compound Berberine Associated with Immunometabolism Regulation
- Author
-
Anish Maskey, Nan Yang, Monica Kim, Kamal Srivastava, Zixi Wang, Yanmei Shi, Yixuan Gong, Julie Wang, David Dunkin, Danna Chung, Jixun Zhan, Mingsan Miao, Hugh Sampson, and Xiu-Min Li
- Subjects
Immunology ,Immunology and Allergy - Published
- 2023
42. CD4+CD126low/− Foxp3+ Cell Population Represents a Superior Subset of Regulatory T Cells in Treating Autoimmune Diseases
- Author
-
Ye Chen, Miller Joseph, Ning Na, Nancy J. Olsen, Bin Li, Anping Xu, Willa A. Hsueh, Julie Wang, Rongzhen Liang, Ruoning Wang, Zhenjian Xu, and Song Guo Zheng
- Subjects
Population ,Cell ,Arthritis ,chemical and pharmacologic phenomena ,Inflammation ,Biology ,03 medical and health sciences ,0302 clinical medicine ,Drug Discovery ,Genetics ,medicine ,education ,Molecular Biology ,030304 developmental biology ,Pharmacology ,0303 health sciences ,education.field_of_study ,FOXP3 ,Interleukin ,hemic and immune systems ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Interleukin-6 receptor ,Immunology ,Molecular Medicine ,medicine.symptom ,Homeostasis - Abstract
CD4+Foxp3+ regulatory T (Treg) cells are crucial for maintaining homeostasis and preventing autoimmune diseases. Nonetheless, we and others have previously reported that natural Treg cells are unstable and dysfunctional in the inflamed environment with a high-salt diet, limiting the Treg function in disease control. In this study, we made an innovative observation showing a high degree of heterogeneity within the Treg pool. We identified that CD126, interleukin (IL)-6 receptor alpha chain, contributed to Treg cell instability. Using a series of in vitro and in vivo experimental approaches, we demonstrated that CD126Lo/− Treg cells presented greater function and were more stable than CD126Hi nTreg cells, even in the presence of IL-6 and inflammation. Blockade of programmed death-1 (PD-1) interrupted CD126Lo/− nTreg cell stability. Additionally, CD126Lo/− Treg cells can treat colitis and established collagen-induced arthritis, while the CD126Hi cell population failed to do this. Moreover, we noted that CD126 expression of Treg cells had a positive correlation to rheumatoid arthritis (RA) severity and the stability of Treg cells. Our results strongly suggest that the manipulation of CD126Lo/− nTreg cells could be a novel strategy for the treatment of autoimmune diseases and for other conditions associated with a deficit of Treg cells.
- Published
- 2020
43. Rhinitis 2020: A practice parameter update
- Author
-
Mark S, Dykewicz, Dana V, Wallace, David J, Amrol, Fuad M, Baroody, Jonathan A, Bernstein, Timothy J, Craig, Chitra, Dinakar, Anne K, Ellis, Ira, Finegold, David B K, Golden, Matthew J, Greenhawt, John B, Hagan, Caroline C, Horner, David A, Khan, David M, Lang, Desiree E S, Larenas-Linnemann, Jay A, Lieberman, Eli O, Meltzer, John J, Oppenheimer, Matthew A, Rank, Marcus S, Shaker, Jeffrey L, Shaw, Gary C, Steven, David R, Stukus, and Julie, Wang
- Subjects
Allergen immunotherapy ,medicine.medical_specialty ,medicine.drug_class ,Immunology ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Nonallergic rhinitis ,Risk Factors ,Food allergy ,Vasomotor Rhinitis ,Prevalence ,Acupuncture ,Humans ,Immunology and Allergy ,Medicine ,030223 otorhinolaryngology ,Intensive care medicine ,Montelukast ,Rhinitis ,business.industry ,Disease Management ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Decongestant ,Phenotype ,Treatment Outcome ,030228 respiratory system ,Practice Guidelines as Topic ,Ipratropium ,Quality of Life ,Disease Susceptibility ,Symptom Assessment ,business ,medicine.drug - Abstract
This comprehensive practice parameter for allergic rhinitis (AR) and nonallergic rhinitis (NAR) provides updated guidance on diagnosis, assessment, selection of monotherapy and combination pharmacologic options, and allergen immunotherapy for AR. Newer information about local AR is reviewed. Cough is emphasized as a common symptom in both AR and NAR. Food allergy testing is not recommended in the routine evaluation of rhinitis. Intranasal corticosteroids (INCS) remain the preferred monotherapy for persistent AR, but additional studies support the additive benefit of combination treatment with INCS and intranasal antihistamines in both AR and NAR. Either intranasal antihistamines or INCS may be offered as first-line monotherapy for NAR. Montelukast should only be used for AR if there has been an inadequate response or intolerance to alternative therapies. Depot parenteral corticosteroids are not recommended for treatment of AR due to potential risks. While intranasal decongestants generally should be limited to short-term use to prevent rebound congestion, in limited circumstances, patients receiving regimens that include an INCS may be offered, in addition, an intranasal decongestant for up to 4 weeks. Neither acupuncture nor herbal products have adequate studies to support their use for AR. Oral decongestants should be avoided during the first trimester of pregnancy. Recommendations for use of subcutaneous and sublingual tablet allergen immunotherapy in AR are provided. Algorithms based on a combination of evidence and expert opinion are provided to guide in the selection of pharmacologic options for intermittent and persistent AR and NAR.
- Published
- 2020
44. Age, sex and racial differences in fibrin formation and fibrinolysis within the healthy population
- Author
-
Julie Wang, Hui Y. Lim, Harshal Nandurkar, and Prahlad Ho
- Subjects
Adult ,Male ,Fibrin ,Fibrinolysis ,Hematology ,General Medicine ,Middle Aged ,Race Factors ,Young Adult ,Tissue Plasminogen Activator ,Humans ,Female ,Fibrin Clot Lysis Time ,Aged - Abstract
Increased fibrin generation and reduced fibrinolytic potential have been detected using global coagulation assays in several hypercoagulable states including cardiovascular disease and venous thromboembolism. We aimed in this study to define the impact of age, sex and race on fibrin generation and lysis using the Overall Haemostatic Potential (OHP) assay in a group of stringently defined healthy adults. Healthy adult patients not receiving anticoagulation and without a history of thrombotic disease were prospectively recruited. Iindividuals with cardiovascular risk factors (e.g. hypertension, diabetes, smoking), receiving hormonal therapy, antiplatelet agents or with abnormal routine blood tests were also excluded. Platelet-poor plasma was obtained and the OHP assay, which evaluates fibrin formation with and without tissue plasminogen activator, was performed on all plasma samples. 144 healthy subjects (34.7% male) with median age 42 years (interquartile range 20, 77) were recruited. After multivariate analysis, age at least 50 years and female sex were associated with significantly increased fibrin generation parameters (overall coagulation potential, OHP, maximum optical density, fibrin) as well as reduced markers of fibrinolysis (overall fibrinolytic potential and time-to-50% lysis). There were no significant differences in OHP parameters between whites, East Asians and South Asians after accounting for age and sex. This study defines age, sex and racial differences of fibrin generation and fibrinolysis as measured by the OHP assay in a sample of healthy subjects. Further studies are warranted in diseased populations, where there is growing awareness of the role of global coagulation assay in defining prothrombotic and hypofibrinolytic states.
- Published
- 2022
45. Reducing Health Disparities in Allergy Immunology: The Time Is Now
- Author
-
Carla M. Davis and Julie Wang
- Subjects
Allergy and Immunology ,Hypersensitivity ,Immunology and Allergy ,Humans - Published
- 2022
46. Bleach baths for atopic dermatitis: A systematic review and meta-analysis including unpublished data, Bayesian interpretation, and GRADE
- Author
-
Layla, Bakaa, Jeffrey M, Pernica, Rachel J, Couban, Kelly Jo, Tackett, Craig N, Burkhart, Liz, Leins, Joanne, Smart, Maria Teresa, Garcia-Romero, Itzel Guadalupe, Elizalde-Jiménez, Michael, Herd, Rachel Netahe, Asiniwasis, Mark, Boguniewicz, Anna, De Benedetto, Lina, Chen, Kathy, Ellison, Winfred, Frazier, Matthew, Greenhawt, Joey, Huynh, Jennifer, LeBovidge, Mary Laura, Lind, Peter, Lio, Monica, O'Brien, Peck Y, Ong, Jonathan I, Silverberg, Jonathan M, Spergel, Julie, Wang, Wendy Smith, Begolka, Lynda, Schneider, and Derek K, Chu
- Subjects
Staphylococcus aureus ,Anti-Infective Agents ,Pruritus ,Eczema ,Humans ,Baths ,Child ,Dermatitis, Atopic - Abstract
Bleach bathing is frequently recommended to treat atopic dermatitis (AD), but its efficacy and safety are uncertain.To systematically synthesize randomized controlled trials (RCTs) addressing bleach baths for AD.We searched MEDLINE, EMBASE, CENTRAL, and GREAT from inception to December 29, 2021, for RCTs assigning patients with AD to bleach vs no bleach baths. Paired reviewers independently and in duplicate screened records, extracted data, and assessed risk of bias (Cochrane version 2) and GRADE quality of evidence. We obtained unpublished data, harmonized individual patient data and did Frequentist and Bayesian random-effects meta-analyses.There were 10 RCTs that enrolled 307 participants (median of mean age 7.2 years, Eczema Area Severity Index baseline mean of means 27.57 [median SD, 10.74]) for a median of 6 weeks (range, 4-10). We confirmed that other trials registered globally were terminated. Bleach baths probably improve AD severity (22% vs 32% improved Eczema Area Severity Index by 50% [ratio of means 0.78, 95% credible interval 0.59-0.99]; moderate certainty) and may slightly reduce skin Staphylococcal aureus colonization (risk ratio, 0.89 [95% confidence interval, 0.73-1.09]; low certainty). Adverse events, mostly dry skin and irritation, along with itch, patient-reported disease severity, sleep quality, quality of life, and risk of AD flares were not clearly different between groups and of low to very low certainty.In patients with moderate-to-severe AD, bleach baths probably improve clinician-reported severity by a relative 22%. One in 10 will likely improve severity by 50%. Changes in other patient-important outcomes are uncertain. These findings support optimal eczema care and the need for additional large clinical trials.PROSPERO Identifier: CRD42021238486.
- Published
- 2022
47. List of contributors
- Author
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Nicole Akar-Ghibril, Hanadys Ale, Juan-Manuel Anaya, Karen M. Anstey, Smita Awasthi, Mary Grace Baker, Jeffrey M. Chambliss, Christopher Chang, Meng Chen, Hei Lam Helena Cheung, Maria Chitty-Lopez, Maryanne Chrisant, Ka Hou Chu, Wilfredo Cosme-Blanco, Aparna Daley, Victoria R. Dimitriades, Amy Dowden, Omar Elsayed-Ali, Elizabeth J. Feuille, Luz Fonacier, Joudeh B. Freij, Maxwell A. Fung, Armando Partida Gaytán, Xiang Ge, Jennifer Gebba, Gisoo Ghaffari, Rachel Shireen Golpanian, Kathleen Hathaway, Jennifer Heimall, Nina Hein, Angel A. Herrera Guerra, Rachel K Horton, Ke Huang, Samuel T. Hwang, David W. Kennedy, Gary Kleiner, Ahnika Kline, Lisa J. Kobrynski, Erini Nessim Kostandy, Merin Kuruvilla, Helen J. Lachmann, Wai Ching Lam, Gerald B. Lee, Joyce S. Lee, Min J. Lee, Heather K. Lehman, Jennifer W. Leiding, Stéphanie Lejeune, Nicki Y.H. Leung, Patrick S.C. Leung, Kyndra Liburd, Zoe Morgan Lipman, Qianjin Lu, Saul O. Lugo Reyes, Jonathan J. Lyons, Aiping Lyu, Richika Makol, Stephanie L. Mawhirt, Eric McGrath, Renata Medina, Kari Nadeau, Iris Nkamba, Kranthi Nomula, Peck Y. Ong, Roxanne C. Oriel, Iris M. Otani, Young Hwan Park, Rasika Patkar, Claire J. Peet, Perdita Permaul, Wanda Phipatanakul, Pavadee Poowuttikul, Lourdes Ramirez, S. Ranganathan Ganakammal, Lucas Restrepo, Marlen Rodriguez, Yhojan Rodríguez, Nevenda Velikova Rose, Nia Rush, Colleen M. Sabella, Amandeep Sandhu, Sonam Sani, Elizabeth Secord, Divya Seth, Tihong Shao, Faina Shenderov, Jennifer Shih, Shang An Shu, Scott H. Sicherer, Jessica Simpson, Jacqueline D. Squire, Panida Sriaroon, Heather Stern, Daniel D. Summerfield, JinLyu Sun, Auddie M. Sweis, Katherine L. Tison, Siena Vadakal, Kelly Valentini, Kristine Vanijcharoenkarn, Sehrish Viqar, Christine Y.Y. Wai, M. Walkiewicz, Jolan E. Walter, Julie Wang, Kristina Wiers-Shamir, Jeffrey L. Winters, Haijing Wu, S. Xirasagar, Jennifer Xu, Gil Yosipovitch, Christa Zerbe, Lidan Linda Zhong, Suqing Zhou, and Xiaoying Zhou
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- 2022
48. Oral, sublingual, and dermatologic immunotherapy for food allergy
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Mary Grace Baker and Julie Wang
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- 2022
49. Anaphylaxis: severity determination, grading systems
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Mary Grace Baker and Julie Wang
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- 2022
50. Long-term neurotoxicity and quality of life in testicular cancer survivors—a nationwide cohort study
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Josephine Rosenvilde, Gedske Daugaard, Lars Dysager, Michael Kreiberg, Julie Wang Skøtt, Mads Agerbæk, Thomas Wagner, Mikkel Bandak, and Jakob Lauritsen
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Male ,Quality of life ,Oncology ,medicine.medical_specialty ,Gynecologic oncology ,Cohort Studies ,Bleomycin ,03 medical and health sciences ,0302 clinical medicine ,Testicular Neoplasms ,Testicular cancer ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Neurotoxicity ,medicine ,Humans ,Survivors ,030212 general & internal medicine ,Etoposide ,Oncology (nursing) ,business.industry ,Cancer ,Odds ratio ,medicine.disease ,Comorbidity ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,Cisplatin ,business ,Cohort study - Abstract
Purpose: To evaluate neurotoxicity in testicular cancer survivors (TCSs) years after treatment and secondly the influence of neurotoxicity on quality-of-life (QoL). Methods: We identified 2234 TCSs who completed the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire. QoL was evaluated with the European Organization for Research and Treatment of Cancer QLQ-C30. Patients were grouped according to treatment strategy: surveillance (N = 1113), infradiaphragmatic radiotherapy (N = 301), cisplatin-etoposide-bleomycin (BEP) (N = 759), and more than one line of treatment (MTOL) (N = 61). Association of treatment modality with long-term neurotoxicity was analyzed with ordinal logistic regression. Secondly, associations between neurotoxicity and QoL were analyzed in BEP-treated patients. Analyses were age-adjusted and repeated with additional adjustment for comorbidity, smoking, and alcohol consumption. Results: After a median follow-up of 18.4 years, treatment with BEP and MTOL was associated with overall increased risk of neurotoxicity (odds ratio 2.4–4.7 depending on treatment intensity, P < 0.001) as well as subscales (peripheral neuropathy, ototoxicity, and dysfunction associated with neuropathy, all P < 0.001). Radiotherapy and surveillance were not associated with neurotoxicity. In patients treated with BEP, neurotoxicity was highly associated with all indicators of worse QoL outcomes (P-trend: 1.5 × 10−17 to 1.1 × 10−28) after almost 20 years of follow-up. Conclusions: Treatment with BEP was associated with long-term neurotoxicity, which was highly associated with decreased QoL. Strategies to ameliorate or prevent neurotoxicity should be investigated. Implications for Cancer Survivors: Treatment with chemotherapy for testicular cancer induces long-term neuro- and ototoxicity which may have severe influence on quality-of-life years after treatment cessation.
- Published
- 2020
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