6 results on '"Upton, Julia E. M."'
Search Results
2. Editorial comment on "Current options in the management of tree nut allergy: A systematic review and narrative synthesis".
- Author
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Bognanni, Antonio, Eigenmann, Philippe, and Upton, Julia E. M.
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- 2024
- Full Text
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3. Revaccination outcomes among adolescents and adults with suspected hypersensitivity reactions following COVID-19 vaccination: A Canadian immunization research network study.
- Author
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Fitzpatrick T, Yamoah P, Lacuesta G, Sadarangani M, Cook V, Pourshahnazari P, Kalicinsky C, Upton JEM, Cameron SB, Zaborniak K, Kanani A, Lam G, Burton C, Constantinescu C, Pernica JM, Abdurrahman Z, Betschel S, Drolet JP, De Serres G, Quach C, Des Roches A, Chapdelaine H, Salvadori MI, Carignan A, McConnell A, Pham-Huy A, Buchan CA, Cowan J, Hildebrand K, and Top KA
- Subjects
- Humans, Male, Female, Canada, Adult, Adolescent, Middle Aged, Young Adult, Child, Aged, SARS-CoV-2 immunology, Hypersensitivity, Drug Hypersensitivity etiology, Drug Hypersensitivity diagnosis, Vaccination adverse effects, COVID-19 Vaccines adverse effects, COVID-19 prevention & control, Immunization, Secondary adverse effects, Anaphylaxis chemically induced, Anaphylaxis etiology
- Abstract
Background: COVID-19 vaccination has been associated with anaphylaxis and hypersensitivity reactions. Infectious disease physicians and allergists in the Canadian Special Immunization Clinic (SIC) Network developed guidance for evaluating patients with adverse events following immunization (AEFI) including suspected hypersensitivity. This study evaluated management and adverse event recurrence following subsequent COVID-19 vaccinations., Methods: Individuals aged 12 years and older enrolled at participating SICs before February 28, 2023 who were referred for suspected or diagnosed hypersensitivity reaction following COVID-19 vaccination, or for prevaccination assessment of suspected allergy to a COVID-19 vaccine component were included. De-identified clinical assessments and revaccination data, captured in a centralized database, were analyzed. The Brighton Collaboration case definition (BCCD) for anaphylaxis (2023 version) was applied., Results: The analysis included 206 participants from 13 sites: 26 participants referred for pre-vaccination assessment and 180 participants referred for adverse events following COVID-19 vaccination (15/180 [8.3%] with BCCD confirmed anaphylaxis, 84 [46.7%] with immediate hypersensitivity symptoms not meeting BCCD, 33 [18.3%] with other diagnosed hypersensitivity reactions, and 48 [26.7%] participants with a final diagnosis of non-hypersensitivity AEFI). Among participants referred for AEFIs following COVID-19 vaccination, 166/180 (92.2%) were recommended for COVID-19 revaccination after risk assessment, of whom 158/166 (95.2%) were revaccinated (all with a COVID-19 mRNA vaccine). After revaccination, 1/15 (6.7%) participants with prior anaphylaxis, 1/77 (1.3%) with immediate hypersensitivity not meeting criteria for anaphylaxis and 1/24 (4.2%) with other physician diagnosed hypersensitivity developed recurrent AEFI symptoms that met the BCCD for anaphylaxis. All 26 participants referred pre-vaccination, including 9 (34.6%) with history of polyethylene glycol-asparaginase reactions, were vaccinated without occurrence of immediate hypersensitivity symptoms., Conclusions: Most individuals in this national cohort who experienced a hypersensitivity event following COVID-19 vaccination and were referred for specialist review were revaccinated without AEFI recurrence, suggesting that specialist evaluation can facilitate safe revaccination., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MS has been an investigator on projects funded by GlaxoSmithKline, Merck, Moderna, Pfizer, and Sanofi-Pasteur; all funds have been paid to his institute, and he has not received any personal payments. VC received honoraria from Pfizer, Aralez pharmaceuticals and CSL Behring financial support for publication from CSL Behring. JEMU reports advisory board for Pfizer, clinical trials with Sanofi, and other from Novartis, all outside the current work. KZ reports honoraria from AstraZeneca and Regeneron. JMP is an investigator on projects funded by MedImmune and Merck; all funds have been paid to his institute, and he has not received any personal payments. ZA reports honoraria for speaker fees for Pfizer outside of the submitted work. AM received honoraria for presentations from Pfizer and Sanofi. ADR participated in multicentric studies with ALK for sublingual immunotherapy as investigator. AC received honoraria for presentations from Pfizer, AstraZeneca, GlaxoSmithKline and Moderna. JC received honoraria for presentations from Pfizer, AstraZeneca, and GlaxoSmithKline. KAT has received funding to her institution from the Coalition for Epidemic Preparedness Innovations for vaccine safety studies. All other authors report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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- View/download PDF
4. Clinical utility analysis of the Hoxb8 mast cell activation test for the diagnosis of peanut allergy.
- Author
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Bachmeier-Zbären N, Celik A, van Brummelen R, Roos N, Steinmann M, Hoang JA, Yin X, Ditlof CM, Duan L, Upton JEM, Kaufmann T, Eggel A, and Eiwegger T
- Abstract
Background: Peanut allergy is among the most severe and common food allergies. The diagnosis has a significant impact on the quality of life for patients and their families. An effective management approach depends on accurate, safe, and easily implementable diagnostic methods. We previously developed a cell-based assay using Hoxb8 mast cells (Hoxb8 MCs) aimed at improving clinical allergy diagnosis. In this study, we assessed its diagnostic performance by measuring blinded sera from a prospectively enrolled and pre-validated peanut allergy cohort., Methods: Hoxb8 MCs were passively sensitized with sera from peanut-allergic and peanut tolerant children and adolescents (n = 112). Degranulation of Hoxb8 MCs was quantified upon stimulation with dose-titrated peanut extract by means of flow cytometry, using CD107a as activation marker. The results from the Hoxb8 mast cell activation test (Hoxb8 MAT) were compared to established diagnostic assays such as the skin prick test (SPT), specific IgE (sIgE) levels, and the basophil activation test (BAT). Additionally, serum samples from BAT nonresponders were assessed with the Hoxb8 MAT., Results: Hoxb8 MAT displayed a robust dose-dependent activation to peanut extract, with a cutoff value of ≤5.2% CD107a positive cells. The diagnostic accuracy was highest at allergen concentrations ≥100 ng/mL, with an area under the receiver operating characteristic curve (AUROC) of 0.97, 93% sensitivity, and 96% specificity, outperforming traditional SPT and sIgE tests. When compared to BAT, Hoxb8 MAT exhibited comparable diagnostic efficacy. Moreover, sera from BAT nonresponders were accurately classified into allergics and nonallergics by the Hoxb8 MAT., Conclusions: The Hoxb8 MAT demonstrated a very good diagnostic precision in patients prospectively assessed for peanut allergy comparable to the fresh whole blood-based BAT. Additionally, it demonstrated its value for accurate classification of BAT nonresponders into allergic and nonallergic individuals. Further investigations into its utility in the routine clinical setting are warranted., (© 2024 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
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- 2024
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5. Baked milk and egg diets revisited.
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Upton JEM, Wong D, and Nowak-Wegrzyn A
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- Child, Humans, Animals, Diet methods, Milk, Cooking methods, Immunoglobulin E, Allergens, Randomized Controlled Trials as Topic, Egg Hypersensitivity, Milk Hypersensitivity
- Abstract
Most children with milk and egg allergy are nonreactive to modified forms of milk and egg in bakery products such as muffins because of conformational changes in proteins. These baked milk (BM) and baked egg (BE) diets have become commonplace in the management of milk and egg allergy, respectively. Current laboratory- and skin test-based diagnostic approaches remain limited in their ability to predict BM/BE tolerance, resulting in various approaches to introduce these foods. One approach to introduce BM/BE is to offer a medically supervised oral food challenge and then advise dietary introduction of baked products for children who have tolerance. Another approach is adapted from a home-based protocol of graded ingestion of BM or BE originally intended for non-IgE mediated allergy, often referred to as a "ladder." The ladder advises home ingestion of increasing amounts of BM or BE. For children who have allergy to BM or BE, the ladder is essentially oral immunotherapy, although not always labeled or recognized as such. Risk assessment and education of patients suitable for home introduction are essential. A home approach that may be called a ladder can also be used to escalate diets after demonstrated tolerance of baked forms by introducing lesser cooked forms of milk or egg after tolerating BM or BE. A randomized controlled trial provided clear evidence that baked diets can hasten the resolution of IgE-mediated milk allergy. Moreover, BM/BE foods have an emerging role in the treatment of non-IgE-mediated allergy. There is tangential evidence for BM and BE diets in the prevention of IgE-mediated allergy., (Copyright © 2024 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
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- 2024
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6. The promise of sublingual and other immunotherapy options for infants and toddlers with food allergy.
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Anagnostou A, Upton JEM, and Chinthrajah RS
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- Child, Preschool, Humans, Administration, Sublingual, Immunotherapy, Desensitization, Immunologic, Allergens, Food Hypersensitivity therapy, Sublingual Immunotherapy
- Abstract
Competing Interests: Disclosure Statement Disclosure of potential conflict of interest: A. Anagnostou reports receiving institutional funding from Aimmune and Novartis; serving as an advisory board member at Novartis and Ready, Set, Food; and receiving consultation and/or speaker fees from ALK, Adelphi, EPG Health, Aimmune Therapeutics, and Genentech. J. E. M. Upton reports receiving research support and/or grants from Novartis, Regeneron, ALK Abelló, DBV Technologies, CIHR, and the SickKids Food Allergy and Anaphylaxis Program; receiving fees from Pfizer, ALK Abello, Bausch Health, and Astra Zeneca; serving as an associate editor for Allergy Asthma and Clinical Immunology; and serving on the board of directors of the Canadian Society of Allergy and Clinical Immunology and the Healthcare Advisory Board of Food Allergy Canada, all outside the submitted work. R. S. Chinthrajah reports receiving grant support from the Consortium for Food Allergy Research, the National Institute of Allergy and Infectious Disease, Food Allergy Research and Education and serving as an advisory board member for Alladapt Immunotherapeutics, Novartis, Allergenis, Intrommune Therapeutics, Phylaxis, and Genentech.
- Published
- 2024
- Full Text
- View/download PDF
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