69 results on '"Gunter J"'
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2. Management of anaphylaxis due to COVID-19 vaccines in the elderly
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Paulo Augusto Moreira Camargos, Radolslaw Gawlik, Mirko Petrovic, Gunter J. Sturm, Kristof Nekam, Sergio Bonini, Zhanat Ispayeva, Marilyn Urrutia Pereira, Jean Bousquet, Antti Lauerma, Menachem Rottem, Arzu Yorgancioglu, Hubert Blain, Antonio Cherubini, Mário Morais-Almeida, Nathalie Salles, Charlotte G. Mortz, Sylwia Smolinska, Davor Plavec, A. Bedbrook, Torsten Zuberbier, Helga Kraxner, M. Beatrice Bilò, Sinthia Bosnic-Anticevich, Gaëtan Gavazzi, Finbarr C. Martin, Alvaro A. Cruz, K. S. Bennoor, Isabella Annesi-Maesano, Mohamed H. Shamji, Karin Hoffmann-Sommergruber, Marina Atanaskovic-Markovic, Carsten Bindslev-Jensen, Lan Tt Le, Isabel Skypala, Ana Todo-Bom, Vincenzo Patella, Lorenzo Cecchi, Charlotte Suppli Ulrik, Oscar Palomares, Joaquin Sastre, Hans Jürgen Hoffmann, Knut Brockow, Eva Untersmayr, Martin Hrubisko, Bernadette Eberlein, Aziz Sheikh, Milan Sova, Osman M. Yusuf, Violeta Kvedariene, G. Walter Canonica, Dana Wallace, Ioana Agache, Milena Sokolowska, Jos M. G. A. Schols, Susan Waserman, Stéphanie Miot, Carla Irani, Regina E Roller-Winsberger, Michael Levin, Yves Rolland, Emma Montella, Bilun Gemicioglu, Bolesław Samoliński, Stefano Del Giacco, Madda lenaIllario, Yehia El-Gamal, Olga Lourenço, Jean-Christoph Roger J-P Caubet, Luisa Brussino, Marysia Recto, De Yun Wang, Igor Kaidashev, Renaud Louis, Antonino Romano, Mario E. Zernotti, Jacques Reynes, Pedro Carreiro-Martins, Alexandra F. Santos, Marek Niedoszytko, M. Gotua, Musa Khaitov, Thomas B. Casale, Andrea Matucci, Bernardo Sousa-Pinto, Rafael Stelmach, Dejan Dokic, Joana Vitte, Motohiro Ebisawa, Maria Teresa Ventura, Joaquim Mullol, Tomas Chivato, Petr Panzner, Oliver Pfaar, Sanna Toppila-Salmi, Ioanna Tsiligianni, Wytske Fokkens, Alessandra Vultaggio, H. Neffen, Juan Carlos Ivancevich, Ya-dong Gao, Anna Sediva, Maja Hofmann, Ana Maria Carriazo, João Fonseca, Marek Jutel, A. Benetos, Nhân Pham-Thi, Mona Al-Ahmad, Arunas Valiulis, Mihaela Zidarn, Elizabeth Angier, Yoshitaka Okamoto, Montserrat Fernandez-Rivas, Cezmi A. Akdis, Philip W. Rouadi, Olivier Guérin, John Farrell, Mikaela Odemyr, George Christoff, Vera Mahler, Claus Bachert, Edward F. Knol, Wienczyslawa Czarlewski, Robyn E O'Hehir, Victoria Cardona, Ludger Klimek, Tari Haahtela, Vincent Le Moing, Branislava Milenkovic, Carmen Rondon, Kaja Julge, Jolanta Walusiak-Skorupa, Nikolaos G. Papadopoulos, Aslı Gelincik, Markus Ollert, Piotr Kuna, Leyla Namazova-Baranova, Margitta Worm, Annick Barbaud, Elena Camelia Berghea, Todor A. Popov, Derek K. Chu, María José Torres, Faradiba Sarquis Serpa, Nicola Scichilone, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Gianni Passalacqua, Humboldt-Universität zu Berlin, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Humboldt University Of Berlin, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Transylvania University, Wrocław Medical University, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Cagliari, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Università Politecnica delle Marche [Ancona] (UNIVPM), Medical Consulting Czarlewski, Universiti Putra Malaysia, University of Southampton, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Belgrade [Belgrade], Ghent University Hospital, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Dhaka Shishu Hospital [Bangladesh], University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Odense University Hospital (OUH), Italian National Research Council, National Research Council [Italy] (CNR), The University of Sydney, Technische Universität München = Technical University of Munich (TUM), Università degli studi di Torino = University of Turin (UNITO), Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil] (UFMG), IRCCS Research Hospital, Milan, Vall d'Hebron University Hospital [Barcelona], Centro Hospitalar de Lisboa Central E.P.E, University of South Florida [Tampa] (USF), Geneva University Hospital (HUG), Azienda Usl Toscana centro [Firenze], Софийски университет = Sofia University, McMaster University [Hamilton, Ontario], State University of Bahia, Institute of Public Health of Republic of North Macedonia [Skopje], Ain Shams University (ASU), Sagamihara National Hospital [Kanagawa, Japan], Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Amsterdam UMC - Amsterdam University Medical Center, Universidade do Porto = University of Porto, Wuhan University [China], CHU Grenoble, Silesian University of Medicine, Istanbul Faculty of Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Centre Hospitalier Universitaire de Nice (CHU Nice), Helsinki University Hospital [Helsinki, Finlande], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Medizinische Universität Wien = Medical University of Vienna, Aarhus University [Aarhus], Oncology Institute of St Elisabeth, University of Naples Federico II = Università degli studi di Napoli Federico II, St Joseph University, Hôtel-Dieu de France (HDF), Université Saint-Joseph de Beyrouth (USJ), Kazakh National Medical University, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Tartu University Institute of Clinical Medicine, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Federal Medicobiological Agency [Moscow, Russian Federation], University Medical Center [Utrecht], Semmelweis University [Budapest], Medical University of Łódź (MUL), Vilnius University [Vilnius], University of Medicine and Pharmacy (VIETNAM), University of Cape Town, CHU Sart Tilman, Université de Liège, University of Beira Interior [Portugal] (UBI), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), uBibliorum, Ear, Nose and Throat, AII - Inflammatory diseases, CHU Montpellier, Wroclaw Medical University [Wrocław, Pologne], University of Bari Aldo Moro (UNIBA), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sagamihara National Hospital, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Toulouse [Toulouse], RS: CAPHRI - R1 - Ageing and Long-Term Care, Health Services Research, Bousquet J., Agache I., Blain H., Jutel M., Ventura M.T., Worm M., Del Giacco S., Benetos A., Bilo B.M., Czarlewski W., Abdul Latiff A.H., Al-Ahmad M., Angier E., Annesi-Maesano I., Atanaskovic-Markovic M., Bachert C., Barbaud A., Bedbrook A., Bennoor K.S., Berghea E.C., Bindslev-Jensen C., Bonini S., Bosnic-Anticevich S., Brockow K., Brussino L., Camargos P., Canonica G.W., Cardona V., Carreiro-Martins P., Carriazo A., Casale T., Caubet J.-C., Cecchi L., Cherubini A., Christoff G., Chu D.K., Cruz A.A., Dokic D., El-Gamal Y., Ebisawa M., Eberlein B., Farrell J., Fernandez-Rivas M., Fokkens W.J., Fonseca J.A., Gao Y., Gavazzi G., Gawlik R., Gelincik A., Gemicioglu B., Gotua M., Guerin O., Haahtela T., Hoffmann-Sommergruber K., Hoffmann H.J., Hofmann M., Hrubisko M., Illario M., Irani C., Ispayeva Z., Ivancevich J.C., Julge K., Kaidashev I., Khaitov M., Knol E., Kraxner H., Kuna P., Kvedariene V., Lauerma A., Le L.T.T., Le Moing V., Levin M., Louis R., Lourenco O., Mahler V., Martin F.C., Matucci A., Milenkovic B., Miot S., Montella E., Morais-Almeida M., Mortz C.G., Mullol J., Namazova-Baranova L., Neffen H., Nekam K., Niedoszytko M., Odemyr M., O'Hehir R.E., Okamoto Y., Ollert M., Palomares O., Papadopoulos N.G., Panzner P., Passalacqua G., Patella V., Petrovic M., Pfaar O., Pham-Thi N., Plavec D., Popov T.A., Recto M.T., Regateiro F.S., Reynes J., Roller-Winsberger R.E., Rolland Y., Romano A., Rondon C., Rottem M., Rouadi P.W., Salles N., Samolinski B., Santos A.F., S Sarquis F., Sastre J., M. G. A. Schols J., Scichilone N., Sediva A., Shamji M.H., Sheikh A., Skypala I., Smolinska S., Sokolowska M., Sousa-Pinto B., Sova M., Stelmach R., Sturm G., Suppli Ulrik C., Todo-Bom A.M., Toppila-Salmi S., Tsiligianni I., Torres M., Untersmayr E., Urrutia Pereira M., Valiulis A., Vitte J., Vultaggio A., Wallace D., Walusiak-Skorupa J., Wang D.-Y., Waserman S., Yorgancioglu A., Yusuf O.M., Zernotti M., Zidarn M., Chivato T., Akdis C.A., Zuberbier T., Klimek L., HUS Inflammation Center, University of Helsinki, and Department of Dermatology, Allergology and Venereology
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Male ,Allergy ,Pediatrics ,Eaaci Position Paper ,COVID-19 vaccines ,older (adults ,GUIDELINES ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Medicine and Health Sciences ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Geriatrics ,MESH: Aged ,RISK ,Vaccines ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,people) ,EPINEPHRINE ,Epinephrine ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,COVID -19 vaccines ,Anaphylaxis ,medicine.drug ,older (adults/people) ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,MESH: Covid-19 ,MESH: Epinephrine ,Immunology ,adrenaline ,anaphylaxis ,Aged ,COVID-19 Vaccines ,Humans ,SARS-CoV-2 ,COVID-19 ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Diabetes mellitus ,Anaphylaxis/etiology ,MESH: SARS-CoV-2 ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,COVID‐19 vaccines ,Older - Adults/people ,Asthma ,MESH: Humans ,business.industry ,adrenaline, anaphylaxis, COVID-19 vaccines, older (adults/people) ,medicine.disease ,Obesity ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,MESH: Male ,MESH: Anaphylaxis ,Older ,3121 General medicine, internal medicine and other clinical medicine ,business ,MESH: Covid-19 vaccines ,030215 immunology - Abstract
Submitted by (omml@ubi.pt) on 2021-07-05T10:47:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T10:49:11Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Rejected by Pessoa (pfep@ubi.pt), reason: Rever os nomes dos autores. Depois da correção é só voltar a submeter. on 2021-07-05T10:54:19Z (GMT) Submitted by (omml@ubi.pt) on 2021-07-05T11:52:24Z No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:34:51Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Approved for entry into archive by Pessoa (pfep@ubi.pt) on 2021-07-05T13:35:49Z (GMT) No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Made available in DSpace on 2021-07-05T13:35:49Z (GMT). No. of bitstreams: 1 2021_Bousquet J_A_COVID anaphylaxis.pdf: 12561118 bytes, checksum: 2f801ee76ad2cb3cbdaa02ffabea8e09 (MD5) Previous issue date: 2021-04-02 info:eu-repo/semantics/publishedVersion
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- 2021
3. Tropomyosin is no accurate marker allergen for diagnosis of shrimp allergy in Central Europe
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João Grilo, Ute Vollmann, Martina Aumayr, Gunter J. Sturm, and Barbara Bohle
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Europe ,Immunology ,Humans ,Immunology and Allergy ,Tropomyosin ,Allergens ,Food Hypersensitivity - Published
- 2022
4. Prospective studies are needed to elucidate the clinical impact of predominant Api m 10 sensitization
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Lisa Arzt-Gradwohl, Urban Čerpes, Jutta Vollmann, Gunter J. Sturm, Barbara Binder, Lukas Koch, Karin Laipold, and Danijela Bokanovic
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Oncology ,medicine.medical_specialty ,business.industry ,Immunology ,Bee Venoms ,medicine.anatomical_structure ,Desensitization, Immunologic ,Internal medicine ,Humans ,Immunology and Allergy ,Medicine ,Prospective Studies ,business ,Prospective cohort study ,Sensitization - Published
- 2021
5. Risk factors and indicators of severe systemic insect sting reactions
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Gunter J. Sturm, Patrizia Bonadonna, Axel Trautmann, Joanna N G Oude Elberink, and Johanna Stoevesandt
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Male ,0301 basic medicine ,EUROPEAN ACADEMY ,medicine.medical_specialty ,Allergy ,BASAL SERUM TRYPTASE ,KIT D816V MUTATION ,Immunology ,tryptase ,venom ,INDUCED ANAPHYLAXIS ,FATAL ANAPHYLAXIS ,Tryptase ,Venom ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,MAST-CELL DISORDERS ,medicine ,Animals ,Humans ,Immunology and Allergy ,Systemic mastocytosis ,Anaphylaxis ,Arthropod Venoms ,mastocytosis ,Angioedema ,biology ,business.industry ,Insect Bites and Stings ,medicine.disease ,Hymenoptera ,PLATELET-ACTIVATING-FACTOR ,Sting ,CONVERTING ENZYME-INHIBITORS ,030104 developmental biology ,age ,030228 respiratory system ,biology.protein ,BEE VENOM ,medication ,HYMENOPTERA VENOM ALLERGY ,medicine.symptom ,business ,Risk assessment - Abstract
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.
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- 2019
6. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma
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Elisabeth Angier, Pawe Gajdanowicz, Ozlem Cavkaytar, Milena Sokolowska, Ralph Mösges, Cezmi A. Akdis, Marek Jutel, Oscar Palomares, Dermot Ryan, Matteo Bonini, Ioana Agache, Juan José Yepes-Nuñez, Graham Roberts, Oliver Pfaar, Nikolaos G. Papadopoulos, Omer Kalayci, Breda Flood, Giovanni Battista Pajno, Ronald van Ree, Gunter J. Sturm, Kenji Izuhara, Roy Gerth van Wijk, Eva M. Varga, Montserrat Fernandez-Rivas, Susanne Lau, Sylwia Smolinska, Erasmus MC other, Internal Medicine, Ear, Nose and Throat, Experimental Immunology, AII - Inflammatory diseases, APH - Global Health, and APH - Personalized Medicine
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0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Allergen immunotherapy ,Allergy ,Lydia Becker Institute ,medicine.medical_treatment ,Immunology ,Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Pharmacotherapy ,ResearchInstitutes_Networks_Beacons/lydia_becker_institute_of_immunology_and_inflammation ,allergen immunotherapy, allergy, asthma, asthma control, asthma exacerbations, GRADE, house dust mites, lung function ,medicine ,Animals ,Humans ,Immunology and Allergy ,Antigens, Dermatophagoides ,Asthma ,Desensitization (medicine) ,House dust mite ,biology ,business.industry ,Pyroglyphidae ,lung function ,Guideline ,Allergens ,asthma ,allergy ,medicine.disease ,biology.organism_classification ,asthma control ,respiratory tract diseases ,GRADE ,030104 developmental biology ,030228 respiratory system ,Desensitization, Immunologic ,asthma exacerbations ,allergen immunotherapy ,business ,house dust mites - Abstract
Allergen immunotherapy (AIT) has been in use for the treatment of allergic disease for more than 100 years. Asthma treatment relies mainly on corticosteroids and other controllers recommended to achieve and maintain asthma control, prevent exacerbations, and improve quality of life. AIT is underused in asthma, both in children and in adults. Notably, patients with allergic asthma not adequately controlled on pharmacotherapy (including biologics) represent an unmet health need. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline providing evidence-based recommendations for the use of house dust mites (HDM) AIT as add-on treatment for HDM-driven allergic asthma. This guideline was developed by a multi-disciplinary working group using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. HDM AIT was separately evaluated by route of administration and children and adults: subcutaneous (SCIT) and sublingual AIT (SLIT), drops, and tablets. Recommendations were formulated for each. The important prerequisites for successful treatment with HDM AIT are (a) selection of patients most likely to respond to AIT and (b) use of allergen extracts and desensitization protocols of proven efficacy. To date, only AIT with HDM SLIT-tablet has demonstrated a robust effect in adults for critical end points (exacerbations, asthma control, and safety). Thus, it is recommended as an add-on to regular asthma therapy for adults with controlled or partially controlled HDM-driven allergic asthma (conditional recommendation, moderate-quality evidence). HDM SCIT is recommended for adults and children, and SLIT drops are recommended for children with controlled HDM-driven allergic asthma as the add-on to regular asthma therapy to decrease symptoms and medication needs (conditional recommendation, low-quality evidence).
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- 2019
7. Isotype-specific binding patterns of serum antibodies to multiple conformational epitopes of Bet v 1
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Stefanie Schmalz, Alexandra Shosherova, Barbara Gepp, Vanessa Mayr, Barbara Bohle, Daniela Ackerbauer, Gunter J. Sturm, Heimo Breiteneder, and Christian Radauer
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medicine.drug_class ,Recombinant Fusion Proteins ,Immunology ,Cross Reactions ,Monoclonal antibody ,Immunoglobulin E ,medicine.disease_cause ,Epitope ,Epitopes ,Allergen ,Hypersensitivity ,medicine ,Humans ,Immunology and Allergy ,Plant Proteins ,biology ,Chemistry ,hemic and immune systems ,Allergens ,Antigens, Plant ,Isotype ,Fusion protein ,Molecular biology ,Epitope mapping ,Immunoglobulin G ,biology.protein ,Pollen ,Antibody - Abstract
Background Birch pollen is an important elicitor of respiratory allergy. The major allergen, Bet v 1, binds IgE exclusively via conformational epitopes. Objective To identify Bet v 1-specific epitope repertoires of IgE and IgG from birch pollen-allergic and non-allergic subjects. Methods Chimeric proteins were created by grafting individual epitope-sized, contiguous surface patches of Bet v 1 onto a non-allergenic structural homologue and expressed in Escherichia coli. Binding of IgE, IgG1 and IgG4 from sera of 30 birch pollen-allergic and 11 non-allergic subjects to Bet v 1, 13 chimeric proteins and four bacterial Bet v 1 homologues were measured by ELISA. The proportion of epitope-specific in total Bet v 1-specific IgE and the cross-reactivity of Bet v 1-specific IgE with bacterial homologues were determined by competitive ELISA. Results Thirteen soluble, correctly folded chimeric proteins were produced. IgE from 27/30 birch pollen-allergic patients bound to 1-12 chimeric proteins (median 4.0) with patient-specific patterns. Three chimeras binding IgE from the majority of sera were identified, whose pgrafted patches overlapped with previously published epitopes. Patterns of IgG1 and IgG4 binding to the chimeric proteins did not correspond to the binding patterns of IgE. Sera of 19/30 birch pollen-allergic patients contained low amounts of IgE to bacterial homologues. Bacterial proteins were able to partially inhibit IgE binding to Bet v 1. Conclusion Epitopes recognized by Bet v 1-specific antibodies from birch pollen-allergic patients are specific to each patient and differ between IgE, IgG1 and IgG4.
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- 2022
8. β-blockers and ACE inhibitors are not a risk factor for severe systemic sting reactions and adverse events during venom immunotherapy
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Marta Chełmińska, Lisa Arzt-Gradwohl, Francesco Marchi, Radosław Gawlik, Marita Nittner-Marszalska, Berta Ruiz-Leon, Donatella Preziosi, Karolina Kita, Aránzazu Jiménez Blanco, Nina Frelih, Darío Antolín-Amérigo, Johanna Stoevesandt, Serrano P, Iwona Poziomkowska-Gęsicka, Marina Mauro, Martina Vachová, Valerio Pravettoni, Roland Lang, Werner Aberer, Christoph Schrautzer, Teresa Alfaya Arias, Gunter J. Sturm, Andrzej Bozek, Sereina A. Herzog, Marta Rosiek-Biegus, Thomas Hawranek, Betül Ayşe Sin, Norbert Reider, Wolfram Hoetzenecker, Mitja Košnik, Patrizia Bonadonna, O Quercia, Elisa Boni, Karin Laipold, Axel Trautmann, Barbara Ernst, Aslı Gelincik, Aytül Sin, Reşat Kendirlinan, and Ege Üniversitesi
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0301 basic medicine ,medicine.medical_specialty ,medicine.drug_class ,beta‐ ,Immunology ,adverse event ,beta‐blocker ,Angiotensin-Converting Enzyme Inhibitors ,Treatment experienced ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Multicenter trial ,Internal medicine ,ACE inhibitor ,medicine ,Immunology and Allergy ,Humans ,Prospective Studies ,Risk factor ,blocker ,Adverse effect ,Beta blocker ,Anaphylaxis ,business.industry ,Insect Bites and Stings ,Venom immunotherapy ,Insect stings ,Sting ,Bee Venoms ,030104 developmental biology ,030228 respiratory system ,Allergen‐Specific Immunotherapy and Biologics ,venom immunotherapy ,Desensitization, Immunologic ,beta-blocker ,Observational study ,Original Article ,Human medicine ,ORIGINAL ARTICLES ,business ,medicine.drug ,systemic insect sting reaction - Abstract
Background There is controversy whether taking beta-blockers or ACE inhibitors (ACEI) is a risk factor for more severe systemic insect sting reactions (SSR) and whether it increases the number or severity of adverse events (AE) during venom immunotherapy (VIT). Methods in this open, prospective, observational, multicenter trial, we recruited patients with a history of a SSR and indication for VIT. The primary objective of this study was to evaluate whether patients taking beta-blockers or ACEI show more systemic AE during VIT compared to patients without such treatment. Results in total, 1,425 patients were enrolled and VIT was performed in 1,342 patients. of all patients included, 388 (27.2%) took antihypertensive (AHT) drugs (10.4% took beta-blockers, 11.9% ACEI, 5.0% beta-blockers and ACEI). Only 5.6% of patients under AHT treatment experienced systemic AE during VIT as compared with 7.4% of patients without these drugs (OR: 0.74, 95% CI: 0.43-1.22, p = 0.25). The severity of the initial sting reaction was not affected by the intake of beta-blockers or ACEI (OR: 1.14, 95% CI: 0.89-1.46, p = 0.29). in total, 210 (17.7%) patients were re-stung during VIT and 191 (91.0%) tolerated the sting without systemic symptoms. of the 19 patients with VIT treatment failure, 4 took beta-blockers, none an ACEI. Conclusions This trial provides robust evidence that taking beta-blockers or ACEI does neither increase the frequency of systemic AE during VIT nor aggravate SSR. Moreover, results suggest that these drugs do not impair effectiveness of VIT. (Funded by Medical University of Graz, Austria; Clinicaltrials.gov number, NCT04269629)., Medizinische Universitat Graz Funding Source: Medline
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- 2021
9. Placebo effects in allergen immunotherapy-An EAACI Task Force Position Paper
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Oliver Pfaar, Mohamed H. Shamji, Glenis Scadding, Ludger Klimek, Stefan Vieths, Ronald van Ree, Antonella Muraro, Jörg Kleine-Tebbe, Bettina Wedi, Karl Christian Bergmann, Anthony J. Frew, Philippe Devillier, Gunter J. Sturm, Carsten Bindslev-Jensen, Roy Gerth van Wijk, Carmen Vidal, Marek Jutel, Peter S. Creticos, Jean Bousquet, Lars Jacobsen, Nikolaos G. Papadopoulos, Stephen R. Durham, Winfried Rief, Ioana Agache, S. Kaul, Manfred Schedlowski, Peter Hellings, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, Ear, Nose and Throat, and Internal Medicine
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Allergy ,medicine.medical_specialty ,Allergen immunotherapy ,Blinding ,business.industry ,Advisory Committees ,Immunology ,Medizin ,Disease ,Placebo Effect ,Placebo ,medicine.disease ,law.invention ,Clinical trial ,Treatment Outcome ,Double-Blind Method ,Randomized controlled trial ,Desensitization, Immunologic ,law ,Physical therapy ,Humans ,Immunology and Allergy ,Medicine ,Position paper ,business - Abstract
The placebo (Latin "I will please") effect commonly occurs in clinical trials. The psychological and physiological factors associated with patients' expectations about a treatment's positive and negative effects have yet to be well characterized, although a functional prefrontal cortex and intense bidirectional communication between the central nervous system and the immune system appear to be prerequisites for a placebo effect. The use of placebo raises certain ethical issues, especially if patients in a placebo group are denied an effective treatment for a long period of time. The placebo effect appears to be relatively large (up to 77%, relative to pretreatment scores) in controlled clinical trials of allergen immunotherapy (AIT), such as the pivotal, double-blind, placebo-controlled (DBPC) randomized clinical trials currently required by regulatory authorities worldwide. The European Academy of Allergy and Clinical Immunology (EAACI) therefore initiated a Task Force, in order to better understand the placebo effect in AIT and its specific role in comorbidities, blinding issues, adherence, measurement time points, variability and the natural course of the disease. In this Position Paper, the EAACI Task Force highlights several important topics regarding the placebo effect in AIT such as a) regulatory aspects, b) neuroimmunological and psychological mechanisms, c) placebo effect sizes in AIT trials, d) methodological limitations in AIT trial design and e) potential solutions in future AIT trial design. In conclusion, this Position Paper aims to examine the methodological problem of placebo in AIT from different aspects and also to highlight unmet needs and possible solutions for future trials. ispartof: ALLERGY vol:76 issue:3 pages:629-647 ispartof: location:Denmark status: published
- Published
- 2021
10. Structural Features of the Invariant Chain Fragment CLIP Controlling Rapid Release from HLA-DR Molecules and Inhibition of Peptide Binding
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Kropshofer, Harald, Vogt, Anne B., and Hammerling, Gunter J.
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- 1995
11. Alloreactive Cytolytic T-Cell Clones Preferentially Recognize Conformational Determinants on Histocompatibility Antigens: Analysis with Genetically Engineered Hybrid Antigens
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Arnold, Bernd, Horstmann, Ulrike, Kuon, Wolfgang, Burgert, Hans-Gerhard, Hammerling, Gunter J., and Kvist, Sune
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- 1985
12. Large local reactions and systemic reactions to insect stings: Similarities and differences
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Urban Čerpes, Gunter J. Sturm, Barbara Binder, Lisa Arzt-Gradwohl, Karin Laipold, and Patrik Tripolt
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Male ,Wasp Venoms ,Toxicology ,Pathology and Laboratory Medicine ,Gastroenterology ,Allergies ,Medicine and Health Sciences ,Toxins ,Child ,Immune Response ,Aged, 80 and over ,Multidisciplinary ,Eukaryota ,food and beverages ,Skin test ,Bees ,Middle Aged ,Insects ,Bee Venoms ,Systemic reaction ,Child, Preschool ,Medicine ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Arthropoda ,Adolescent ,Science ,Toxic Agents ,Immunology ,Young Adult ,Signs and Symptoms ,Diagnostic Medicine ,Internal medicine ,Hypersensitivity ,medicine ,Animals ,Humans ,In patient ,Anaphylaxis ,Local Reaction ,Skin Tests ,Aged ,Retrospective Studies ,Inflammation ,Venoms ,business.industry ,fungi ,Organisms ,Biology and Life Sciences ,Insect Bites and Stings ,Total ige ,Allergens ,Immunoglobulin E ,Invertebrates ,Hymenoptera ,Trunk ,Insect stings ,Sting ,Immunoglobulin G ,Clinical Immunology ,Clinical Medicine ,business - Abstract
BACKGROUND:Large local reactions (LLR) to Hymenoptera stings were considered as IgE-mediated late-phase inflammatory reactions. However, in older studies, most patients with LLR were skin test positive, but only around 50% had detectable sIgE determined by the RAST system. METHODS:Data of 620 patients were evaluated retrospectively: 310 patients who suffered from LLR and 310 patients with previous systemic sting reactions (SSR). We aimed to clarify if sIgE can generally be detected by the CAP system in patients with LLR; sIgE levels and clinical parameters were compared between patients with LLR and SSR. RESULTS:Positive sIgE levels were detected in 80.7% of patients with LLR, and in 95.2% of patients with SSR (p20cm, with a mean duration of seven days. In only 2.9% of patients, LLRs occurred after stings on the trunk, while 14.8% of SSR resulted from stings on this site (p
- Published
- 2020
13. EAACI guidelines on allergen immunotherapy: Executive statement
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Giorgio Walter Canonica, G. B. Pajno, Ulrich Wahn, Aziz Sheikh, Stephen R. Durham, R. van Ree, Susanne Halken, Oliver Pfaar, Gunter J. Sturm, Claus Bachert, Moises A. Calderon, Eva-Maria Varga, Dermot Ryan, R. Gerth van Wijk, H.-J. Malling, Elizabeth Angier, Graham Roberts, Montserrat Fernandez-Rivas, Steffen Lau, Marek Jutel, Antonella Muraro, Ioana Agache, Internal Medicine, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, and AII - Amsterdam institute for Infection and Immunity
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0301 basic medicine ,Allergen immunotherapy ,medicine.medical_specialty ,Statement (logic) ,Immunology ,Immunology and Allergy, Immunology ,03 medical and health sciences ,Editorial ,030104 developmental biology ,0302 clinical medicine ,030228 respiratory system ,Desensitization, Immunologic ,Family medicine ,Political science ,Practice Guidelines as Topic ,Hypersensitivity ,medicine ,Research studies ,Humans ,Immunology and Allergy ,medicine.symptom ,Reimbursement ,Confusion - Abstract
The allergist's community has recently celebrated 100 year of Allergen Immunotherapy (AIT). Unfortunately the implemention of this treatment is still impaired by some challenges. With the diversity of definitions, methodology and different allergen products used, research studies have produced conflicting outcomes. This has resulted in confusion about the benefits and risks of AIT amongst policymakers and professionals, as well as in the variable availability of AIT products, regulation and reimbursement policies globally. In 2015 EAACI initiated the AIT Guidelines project as part of the Presidential plan in order to settle the controversies. This article is protected by copyright. All rights reserved.
- Published
- 2018
14. EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy
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Ulugbek Nurmatov, Aziz Sheikh, Kari C. Nadeau, Edward F. Knol, Mika J. Mäkelä, Carsten Bindslev-Jensen, R. G. Van Wijk, Ioana Agache, M. Ebisawa, Oliver Pfaar, E-M. Varga, S. Dhami, Cezmi A. Akdis, Philippe Eigenmann, Y Boloh, Cansin Sackesen, Nikolaos G. Papadopoulos, Montserrat Alvaro-Lozano, G. Du Toit, Graham Roberts, Antonella Muraro, Montserrat Fernandez-Rivas, Elizabeth Angier, Kirsten Beyer, Stefania Arasi, Dermot Ryan, Steffen Lau, Marek Jutel, Liam O'Mahony, R. van Ree, Susanne Halken, Gunter J. Sturm, Alexandra F. Santos, Giovanni B. Pajno, Lars K. Poulsen, Wesley Burks, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, Ear, Nose and Throat, and Internal Medicine
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Allergy ,medicine.medical_treatment ,Desensitization ,medicine.disease_cause ,0302 clinical medicine ,Allergen ,allergy ,Medicine ,Immunology and Allergy ,030212 general & internal medicine ,allergen immunotherapy ,Desensitization (medicine) ,Allergen immunotherapy ,Pediatric ,Food Hypersensitivity/prevention & control ,ddc:618 ,adult ,pediatric ,3. Good health ,Tolerance induction ,Immunoglobulin E/immunology ,Immunologic/methods/standards ,adolescent ,Food Hypersensitivity ,Adult ,medicine.medical_specialty ,Adolescent ,Immunology ,03 medical and health sciences ,Food allergy ,Internal medicine ,Animals ,Humans ,Eosinophilic esophagitis ,business.industry ,food ,Immunoglobulin E ,medicine.disease ,Adolescent, Adult, Allergen immunotherapy, Allergy, Food, Pediatric, Immunology and Allergy, Immunology ,030228 respiratory system ,Desensitization, Immunologic ,Food ,Egg allergy ,business - Abstract
Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA-AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE-mediated Food Allergy, aims to provide evidence-based recommendations for active treatment of IgE-mediated food allergy with FA-AIT. Immunotherapy relies on the delivery of gradually increasing doses of specific allergen to increase the threshold of reaction while on therapy (also known as desensitization) and ultimately to achieve post-discontinuation effectiveness (also known as tolerance or sustained unresponsiveness). Oral FA-AIT has most frequently been assessed: here, the allergen is either immediately swallowed (OIT) or held under the tongue for a period of time (SLIT). Overall, trials have found substantial benefit for patients undergoing either OIT or SLIT with respect to efficacy during treatment, particularly for cow's milk, hen's egg, and peanut allergies. A benefit post-discontinuation is also suggested, but not confirmed. Adverse events during FA-AIT have been frequently reported, but few subjects discontinue FA-AIT as a result of these. Taking into account the current evidence, FA-AIT should only be performed in research centers or in clinical centers with an extensive experience in FA-AIT. Patients and their families should be provided with information about the use of FA-AIT for IgE-mediated food allergy to allow them to make an informed decision about the therapy.
- Published
- 2018
15. A safe and efficient 7‐week immunotherapy protocol with aluminum hydroxide adsorbed vespid venom
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Gunter J. Sturm, Karin Laipold, Ines Schwarz, Urban Čerpes, Lisa Arzt-Gradwohl, Barbara Binder, Christoph Schrautzer, Sereina A. Herzog, Danijela Bokanovic, Werner Aberer, and Lukas Koch
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business.industry ,medicine.medical_treatment ,Immunology ,Aluminum Hydroxide ,Wasp Venoms ,Venom ,Immunotherapy ,Bee Venoms ,chemistry.chemical_compound ,Adsorption ,chemistry ,Desensitization, Immunologic ,Humans ,Immunology and Allergy ,Medicine ,Hydroxide ,Human medicine ,Letters to the Editor ,business ,Letter to the Editor ,Nuclear chemistry - Published
- 2019
16. Allergen immunotherapy for insect venom allergy
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Franziska Ruëff, Radosław Gawlik, Moises A. Calderon, Darío Antolín-Amérigo, Ewa Cichocka-Jarosz, Ervin Ç. Mingomataj, Markus Ollert, Danijela Bokanovic, Eva-Maria Varga, Joanna Lange, Hadar Zaman, Aziz Sheikh, M. B. Bilò, T. Jakob, V. Pravettoni, Miqdad Asaria, Graham Roberts, Oliver Pfaar, H. N. G. Oude Elberink, Constantinos Pitsios, G. Netuveli, Mitja Košnik, S. Dhami, Antonella Muraro, Holger Mosbech, Cezmi A. Akdis, Betül Ayşe Sin, Dimitris I. Mitsias, Gunter J. Sturm, University of Zurich, and Dhami, S
- Subjects
0301 basic medicine ,STINGS ,PROTOCOL ,Allergy ,Cost-Benefit Analysis ,CHILDREN ,law.invention ,DOUBLE-BLIND ,0302 clinical medicine ,Randomized controlled trial ,law ,Risk Factors ,10183 Swiss Institute of Allergy and Asthma Research ,Immunology and Allergy ,HYMENOPTERA VENOM ,systemic sting reaction ,Arthropod Venoms ,HYPERSENSITIVITY ,ANAPHYLAXIS ,Absolute risk reduction ,Disease Management ,LARGE LOCAL REACTIONS ,Treatment Outcome ,SUBLINGUAL IMMUNOTHERAPY ,Meta-analysis ,2723 Immunology and Allergy ,Anaphylaxis ,Allergen immunotherapy ,medicine.medical_specialty ,Immunology ,610 Medicine & health ,CONTROLLED-TRIAL ,03 medical and health sciences ,hymenoptera venom allergy ,medicine ,Animals ,Humans ,Intensive care medicine ,Adverse effect ,2403 Immunology ,business.industry ,Insect Bites and Stings ,Allergens ,medicine.disease ,Sting ,030104 developmental biology ,030228 respiratory system ,Desensitization, Immunologic ,insect venom allergy ,business - Abstract
Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines on Allergen Immunotherapy (AIT) for the management of insect venom allergy. To inform this process, we sought to assess the effectiveness, cost-effectiveness and safety of AIT in the management of insect venom allergy.Methods: We undertook a systematic review, which involved searching 15 international biomedical databases for published and unpublished evidence. Studies were independently screened and critically appraised using established instruments. Data were descriptively summarized and, where possible meta-analysed.Results: Our searches identified a total of 16,917 potentially eligible studies of which 17 satisfied our inclusion criteria. The available evidence was limited both in volume and quality, but suggested that venom immunotherapy (VIT) could substantially reduce the risk of subsequent severe systemic sting reactions (OR=0.08, 95% CI 0.03 to 0.26); meta-analysis showed that it also improved disease specific quality of life (risk difference=1.41, 95% CI 1.04 to 1.79). Adverse effects were experienced in both the build-up and maintenance phases, but most were mild with no fatalities being reported. The very limited evidence found on modeling cost-effectiveness suggested that VIT was likely to be cost-effective in those at high risk of repeated systemic sting reactions and/or impaired quality of life.Conclusions: The limited available evidence suggested that VIT is effective in reducing severe subsequent systemic sting reactions and in improving disease specific quality of life. VIT proved to be safe and no fatalities were recorded in the studies included in this review. The cost-effectiveness of VIT needs to be established.
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- 2017
17. Simultaneous up-dosing of bee and vespid venom immunotherapy is safe
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Lisa Arzt-Gradwohl, Patrik Tripolt, Barbara Binder, Danijela Bokanovic, Gunter J. Sturm, Urban Čerpes, Christoph Schrautzer, Lukas Koch, and Karin Laipold
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business.industry ,Immunology ,Hymenoptera venom allergy ,Insect Bites and Stings ,Wasp Venoms ,Pharmacology ,Bees ,Venom immunotherapy ,Hymenoptera ,adverse events ,bee venom immunotherapy ,Bee Venoms ,hymenoptera venom allergy ,Desensitization, Immunologic ,vespid venom immunotherapy ,Immunology and Allergy ,Medicine ,Animals ,Dosing ,Immunotherapy ,business ,Adverse effect ,Letters to the Editor ,simultaneous venom immunotherapy ,Letter to the Editor - Published
- 2019
18. Medical Algorithms: Diagnosis and treatment of Hymenoptera venom allergy
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Gunter J. Sturm, Eva M. Varga, and Lisa Arzt-Gradwohl
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Moderate to severe ,medicine.medical_specialty ,Weakly positive ,Immunology ,Clinical Decision-Making ,Immunoglobulin E ,Quality of life ,Hypersensitivity ,Immunology and Allergy ,Medicine ,Animals ,Arthropod Venoms ,biology ,business.industry ,fungi ,food and beverages ,Hymenoptera venom allergy ,Disease Management ,Insect Bites and Stings ,Allergens ,Venom immunotherapy ,Dermatology ,Skin symptoms ,Hymenoptera ,Sting ,biology.protein ,business ,Algorithms - Abstract
Diagnosis of Hymenoptera venom allergy (HVA) is straightforward in the majority of patients, but can be challenging in double positive and test negative patients. Test results sometimes can be confusing as patients with high skin test reactivity and high specific IgE (sIgE) levels are not at risk for severe systemic sting reactions (SSR), and conversely, patients with weakly positive or even negative tests can experience severe SSR. Venom immunotherapy (VIT) is safe, highly effective, and recommended in patients with moderate to severe SSR and in patients with SSR confined to generalized skin symptoms if quality of life is impaired.
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- 2019
19. Contraindications to immunotherapy: a global approach
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Oliver Pfaar, Pascal Demoly, Moises A. Calderon, Franziska Ruëff, G. Paraskevopoulos, Erkka Valovirta, Constantinos Pitsios, Gunter J. Sturm, M. Tsoumani, P. Rodriguez del Rio, M. B. Bilò, Radosław Gawlik, University of Cyprus [Nicosia], University of Manchester [Manchester], Medical University Graz, Silesian Medical University, Katowice, Poland, Ludwig-Maximilians-Universität München (LMU), University of Turku, Heidelberg University, Medical Faculty [Mannheim], Imperial College London, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Pulmonary and Respiratory Medicine ,Allergen immunotherapy ,medicine.medical_specialty ,medicine.medical_treatment ,Immunology ,Autoimmunity ,Review ,Venom hypersensitivity ,03 medical and health sciences ,0302 clinical medicine ,Age groups ,Pregnancy ,medicine ,Immunology and Allergy ,In patient ,Beta-blocker ,ACE-inhibitor ,Intensive care medicine ,030304 developmental biology ,Asthma ,0303 health sciences ,business.industry ,Contraindications ,Respiratory allergy ,Malignancy ,Immunotherapy ,[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy ,RC581-607 ,medicine.disease ,3. Good health ,Uncontrolled asthma ,030228 respiratory system ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Immunologic diseases. Allergy ,business - Abstract
Background Recommendations on contraindications to allergen immunotherapy (AIT) have been independently developed by National and International Societies/Academies. AIT contraindications are mainly based on case reports, case-series, or experts’ opinion, while evidence-based information is limited. The aim of the present review was to describe existing guidelines on contraindications to AIT and to highlight differences between them. Main body An extended review of the literature regarding contraindications to AIT for respiratory allergy and venom hypersensitivity was performed. Furthermore, Societies and Academies registered in the World Allergy Organization and EAACI databases, were asked for additional information. Only AIT guidelines published under official auspicies were included. A large heterogeneity among the various recommendations on contraindications was registered. Common contraindications to most of the guidelines were: lack of adherence, pregnancy before the start of AIT, the use of beta-blockers, certain age groups, uncontrolled asthma, autoimmune diseases and malignancies. Conclusion As new data arise, revisions might soon be needed allowing AIT in the cases of patients treated with ACE inhibitors and beta-blockers, in elderly patients and in patients with concomitant autoimmune diseases and neoplasias in remission. The decision to prescribe AIT is always tailor-made, balancing risk vs benefit. Creating globally accepted guidelines would help Allergologists in their decision making.
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- 2019
20. Perspectives in allergen immunotherapy: 2019 and beyond
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Andreas Nandy, Christoph Willers, Harald Renz, Stephen R. Durham, Petra Zieglmayer, Marek Jutel, Mohamed H. Shamji, Cezmi A. Akdis, Ronald van Ree, Jörg Kleine-Tebbe, Gunter J. Sturm, Matthias V. Kopp, Anne-Marie Salapatek, Ioana Agache, J. Christian Virchow, Ulrich Wahn, Frédéric de Blay, Peter Hellings, Graham Roberts, Ludger Klimek, Oliver Pfaar, Radosław Gawlik, Adam Chaker, Carsten B. Schmidt-Weber, Ronald L. Rabin, Sergio Bonini, University of Zurich, and Pfaar, Oliver
- Subjects
0301 basic medicine ,Allergy ,Allergen Exposure Chamber ,Allergen Immunotherapy ,Allergic Asthma ,Biomarker ,Clinical Trials ,FOOD ALLERGY ,DOUBLE-BLIND ,0302 clinical medicine ,10183 Swiss Institute of Allergy and Asthma Research ,Immunology and Allergy ,EAACI AIT GUIDELINES ,biology ,Pyroglyphidae ,Allergic asthma ,TREATMENT PHASE ,ddc ,SUBLINGUAL IMMUNOTHERAPY ,2723 Immunology and Allergy ,biomarker ,Life Sciences & Biomedicine ,allergic asthma ,allergen exposure chamber ,Allergen immunotherapy ,medicine.medical_specialty ,Immunology ,610 Medicine & health ,03 medical and health sciences ,SUBCUTANEOUS IMMUNOTHERAPY ,medicine ,Animals ,Humans ,VENOM ALLERGY ,Antibodies, Blocking ,CLINICAL-EFFICACY ,Asthma ,House dust mite ,2403 Immunology ,Sublingual Immunotherapy ,clinical trials ,Science & Technology ,business.industry ,GRASS-POLLEN IMMUNOTHERAPY ,Allergens ,allergen immunotherapy ,biology.organism_classification ,medicine.disease ,Antibodies, Neutralizing ,Rhinitis, Allergic ,respiratory tract diseases ,Clinical trial ,030104 developmental biology ,030228 respiratory system ,Immunoglobulin G ,Family medicine ,ASTHMA ,Allergists ,ALLERGEN EXPOSURE ,business ,Biomarkers - Abstract
The seventh "Future of the Allergists and Specific Immunotherapy (FASIT)" workshop held in 2019 provided a platform for global experts from academia, allergy clinics, regulatory authorities and industry to review current developments in the field of allergen immunotherapy (AIT). Key domains of the meeting included the following: (a) Biomarkers for AIT and allergic asthma; (b) visions for the future of AIT; (c) progress and data for AIT in asthma and the updates of GINA and EAACI Asthma Guidelines (separated for house dust mite SCIT, SLIT tablets and SLIT drops; patient populations) including a review of clinically relevant endpoints in AIT studies in asthma; (d) regulatory prerequisites such as the "Therapy Allergen Ordinance" in Germany; (e) optimization of trial design in AIT clinical research; (f) challenges planning and conducting phase III (field) studies and the future role of Allergen Exposure Chambers (AEC) in AIT product development from the regulatory point of view. We report a summary of panel discussions of all six domains and highlight unmet needs and possible solutions for the future. ispartof: ALLERGY vol:74 pages:3-25 ispartof: location:Denmark status: published
- Published
- 2019
21. 2019 ARIA Care pathways for allergen immunotherapy
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Dana Wallace, Karin C. Lødrup Carlsen, M. T. Ventura, Igor Kaidashev, Stephen R. Durham, Motohiro Ebisawa, Oliver Pfaar, Hae-Sim Park, Daniel Laune, Wytske Fokkens, Antonella Muraro, Moises A. Calderon, Torsten Zuberbier, Mohamed H. Shamji, Mark S. Dykewicz, Roy Gerth van Wijk, Josep M. Antó, Samantha Walker, Petr Panzner, Giorgio Walter Canonica, Nelson Rosario, Juan Carlos Ivancevich, Holger J. Schünemann, Susanne Halken, Lorenzo Cecchi, Sinthia Bosnic-Anticevich, Violeta Kvedariene, Stefania La Grutta, João Fonseca, Marek L Kowalski, Tari Haahtela, Aziz Sheikh, Montserrat Fernandez-Rivas, Nhan Pham-Thi, Isabelle Bosse, Jean Bousquet, Lan Le, Despo Ierodiakonou, Tomohisa Iinuma, Lars Jacobsen, Christine Rolland, Gert Marien, Wienczyslawa Czarlewski, Glenis Scadding, Ioana Agache, Bolesław Samoliński, Olga Lourenço, Ludger Klimek, Yoshitaka Okamoto, Ulrich Wahn, Joaquim Mullol, Erkka Valovirta, Luigi Caraballo, Sanna Toppila-Salmi, Ioanna Tsiligianni, Derek K. Chu, Ruby Pawankar, Jean Luc Fauquert, Musa Khaitov, Jorg Kleine Tebbe, Jean-François Fontaine, Victoria Cardona, Désirée Larenas-Linemann, Thomas B. Casale, Omer Kalayci, Alvaro A. Cruz, Arunas Valiulis, Anna Bedbrook, Susanne Lau, Alkis Togias, H.-J. Malling, Claus Bachert, Dermot Ryan, Elísio Costa, Giovanni Passalacqua, Ignacio J. Ansotegui, Ana Todo Bom, Marek Jutel, Enrica Menditto, Piotr Kuna, Nikolaos G. Papadopoulos, Gregoire Mercier, Mario Sánchez-Borges, Karl-Christian Bergmann, Susan Waserman, Gunter J. Sturm, Maryline Valentin-Rostan, Arzu Yorgancioglu, Giovanni Battista Pajno, Jan Brozek, George Du Toit, Robyn E O'Hehir, Peter Hellings, Graham Roberts, uBibliorum, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Center for Rhinology and Allergology, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], Department of Allergy and Immunology, Hospital Quiròn Bizkaia Erandio, UPC Research Laboratories, Allergy Department, University of Crete [Heraklion] (UOC), Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Universitat Pompeu Fabra [Barcelona] (UPF), Ghent University Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Department of Dermatology and Allergy [Berlin, Allemagne], Comprehensive Allergy Center [Berlin, Allemagne], Berlin Institute of Health (BIH)-Berlin Institute of Health (BIH), The University of Sydney, Woolcock Institute of Medical Research [Sydney], CHU Montpellier, Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], Section of Allergy and Clinical Immunology [London, UK], Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Institute for Immunological Research (University of Cartagena), University of Cartagena, Allergy Section, Department of Internal Medicine, Vall d'Hebron University Hospital [Barcelona], Division of Allergy and Immunology, Department of Medicine, Creighton University, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Universidade do Porto, Instituto de Biologia Molecular e Celular (IBMC), Universidade Federal da Bahia (UFBA), UCB Pharma, Colombes, Section of Allergy and Clinical Immunology, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute [UK], King‘s College London, Saint Louis University School of Medicine [St Louis], Sagamihara National Hospital, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Center of Research in Health Technologies and Information Systems (CINTESIS), Department of Allergology, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Helsinki University Hospital, Odense University Hospital, University Hospitals Leuven [Leuven], Chiba University Hospital, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Research Centre for Prevention and Health (RCPH), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Capital Region of Denmark, Department of Clinical Immunology, Wroclaw Medical University, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Laboratory of Molecular Immunology [Moscow, Russian Federation] (National Research Center), Institute of Immunology [Moscow, Russian Federation]-Federal Medicobiological Agency [Moscow, Russian Federation], Hacettepe University = Hacettepe Üniversitesi, Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Department of Immunology, Rheumatology and Allergy, Division of Internal Medicine, Asthma and Allergy, Medical University of Łódź (MUL)-Barlicki University Hospital, Vilnius University [Vilnius], CNR-IBIM : National Research Council-Institute of Biomedicine and Molecular Immunology, Department of Pediatric Pneumology and Immunology, Ho Chi Minh City University of Technology (HCMUT), University of Oslo (UiO), Faculty of Health Sciences and CICS-UB (Health Sciences Research Centre), 'Federico II' University of Naples Medical School, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Food Allergy Referral Centre Veneto Region [Padua, Italy], Universita degli Studi di Padova, Monash University [Melbourne], Department of Otorhinolaryngology, Department of Pediatrics, Allergy Unit, University of Messina, Ajou University School of Medicine, Department of Allergology and Clinical Immunology, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Allergy and Respiratory Diseases, University of Genoa (UNIGE), Saint Mary's Hospital [London], St Mary's Hospital [London], Department of Pediatrics, Nippon Medical School, Pediatrics, Universidade Federal do Paraná (UFPR), Medical Centre, Woodbrook Medical Centre, Medical University of Warsaw - Poland, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Department of Allergy and Clinical Immunology [Caracas, Venezuela], Centro Medico-Docente La Trinidad, The Royal National Throat, Nose and Ear Hospital, Imperial College London, Centre for Population Health Sciences, University of Edinburgh, Medical University Graz, University of Coimbra [Portugal] (UC), Vilnius University Clinic of Children's Diseases, Suomen Terveystalo Allergy Clinic, Università degli studi di Bari Aldo Moro (UNIBA), Department for Pediatric Pneumology and Immunology, Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, (MRC), Guy's Hospital [London], Nova Southeastern University (NSU), Department of Pulmonology, Manisa Celal Bayar University, Department of Dermatology, Medical School-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Association Asthme et Allergie, Internal Medicine, Bousquet, J., Pfaar, O., Togias, A., Schunemann, H. J., Ansotegui, I., Papadopoulos, N. G., Tsiligianni, I., Agache, I., Anto, J. M., Bachert, C., Bedbrook, A., Bergmann, K. -C., Bosnic-Anticevich, S., Bosse, I., Brozek, J., Calderon, M. A., Canonica, G. W., Caraballo, L., Cardona, V., Casale, T., Cecchi, L., Chu, D., Costa, E., Cruz, A. A., Czarlewski, W., Durham, S. R., Du Toit, G., Dykewicz, M., Ebisawa, M., Fauquert, J. L., Fernandez-Rivas, M., Fokkens, W. J., Fonseca, J., Fontaine, J. -F., Gerth van Wijk, R., Haahtela, T., Halken, S., Hellings, P. W., Ierodiakonou, D., Iinuma, T., Ivancevich, J. C., Jacobsen, L., Jutel, M., Kaidashev, I., Khaitov, M., Kalayci, O., Kleine Tebbe, J., Klimek, L., Kowalski, M. L., Kuna, P., Kvedariene, V., La Grutta, S., Larenas-Linemann, D., Lau, S., Laune, D., Le, L., Lodrup Carlsen, K., Lourenco, O., Malling, H. -J., Marien, G., Menditto, E., Mercier, G., Mullol, J., Muraro, A., O'Hehir, R., Okamoto, Y., Pajno, G. B., Park, H. -S., Panzner, P., Passalacqua, G., Pham-Thi, N., Roberts, G., Pawankar, R., Rolland, C., Rosario, N., Ryan, D., Samolinski, B., Sanchez-Borges, M., Scadding, G., Shamji, M. H., Sheikh, A., Sturm, G. J., Todo Bom, A., Toppila-Salmi, S., Valentin-Rostan, M., Valiulis, A., Valovirta, E., Ventura, M. -T., Wahn, U., Walker, S., CORBO UGULINO, Wallace, Waserman, S., Yorgancioglu, A., Zuberbier, T., Hospital Quirónsalud Bizkaia [Bilbao], Sagamihara National Hospital [Kanagawa, Japan], Universidade do Porto = University of Porto, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Capital Region of Denmark, Wrocław Medical University, Università degli Studi di Padova = University of Padua (Unipd), Charles University [Prague] (CU)-Medical Faculty in Pilsen, Università degli studi di Genova = University of Genoa (UniGe), Centro Médico Docente La Trinidad, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), and Hibade, Monique
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Cost effectiveness ,[SDV]Life Sciences [q-bio] ,Cost-Benefit Analysis ,Comorbidity ,medicine.disease_cause ,0302 clinical medicine ,Allergen ,Cost of Illness ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,Precision Medicine ,mHealth ,Children ,media_common ,Allergen immunotherapy ,Rhinitis ,Disease Management ,3. Good health ,[SDV] Life Sciences [q-bio] ,rhiniti ,Treatment Outcome ,Practice Guidelines as Topic ,Critical Pathways ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Disease Susceptibility ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,medicine.medical_specialty ,[SDV.IMM] Life Sciences [q-bio]/Immunology ,Attitude of Health Personnel ,Immunology ,Clinical Decision-Making ,03 medical and health sciences ,Pharmacotherapy ,rhinitis ,stratification ,children ,media_common.cataloged_instance ,Animals ,Humans ,European union ,Intensive care medicine ,allergen immunotherapy, asthma, children, mHealth, rhinitis, stratification ,Asthma ,business.industry ,Allergens ,asthma ,medicine.disease ,Rhinitis, Allergic ,Review article ,030228 respiratory system ,Desensitization, Immunologic ,allergen immunotherapy ,Stratification ,business ,Biomarkers - Abstract
Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including health professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as on the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow up of patients. This article is protected by copyright. All rights reserved.
- Published
- 2019
22. Possible utility of basophil activation test in dual honeybee and vespid sensitization
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Christoph Schrautzer, Gunter J. Sturm, Karin Laipold, Werner Aberer, Ines Schwarz, Barbara Binder, Danijela Bokanovic, and Lisa Arzt-Gradwohl
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business.industry ,Wasp Venoms ,Bees ,DUAL (cognitive architecture) ,Basophils ,Bee Venoms ,Basophil activation ,medicine.anatomical_structure ,Immunology ,medicine ,Animals ,Humans ,Immunology and Allergy ,business ,Sensitization - Published
- 2020
23. Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States:An analysis from the EAACI AIT Guidelines Project
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Jay E. Slater, Sergio Bonini, Ioana Agache, Claudio Rhyner, Oscar Palomares, Thomas B. Casale, R. Gerth van Wijk, Aziz Sheikh, Cezmi A. Akdis, R. van Ree, Susanne Halken, Elizabeth Angier, Antonella Muraro, S. Vieths, Carlo Pini, Eva-Maria Varga, J. Bridgewater, G. B. Pajno, Marcel H. N. Hoefnagel, Ronald L. Rabin, Dermot Ryan, Gunter J. Sturm, Oliver Pfaar, Steffen Lau, Graham Roberts, M. Timon, Marek Jutel, Joyce A. Goldstein, Montserrat Fernandez-Rivas, Ruby Pawankar, Ludger Klimek, Andreas Bonertz, D. Hamerlijnk, Domingo Barber, Lars K. Poulsen, Internal Medicine, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, Ear, Nose and Throat, and AII - Amsterdam institute for Infection and Immunity
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0301 basic medicine ,Quality Control ,Allergen immunotherapy ,Allergy ,media_common.quotation_subject ,Immunology ,Review ,medicine.disease_cause ,Allergen immunotherapy, Allergy, Manufacturing, Quality, Regulation, Immunology and Allergy, Immunology ,03 medical and health sciences ,Consistency (database systems) ,0302 clinical medicine ,Allergen ,Documentation ,medicine ,Journal Article ,media_common.cataloged_instance ,Humans ,Technology, Pharmaceutical ,Immunology and Allergy ,Quality (business) ,European union ,media_common ,business.industry ,regulation ,Allergens ,allergy ,Quality ,United States ,Product (business) ,Europe ,Manufacturing ,manufacturing ,allergen immunotherapy ,quality ,030104 developmental biology ,030228 respiratory system ,Risk analysis (engineering) ,Desensitization, Immunologic ,Practice Guidelines as Topic ,business ,Regulation - Abstract
Adequate quality is essential for any medicinal product to be eligible for marketing. Quality includes verification of the identity, content and purity of a medicinal product in combination with a specified production process and its control. Allergen products derived from natural sources require particular considerations to ensure adequate quality. Here, we describe key aspects of the documentation on manufacturing and quality aspects for allergen immunotherapy products in the European Union and the United States. In some key parts, requirements in these areas are harmonized while other fields are regulated separately between both regions. Essential differences are found in the use of Reference Preparations, or the requirement to apply standardized assays for potency determination. Since the types of products available are different in specific regions, regulatory guidance for such products may also be available in one specific region only, such as for allergoids in the European Union. Region-specific issues and priorities are a result of this. As allergen products derived from natural sources are inherently variable in their qualitative and quantitative composition, these products present special challenges to balance the variability and ensuring batch-to-batch consistency. Advancements in scientific knowledge on specific allergens and their role in allergic disease will consequentially find representation in future regulatory guidelines. This article is protected by copyright. All rights reserved.
- Published
- 2018
24. EAACI Guidelines on Allergen Immunotherapy:Allergic Rhinoconjunctivitis
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Ralph Mösges, Graham Roberts, Jamie Wilkinson, P W Hellings, Eckard Hamelmann, E. Angier, Désirée Larenas-Linnemann, Andrew James Williams, Sandra Y. Lin, Olympia Tsilochristou, Steffen Lau, Constantinos Pitsios, Cezmi A. Akdis, Lewei Zhang, Montserrat Fernandez-Rivas, Ioana Agache, Marek Jutel, P. Maggina, Carsten B. Schmidt-Weber, S. Dhami, Lars Jacobsen, Antonella Muraro, Dermot Ryan, Ruby Pawankar, I. J. Ansotegui, Gunter J. Sturm, G. Rotiroti, Elideanna Pastorello, Frans Timmermans, R. van Ree, Stefania Arasi, Susanne Halken, Edward F. Knol, Moises A. Calderon, Cemal Cingi, Aziz Sheikh, J. N. G. Oude Elberink, Giovanni B. Pajno, Martin Penagos, Oliver Pfaar, Stephen R. Durham, Jean-Luc Fauquert, R. Gerth van Wijk, Eva-Maria Varga, Margitta Worm, Internal Medicine, Erasmus MC other, Ear, Nose and Throat, AII - Inflammatory diseases, APH - Personalized Medicine, APH - Global Health, Experimental Immunology, AII - Amsterdam institute for Infection and Immunity, and Groningen Research Institute for Asthma and COPD (GRIAC)
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Allergy ,Allergen immunotherapy ,medicine.medical_specialty ,Immunology ,Population ,Placebo-controlled study ,SHORT-TERM IMMUNOTHERAPY ,COST-EFFECTIVENESS ANALYSIS ,Allergen immunotherapy, Allergic conjunctivitis, Allergic rhinitis, Allergy, Rhinoconjunctivitis, Immunology and Allergy, Immunology ,PLACEBO-CONTROLLED TRIAL ,law.invention ,DOUBLE-BLIND ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Randomized controlled trial ,SUBLINGUAL-SWALLOW IMMUNOTHERAPY ,law ,medicine ,HOUSE-DUST-MITE ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,Intensive care medicine ,education ,Conjunctivitis, Allergic ,education.field_of_study ,allergic rhinitis ,business.industry ,PERSISTENT SUBCUTANEOUS NODULES ,rhinoconjunctivitis ,GRASS-POLLEN IMMUNOTHERAPY ,Guideline ,RANDOMIZED CONTROLLED-TRIAL ,medicine.disease ,allergy ,Rhinitis, Allergic ,Allergic conjunctivitis ,allergic conjunctivitis ,030228 respiratory system ,Desensitization, Immunologic ,allergen immunotherapy ,ADVERSE SYSTEMIC REACTIONS ,business - Abstract
Allergic rhinoconjunctivitis (AR) is an allergic disorder of the nose and eyes affecting about a fifth of the general population. Symptoms of AR can be controlled with allergen avoidance measures and pharmacotherapy. However, many patients continue to have ongoing symptoms and an impaired quality of life; pharmacotherapy may also induce some side-effects. Allergen immunotherapy (AIT) represents the only currently available treatment that targets the underlying pathophysiology and it may have a disease modifying effect. Either the subcutaneous (SCIT) or sublingual (SLIT) routes may be used. This Guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on AIT for AR and is part of the EAACI presidential project "EAACI Guidelines on Allergy Immunotherapy". It aims to provide evidence-based clinical recommendations and has been informed by a formal systematic review and meta-analysis. Its generation has followed the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included involvement of the full range of stakeholders. In general, broad evidence for the clinical efficacy of AIT for AR exists but a product-specific evaluation of evidence is recommended. In general, SCIT and SLIT are recommended for both seasonal and perennial AR for its short term benefit. The strongest evidence for long-term benefit is documented for grass AIT (especially for the grass-tablets) where long-term benefit is seen. To achieve long-term efficacy, it is recommended that a minimum of 3 years of therapy is used. Many gaps in the evidence base exist, particularly around long-term benefit and use in children. This article is protected by copyright. All rights reserved
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- 2018
25. Immunological differences between insect venom-allergic patients with and without immunotherapy and asymptomatically sensitized subjects
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Danijela Bokanovic, Christoph Schrautzer, Norbert Reider, Jutta Vollmann, Gunter J. Sturm, Wolfgang Pfützner, Sereina A. Herzog, Christian Möbs, Karin Laipold, Barbara Bohle, Werner Aberer, and Lisa Arzt
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0301 basic medicine ,Male ,Allergy ,medicine.medical_treatment ,Venom ,Basophil ,Immunoglobulin E ,0302 clinical medicine ,Antibody Specificity ,Immunology and Allergy ,Sensitization ,Arthropod Venoms ,Aged, 80 and over ,Immunoassay ,biology ,Middle Aged ,medicine.anatomical_structure ,Phenotype ,Female ,medicine.symptom ,Adult ,Adolescent ,Immunology ,complex mixtures ,Asymptomatic ,Sensitivity and Specificity ,03 medical and health sciences ,Young Adult ,medicine ,Hypersensitivity ,Humans ,Aged ,business.industry ,fungi ,Insect Bites and Stings ,Immunotherapy ,Allergens ,medicine.disease ,eye diseases ,Sting ,030104 developmental biology ,030228 respiratory system ,Biological Variation, Population ,Immunoglobulin G ,Asymptomatic Diseases ,biology.protein ,Human medicine ,business - Abstract
BackgroundCurrently available tests are unable to distinguish between asymptomatic sensitization and clinically relevant Hymenoptera venom allergy. A reliable serological marker to monitor venom immunotherapy (VIT) does also not exist. Our aim was to find reliable serological markers to predict tolerance to bee and vespid stings. MethodsWe included 77 asymptomatically sensitized subjects, 85 allergic patients with acute systemic sting reactions, and 61 allergic patients currently treated with VIT. Levels of sIgE and sIgG(4) to bee and vespid venom, rApi m 1, and rVes v 5 were measured immediately after allergic sting reactions or before sting challenges and 4 weeks later. All sting challenges were tolerated. The inhibitory activity was determined using BAT inhibition and ELIFAB assay. ResultsMedian sIgG(4) levels were 96-fold higher in VIT patients (P < .001) while sIgE/sIgG(4) ratios were consistently lower (P < .001). The ELIFAB assay was paralleled by low sIgE/sIgG(4) ratios in VIT patients, showing markedly higher allergen-blocking capacity (P < .001). An almost complete inhibition of the basophil response was seen in all patients treated with vespid venom, but not in those treated with bee venom. Four weeks after the sting, sIgE and sIgG(4) levels were increased in allergic and asymptomatically sensitized patients, but not in VIT patients. ConclusionImmunological responses after stings varied in bee and vespid venom-allergic patients. In patients under VIT, sIgE and sIgG(4) remained completely stable after sting challenges. Monitoring VIT efficacy was only possible in vespid venom allergy, and the sIgG(4) threshold for rVes v 5 had the highest sensitivity to confirm tolerance. The BAT inhibition test was the most reliable tool to confirm tolerance on an individual basis.
- Published
- 2018
26. The urgent need for a harmonized severity scoring system for acute allergic reactions
- Author
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Katrina J. Allen, Franziska Ruëff, J. O'b. Hourihane, Victoria Cardona, Barbara Ballmer-Weber, Carlos A. Camargo, Allan Clark, Graham Roberts, Karin Hoffmann-Sommergruber, Aziz Sheikh, Kirsten Beyer, Frans Timmermans, E. N. C. Mills, Paul Turner, E. Angier, Jonathan M. Spergel, Philippe Eigenmann, Audrey DunnGalvin, Ioana Agache, Gunter J. Sturm, Antonella Muraro, Caroline Nilsson, M.J. Torres, Margitta Worm, Magnus Wickman, Esben Eller, Carsten Bindslev-Jensen, Lars K. Poulsen, Montserrat Fernandez-Rivas, R. van Ree, Susanne Halken, Antonella Cianferoni, M. B. Bilò, Steffen Lau, Marek Jutel, Medical Research Council (MRC), Commission of the European Communities, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, Ear, Nose and Throat, and AII - Amsterdam institute for Infection and Immunity
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0301 basic medicine ,Allergy ,Peanut allergy ,GUIDELINES ,Severity of Illness Index ,DOUBLE-BLIND ,0302 clinical medicine ,Anaphylaxis/diagnosis ,Validation ,Immunology and Allergy ,Disease management (health) ,Hypersensitivity/diagnosis/immunology ,Anaphylaxis/diagnosis/immunology ,Severity score ,validation ,CLINICAL IMMUNOLOGY ,ddc:618 ,PEANUT ALLERGY ,Stakeholder ,Disease Management ,1107 Immunology ,Practice Guidelines as Topic ,Immunoglobulin E/immunology ,venom allergy ,Venom allergy ,Life Sciences & Biomedicine ,EUROPEAN ACADEMY ,medicine.medical_specialty ,Hypersensitivity/diagnosis ,Immunology ,Drug allergy ,ORGANIZATION ,Development ,allergic reactions ,CLASSIFICATION ,03 medical and health sciences ,Allergens/immunology ,FOOD ,Patient experience ,Severity of illness ,Food allergy ,Hypersensitivity ,anaphylaxis ,medicine ,Humans ,Angioedema ,Intensive care medicine ,development ,Anaphylaxis ,Asthma ,food allergy ,Health Services Needs and Demand ,Science & Technology ,urticarial ,business.industry ,VENOM IMMUNOTHERAPY ,angioedema ,Public health ,ANAPHYLACTOID REACTIONS ,Allergens ,Immunoglobulin E ,asthma ,medicine.disease ,Urticarial ,030104 developmental biology ,030228 respiratory system ,Allergic reactions ,severity score ,business ,drug allergy - Abstract
The accurate assessment and communication of the severity of acute allergic reactions is important to patients, clinicians, researchers, the food industry, public health and regulatory authorities. Severity has different meanings to different stakeholders with patients and clinicians rating the significance of particular symptoms very differently. Many severity scoring systems have been generated, most focusing on the severity of reactions following exposure to a limited group of allergens. They are heterogeneous in format, none has used an accepted developmental approach and none has been validated. Their wide range of outcome formats has led to difficulties with interpretation and application. Therefore there is a persisting need for an appropriately developed and validated severity scoring system for allergic reactions that works across the range of allergenic triggers and addresses the needs of different stakeholder groups. We propose a novel approach to develop and then validate a harmonized scoring system for acute allergic reactions, based on a data-driven method that is informed by clinical and patient experience and other stakeholders' perspectives. We envisage two formats: (i) a numerical score giving a continuum from mild to severe reactions that is clinically meaningful and is useful for allergy healthcare professionals and researchers; and (ii) a three grade based ordinal format that is simple enough to be used and understood by other professionals and patients. Testing of reliability and validity of the new approach in a range of settings and populations will allow eventual implementation of a standardized scoring system in clinical studies and routine practice. This article is protected by copyright. All rights reserved.
- Published
- 2018
27. Challenges in the implementation of EAACI guidelines on allergen immunotherapy:A global perspective on the regulation of allergen products
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S. Vieths, Marcel H. N. Hoefnagel, Ruby Pawankar, Gunter J. Sturm, Lars K. Poulsen, Montserrat Fernandez-Rivas, Oliver Pfaar, Domingo Barber, Ioana Agache, Ludger Klimek, Thomas B. Casale, Jay E. Slater, Eva-Maria Varga, Graham Roberts, Cezmi A. Akdis, Antonella Muraro, Joyce A. Goldstein, Ronald L. Rabin, Andreas Bonertz, Oscar Palomares, Aziz Sheikh, D. Hamerlijnk, Carlo Pini, R. van Ree, Susanne Halken, Steffen Lau, Marek Jutel, R. Gerth van Wijk, J. Bridgewater, M. Timon, Sergio Bonini, Claudio Rhyner, Elizabeth Angier, G. B. Pajno, Erasmus MC other, and Internal Medicine
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0301 basic medicine ,Allergen immunotherapy ,allergic diseases ,allergen immunotherapy, allergic diseases, allergy, regulation, Immunology and Allergy, Immunology ,Immunology ,Review ,medicine.disease_cause ,Marketing authorization ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Desensitization, Immunologic/methods ,Hypersensitivity ,medicine ,Journal Article ,media_common.cataloged_instance ,Immunology and Allergy ,Humans ,Hypersensitivity/epidemiology ,Marketing ,European union ,Allergens/administration & dosage ,Health policy ,media_common ,business.industry ,Member states ,Health Policy ,Perspective (graphical) ,Authorization ,regulation ,Allergens ,allergy ,United States ,Europe ,030104 developmental biology ,030228 respiratory system ,Desensitization, Immunologic ,Practice Guidelines as Topic ,allergen immunotherapy ,business - Abstract
Regulatory approaches for allergen immunotherapy (AIT) products and the availability of high-quality AIT products are inherently linked to each other. While allergen products are available in many countries across the globe, their regulation is very heterogeneous. First, we describe the regulatory systems applicable for AIT products in the European Union (EU) and in the United States (US). For Europe, a depiction of the different types of relevant procedures, as well as the committees involved, is provided and the fundamental role of national agencies of the EU member states in this complex and unique network is highlighted. Furthermore, the regulatory agencies from Australia, Canada, Japan, Russia, and Switzerland provided information on the system implemented in their countries for the regulation of allergen products. While AIT products are commonly classified as biological medicinal products, they are made available by varying types of procedures, most commonly either by obtaining a marketing authorization or by being distributed as named patient products. Exemptions from marketing authorizations in exceptional cases, as well as import of allergen products from other countries, are additional tools applied by countries to ensure availability of needed AIT products. Several challenges for AIT products are apparent from this analysis and will require further consideration.
- Published
- 2018
28. EAACI Guidelines on Allergen Immunotherapy:Prevention of allergy
- Author
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Montserrat Fernandez-Rivas, Paolo Maria Matricardi, Frans Timmermans, Oliver Pfaar, Ulrich Wahn, Nikolaos G. Papadopoulos, Eva-Maria Varga, Stefania Arasi, Alexandra F. Santos, Jörg Kleine-Tebbe, Susanne Lau, Ioana Agache, Ignacio J. Ansotegui, R. van Ree, Susanne Halken, Giovanni B. Pajno, Sangeeta Dhami, Dermot Ryan, Désirée Larenas-Linnemann, Marek Jutel, Maria Kristiansen, Antonella Muraro, Moises A. Calderon, Martin Penagos, Roy Geerth van Wijk, Gunter J. Sturm, Aziz Sheikh, Elisabeth Angier, Graham Roberts, George Du Toit, Internal Medicine, and Erasmus MC other
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Allergen immunotherapy ,medicine.medical_specialty ,Allergy ,allergic diseases ,Adolescent ,Immunology ,atopy ,Allergic condition ,Review ,Pediatrics ,sensitization ,Allergic sensitization ,Atopy ,03 medical and health sciences ,0302 clinical medicine ,AGREE II, allergen immunotherapy, allergic diseases, allergic rhinitis, allergy, asthma, atopic dermatitis/eczema, atopy, prevention, sensitization, Pediatrics, Perinatology and Child Health, Immunology and Allergy, Immunology ,Secondary Prevention/methods ,prevention ,Desensitization, Immunologic/methods ,medicine ,Hypersensitivity ,Secondary Prevention ,Journal Article ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,atopic dermatitis/eczema ,Intensive care medicine ,Child ,Asthma ,allergic rhinitis ,business.industry ,Guideline ,Perinatology and Child Health ,asthma ,medicine.disease ,allergy ,AGREE II ,Primary Prevention/methods ,Clinical trial ,Primary Prevention ,030228 respiratory system ,Desensitization, Immunologic ,Hypersensitivity/prevention & control ,Pediatrics, Perinatology and Child Health ,allergen immunotherapy ,business - Abstract
Allergic diseases are common and frequently coexist. Allergen immunotherapy (AIT) is a disease-modifying treatment for IgE-mediated allergic disease with effects beyond cessation of AIT that may include important preventive effects. The European Academy of Allergy and Clinical Immunology (EAACI) has developed a clinical practice guideline to provide evidence-based recommendations for AIT for prevention of i) development of allergic comorbidities in those with established allergic diseases, ii) development of first allergic condition and iii) allergic sensitization. This guideline has been developed using the Appraisal of Guidelines for Research & Evaluation (AGREE II) framework, which involved a multi-disciplinary expert working group, a systematic review of the underpinning evidence and external peer-review of draft recommendations. Our key recommendation is that a three year course of subcutaneous or sublingual AIT can be recommended for children and adolescents with moderate to severe allergic rhinitis (AR) triggered by grass/birch pollen allergy to prevent asthma for up to two years post-AIT in addition to its sustained effect on AR symptoms and medication. Some trial data even suggest a preventive effect on asthma symptoms and medication more than two years post AIT. We need more evidence concerning AIT for prevention in individuals with AR triggered by house dust mites or other allergens and for the prevention of allergic sensitization, the first allergic disease or for prevention of allergic co-morbidities in those with other allergic conditions. Evidence for the preventive potential of AIT as disease modifying treatment exists but there is an urgent need for more high-quality clinical trials. This article is protected by copyright. All rights reserved.
- Published
- 2017
29. Phosphoinositide-dependent protein kinase 1 (PDK1) mediates potent inhibitory effects on eosinophils
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Gunter J. Sturm, Eva M. Sturm, Akos Heinemann, Gerald P. Parzmair, Rufina Schuligoi, Robert Frei, Astrid Hammer, Balázs Radnai, and Irmgard Th. Lippe
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animal structures ,Immunology ,Chemotaxis ,Biology ,Eosinophil ,Cell biology ,Eosinophil migration ,medicine.anatomical_structure ,medicine ,Immunology and Allergy ,Phosphorylation ,lipids (amino acids, peptides, and proteins) ,Prostaglandin E2 ,Receptor ,Protein kinase A ,PI3K/AKT/mTOR pathway ,medicine.drug - Abstract
Prostaglandin E2 (PGE2 ) protects against allergic responses via binding to prostanoid receptor EP4, which inhibits eosinophil migration in a PI3K/PKC-dependent fashion. The phosphoinositide-dependent protein kinase 1 (PDK1) is known to act as a downstream effector in PI3K signaling and has been implicated in the regulation of neutrophil migration. Thus, here we elucidate whether PDK1 mediates inhibitory effects of E-type prostanoid receptor 4 (EP4) receptors on eosinophil function. Therefore, eosinophils were isolated from human peripheral blood or differentiated from mouse BM. PDK1 signaling was investigated in shape change, chemotaxis, CD11b, respiratory burst, and Ca(2+) mobilization assays. The specific PDK1 inhibitors BX-912 and GSK2334470 prevented the inhibition by prostaglandin E2 and the EP4 agonist ONO-AE1-329. Depending on the cellular function, PDK1 seemed to act through PI3K-dependent or PI3K-independent mechanisms. Stimulation of EP4 receptors caused PDK1 phosphorylation at Ser396 and induced PI3K-dependent nuclear translocation of PDK1. EP4-induced inhibition of shape change and chemotaxis was effectively reversed by the Akt inhibitor triciribine. In support of this finding, ONO-AE1-329 induced a PI3K/PDK1-dependent increase in Akt phosphorylation. In conclusion, our data illustrate a critical role for PDK1 in transducing inhibitory signals on eosinophil effector function. Thus, our results suggest that PDK1 might serve as a novel therapeutic target in diseases involving eosinophilic inflammation.
- Published
- 2015
30. Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy
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E. Angier, Montserrat Fernandez-Rivas, Amena Warner, G. B. Pajno, Stefania Arasi, Aziz Sheikh, Oliver Pfaar, Ioana Agache, Eva-Maria Varga, Antonella Muraro, Victoria Cardona, Dermot Ryan, Steffen Lau, Graham Roberts, R. Gerth van Wijk, Marek Jutel, Maria Kristiansen, Hadar Zaman, Gunter J. Sturm, Carmen Vidal, R. van Ree, Susanne Halken, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, Ear, Nose and Throat, AII - Amsterdam institute for Infection and Immunity, and Internal Medicine
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Allergen immunotherapy ,medicine.medical_specialty ,Pediatrics ,barriers ,Immunology ,Alternative medicine ,Primary care ,Care provision ,03 medical and health sciences ,primary care ,0302 clinical medicine ,barriers, care pathways, educational needs, immunotherapy guidelines, primary care ,Journal Article ,Hypersensitivity ,Immunology and Allergy ,Medicine ,Humans ,030212 general & internal medicine ,Disease management (health) ,immunotherapy guidelines ,Reimbursement ,educational needs ,business.industry ,030228 respiratory system ,care pathways ,Desensitization, Immunologic ,Family medicine ,Preparedness ,Practice Guidelines as Topic ,business ,Situation analysis - Abstract
PURPOSE: The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe.METHODS: We undertook a mixed-methods, situational analysis. This involved a purposeful literature search, and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe.RESULTS: The 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence-based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32-48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers.CONCLUSIONS: Successful working with primary care providers is essential to scaling-up AIT provision in Europe, but to achieve this the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency. This article is protected by copyright. All rights reserved.
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- 2017
31. EAACI Guidelines on Allergen Immunotherapy: Hymenoptera venom allergy
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Montserrat Fernandez-Rivas, Moises A. Calderon, M. B. Bilò, Hadar Zaman, E. Angier, Franziska Ruëff, Oliver Pfaar, G. B. Pajno, Dermot Ryan, Ewa Cichocka-Jarosz, Ervin Ç. Mingomataj, Graham Roberts, Antonella Muraro, Stefania Arasi, R. van Ree, Mitja Košnik, V. Pravettoni, Aziz Sheikh, Gunter J. Sturm, Darío Antolín-Amérigo, Susanne Halken, Joanna Lange, Eva-Maria Varga, R. G. Van Wijk, Markus Ollert, Cezmi A. Akdis, Holger Mosbech, Radosław Gawlik, O. Spranger, Dimitris I. Mitsias, Steffen Lau, Constantinos Pitsios, Marek Jutel, Ioana Agache, S. Dhami, Betül Ayşe Sin, Thilo Jakob, J. N. G. Oude Elberink, APH - Personalized Medicine, AII - Inflammatory diseases, APH - Global Health, Experimental Immunology, Ear, Nose and Throat, AII - Amsterdam institute for Infection and Immunity, Groningen Research Institute for Asthma and COPD (GRIAC), Erasmus MC other, and Internal Medicine
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Allergy ,Effectiveness ,BASOPHIL ACTIVATION TEST ,PLACEBO-CONTROLLED TRIAL ,Insect sting allergy ,030207 dermatology & venereal diseases ,0302 clinical medicine ,Autoinjector ,QUALITY-OF-LIFE ,Immunology and Allergy ,Medicine ,systemic sting reaction ,Allergen immunotherapy ,honeybee venom ,LONG-TERM PROTECTION ,LARGE LOCAL REACTIONS ,3. Good health ,HONEY-BEE VENOM ,Bee Venoms ,Hymenoptera venom allergy ,Safety ,Anaphylaxis, Effectiveness, Hymenoptera venom allergy, Safety, Venom immunotherapy, Immunology and Allergy, Immunology ,vespid venom ,Anaphylaxis ,safety ,medicine.medical_specialty ,Immunology ,INDOLENT SYSTEMIC MASTOCYTOSIS ,effectiveness ,API M 10 ,YELLOW JACKET VENOM ,INSECT STING ALLERGY ,03 medical and health sciences ,Hypersensitivity ,anaphylaxis ,Animals ,Humans ,Adverse effect ,business.industry ,Guideline ,medicine.disease ,Dermatology ,Sting ,030228 respiratory system ,Desensitization, Immunologic ,venom immunotherapy ,HYMENOPTERA VENOM ALLERGY ,business - Abstract
Hymenoptera venom allergy is a potentially life-threatening allergic reaction following a honeybee, vespid or ant sting. Systemic allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate-to-severe with a risk of life-threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1 -antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence-based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta-analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom allergic children and adults to prevent further moderate to severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline auto-injector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence-based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence. This article is protected by copyright. All rights reserved
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- 2017
32. Questionable diagnostic benefit of the commercially available panel of bee venom components
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Gunter J. Sturm, Werner Aberer, Christoph Schrautzer, Lisa Arzt, Ines Schwarz, Danijela Bokanovic, and Karin Laipold
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0301 basic medicine ,Allergy ,business.industry ,Immunology ,Insect Bites and Stings ,Cross Reactions ,Immunoglobulin E ,medicine.disease ,medicine.disease_cause ,Sensitivity and Specificity ,03 medical and health sciences ,Bee Venoms ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Allergen ,030228 respiratory system ,Bee venom ,medicine ,Immunology and Allergy ,Animals ,Insect Proteins ,business ,Sensitization - Abstract
For many years, only the major allergen rApi m 1 has been available on the ImmunoCAP system for routine diagnosis of bee venom (BV) allergy. Now, there are five components available, and we aimed to detect the sensitivity and specificity of rApi m 1, 2, 3, 5, and 10 in BV-allergic patients. We further evaluated the sensitivity of rApi m 1 and 2 of an alternative platform and investigated possible differences in the sensitization profile between monosensitization and clinically relevant double sensitization. Analysis of the whole panel of BV allergens of the CAP system still resulted in a lower sensitivity than analysis of the combination of rApi m 1 and 2 of the Immulite (71.6% vs 85.8%). Sensitization rate of rApi m 5 was more than doubled in double-sensitized patients, while there was no difference for rApi m 2. The benefit of the commercially available panel of BV components is questionable, due to the insufficient sensitivity and still unavailable important cross-reacting allergens.
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- 2017
33. Erratum to: Allergen immunotherapy for insect venom allergy: protocol for a systematic review
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V. Pravettoni, Joanna Lange, Ulugbek Nurmatov, Franziska Ruëff, Cezmi A. Akdis, Gunter J. Sturm, Danijela Bokanovic, Constantinos Pitsios, Moises A. Calderon, M. Beatrice Bilò, Eva-Maria Varga, Darío Antolín-Amérigo, Joanna N G Oude Elberink, Dimitris I. Mitsias, Sangeeta Dhami, Betül Ayşe Sin, Thilo Jakob, Aziz Sheikh, Oliver Pfaar, Mitja Košnik, Graham Roberts, Radosław Gawlik, Antonella Muraro, Holger Mosbech, Ewa Cichocka-Jarosz, and Ervin Ç. Mingomataj
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Pulmonary and Respiratory Medicine ,Protocol (science) ,medicine.medical_specialty ,Allergen immunotherapy ,Allergy ,business.industry ,Immunology ,Section (typography) ,RC581-607 ,medicine.disease ,3. Good health ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Family medicine ,Insect venom allergy ,medicine ,Immunology and Allergy ,media_common.cataloged_instance ,European union ,Immunologic diseases. Allergy ,business ,media_common - Abstract
Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below: Funding EAACI and the BM4SIT project (Grant Number 601763) in the European Union’s Seventh Framework Programme FP7.
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- 2017
34. New trends in anaphylaxis
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Victoria Cardona, Ioana Maris, Gunter J. Sturm, Ewa Cichocka-Jarosz, Margitta Worm, Jörg Kleine-Tebbe, and Sabine Dölle
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medicine.medical_specialty ,Allergy ,Target groups ,Review ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,food ,Molecular diagnostics ,medicine ,Immunology and Allergy ,Insect venom ,Intensive care medicine ,Anaphylaxis ,business.industry ,Goji berry ,Guideline ,Education food allergy ,medicine.disease ,Training methods ,food.food ,Sting ,030228 respiratory system ,Immunology ,Hymenoptera venom allergy ,Emergency care ,business - Abstract
This review presents the current trends in anaphylaxis management discussed at the fourth International Network for Online-Registration of Anaphylaxis (NORA) conference held in Berlin in April 2017. Current data from the anaphylaxis registry show that Hymenoptera venom, foods, and pharmaceutical drugs are still among the most frequent triggers of anaphylaxis. Rare triggers include chicory, cardamom, asparagus, and goji berries. A meta-analysis on recent trends in insect venom anaphylaxis demonstrated for the first time that, although data on the efficacy of insect venom immunotherapy is limited, the occurrence of severe reactions upon repeated sting events can be prevented and patients’ quality of life improved. Molecular diagnostics of insect venom anaphylaxis have significantly improved diagnostic sensitivity and specificity. Self-treatment of anaphylaxis is of great importance. Recent data from the anaphylaxis registry show an increase (from 23% in 2012 to 29% in 2016) in the use of adrenaline as recommended in the guidelines. A survey on the implementation of guidelines conducted among the centers reporting to the anaphylaxis registry highlights the extent to which the guideline has been perceived and implemented. Reports on a variety of cases in the anaphylaxis registry illustrate the diversity of this potentially life-threatening reaction. Component-resolved diagnostics can help to specify sensitization profiles in anaphylaxis, particularly in terms of the risk for severe reactions. Recent studies on anaphylaxis awareness show that training methods are effective; nevertheless, target groups and learning methods need to undergo further scientific investigation in coming years.
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- 2017
35. Determination of sIgE to rPhl p 1 is sufficient to diagnose grass pollen allergy
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Danijela Bokanovic, Akos Heinemann, Wolfgang Hemmer, Gunter J. Sturm, J. Scheffel, Peter Komericki, and Werner Aberer
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Hypersensitivity, Immediate ,medicine.medical_specialty ,Immunology ,Provocation test ,medicine.disease_cause ,Gastroenterology ,Asymptomatic ,Phleum ,Food allergy ,Internal medicine ,Pollen ,medicine ,Humans ,Immunology and Allergy ,Prospective Studies ,Sensitization ,Skin Tests ,Timothy-grass ,biology ,Plant Extracts ,business.industry ,Rhinitis, Allergic, Seasonal ,Antigens, Plant ,Immunoglobulin E ,biology.organism_classification ,medicine.disease ,Basophils ,Basophil activation ,medicine.anatomical_structure ,medicine.symptom ,business - Abstract
Background New diagnostic tools such as the basophil activation test (BAT) and component-resolved diagnosis (CRD) are promising for hymenoptera venom or food allergy. A clear benefit for inhalant allergens has not yet been shown. Our aim was to compare new and established tests for grass pollen allergy. Methods Forty-nine patients with grass pollen allergy and 47 controls were prospectively enrolled in the study. A symptom score was calculated for each patient. Conjunctival provocation tests (CPT), skin prick tests (SPT), BAT, and sIgE determination including CRD were performed. Sensitivity and specificity were compared and results were correlated with the symptom score. Results Single determination of sIgE to rPhl p 1 showed the best balance between sensitivity (98%) and specificity (92%). Use of additional components, such as rPhl p 2 and 5, did not increase sensitivity. Generally, sensitivity of tests was high: SPT 100%, ISAC-112 100%, sIgE to timothy grass 98%, BAT 98%, ISAC-103 84%, and CPT 83%. Specificity ranged from 79% (SPT) to 96% (CPT). All test results and calculated values (e.g. ratio sIgE/tIgE) did not correlate with symptom severity. Asymptomatic sensitization to timothy grass in controls was rare in the CAP (11%) and predominantly due to Phl p 1 sensitization. Conclusion rPhl p 1 was sufficient to diagnose grass pollen allergy, and sIgE patterns were the same in symptomatically and asymptomatically sensitized subjects. The testing of multiple components was of minor importance, and no test correlated with symptom severity.
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- 2013
36. Reply
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Gunter J. Sturm, Christoph Schrautzer, Lisa Arzt, and Werner Aberer
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Immunology ,Immunology and Allergy ,Animals ,Biological Assay ,Allergens ,Hymenoptera - Published
- 2016
37. Hymenoptera stings in the head region induce impressive, but not severe sting reactions
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Cesare Massone, Lisa Arzt, Ines Schwarz, Danijela Bokanovic, Michael Horn, Christoph Schrautzer, Gunter J. Sturm, and Werner Aberer
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Immunology ,Posterior region ,Tryptase ,macromolecular substances ,Insect bites and stings ,Severity of Illness Index ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Basal (phylogenetics) ,Young Adult ,0302 clinical medicine ,Severity of illness ,medicine ,Immunology and Allergy ,Animals ,Humans ,Risk factor ,Young adult ,Child ,Arthropod Venoms ,Aged ,Skin ,Aged, 80 and over ,biology ,business.industry ,Insect Bites and Stings ,Allergens ,Middle Aged ,medicine.disease ,Dermatology ,Hymenoptera ,Surgery ,Sting ,030228 respiratory system ,biology.protein ,Female ,Symptom Assessment ,business ,Biomarkers - Abstract
Stings in the head region are considered to be a risk factor for severe systemic reactions to hymenoptera stings. We supposed that stings in skin areas, which are well supplied with blood, lead to more severe reactions and tested our hypothesis in 847 patients with confirmed hymenoptera venom allergy. However, symptom severity was independent from sting site: only 16.3% of patients with severe reactions were stung on the head (P = 0.017). But we confirmed age > 40 years (P < 0.001) as well as elevated basal tryptase levels (P = 0.001) as risk factors. Taking antihypertensive drugs seemed to have an influence: 41.7% of patients taking antihypertensive drugs experienced a severe reaction compared to 29.5% of patients, not taking such drugs (P = 0.019). However, considering patients' age in regression analysis, taking antihypertensive drugs had no effect on symptom severity (P = 0.342). Importantly, in most patients with severe reactions, cutaneous signs were absent (P < 0.001).
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- 2016
38. Self-medication of anaphylactic reactions due to Hymenoptera stings - An EAACI Task Force Consensus Statement
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Franziska Ruëff, Vincenzo Patella, T. Jakob, Arthur Helbling, Holger Mosbech, Javier Fernández, Marek Niedoszytko, J N G Oude-Elberink, Valerio Pravettoni, Ewa Cichocka-Jarosz, Patrizia Bonadonna, Radosław Gawlik, Joanna Lange, M. B. Bilò, Gunter J. Sturm, Mitja Košnik, R. Rodrigues-Alves, R. Pumphrey, and Groningen Research Institute for Asthma and COPD (GRIAC)
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medicine.medical_specialty ,EUROPEAN ACADEMY ,Epinephrine ,Injections, Subcutaneous ,Immunology ,Self Medication ,Insect bites and stings ,FOOD ALLERGY ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,SYSTEMIC REACTIONS ,15 KG ,Immunology and Allergy ,Medicine ,Animals ,Humans ,Medical prescription ,610 Medicine & health ,Intensive care medicine ,Anaphylaxis ,INJECTABLE EPINEPHRINE ,CLINICAL IMMUNOLOGY ,adrenaline ,business.industry ,AUTOINJECTOR NEEDLE LENGTH ,Insect Bites and Stings ,Emergency department ,Allergens ,medicine.disease ,Hymenoptera ,Surgery ,EPINEPHRINE AUTO-INJECTORS ,Sting ,030228 respiratory system ,insect venom allergy ,Allergists ,immunotherapy ,business ,EMERGENCY TREATMENT ,Self-medication - Abstract
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.
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- 2016
39. Allergen immunotherapy for insect venom allergy : protocol for a systematic review
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Sangeeta Dhami, Oliver Pfaar, Franziska Ruëff, V. Pravettoni, Antonella Muraro, Holger Mosbech, Dimitris I. Mitsias, Betül Ayşe Sin, Darío Antolín-Amérigo, Graham Roberts, Thilo Jakob, Mitja Košnik, Gunter J. Sturm, Ewa Cichocka-Jarosz, Ervin Ç. Mingomataj, Joanna Lange, Danijela Bokanovic, Eva-Maria Varga, Joanna N G Oude Elberink, Radosław Gawlik, Cezmi A. Akdis, M. Beatrice Bilò, Aziz Sheikh, Ulugbek Nurmatov, Moises A. Calderon, Constantinos Pitsios, and Groningen Research Institute for Asthma and COPD (GRIAC)
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Allergen immunotherapy ,medicine.medical_specialty ,Allergy ,Clinical immunology ,Immunology ,CHILDREN ,complex mixtures ,03 medical and health sciences ,Study Protocol ,0302 clinical medicine ,Insect venom allergy ,medicine ,MANAGEMENT ,Immunology and Allergy ,EPIDEMIOLOGY ,Insect sting ,HYMENOPTERA VENOM ,Intensive care medicine ,Protocol (science) ,ANAPHYLAXIS ,business.industry ,Hymenoptera venom allergy ,medicine.disease ,R1 ,Hymenoptera venom ,Systemic sting reaction ,030104 developmental biology ,030228 respiratory system ,BIAS ,Erratum ,business ,Anaphylaxis - Abstract
BackgroundThe European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for the Management of Insect Venom Allergy. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in the management of insect venom allergy.MethodsWe will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised.DiscussionThe findings from this review will be used to inform the development of recomendations for EAACI’s Guidelines on AIT.
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- 2016
40. Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies: An AIRWAYS Integrated Care Pathways (ICPs) programme item (Action Plan B3 of the European Innovation Partnership on active and healthy ageing) and the Global Alliance against Chronic Respiratory Diseases (GARD), a World Health Organization GARD research demonstration project
- Author
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Oliver Pfaar, Luciana Kase Tanno, Antonella Muraro, M. Bewick, G.W. Canonica, Pascal Demoly, Mohamed H. Shamji, Cezmi A. Akdis, T. Zuberbier, Dirceu Solé, H.-J. Malling, J Mullol, Alain Didier, Gunter J. Sturm, B. Samolinski, Claus Bachert, G. Passalacqua, Carmen Vidal, Andrew Bush, L. Cox, Stephen R. Durham, Anca-Mirela Chiriac, V. Cardona, Ana I. Tabar, M. T. Ventura, P. Devillier, G. Du Toit, Eva-Maria Varga, David Price, Thomas B. Casale, P. Rodriguez del Rio, Barbara Bohle, D. Larenas-Linnemann, Aziz Sheikh, G. Di Lorenzo, Margitta Worm, R. Rueff, R. van Ree, Susanne Halken, Davide Caimmi, Alessandro Fiocchi, J. C. Sisul, F. de Blay, Piotr Kuna, R. Gerth van Wijk, M. Matricardi, Moises A. Calderon, Ludger Klimek, Sergio Bonini, R. M. Gomez, Gabriela Senti, G. K. Scadding, Peter Eng, Nikolaos G. Papadopoulos, Adam T. Fox, Jean Bousquet, B. M. Bilo, Elideanna Pastorello, Edward F. Knol, Jörg Kleine-Tebbe, T. Haathela, Lars Jacobsen, R. Moesges, Adnan Custovic, Allan Linneberg, Peter Hellings, J. Just, Imperial College London, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'allergologie et de pneumologie [Hôpital Arnaud de Villeneuve], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), University of South Florida [Tampa] (USF), Universität Zürich [Zürich] = University of Zurich (UZH), Ghent University Hospital, iQ4U consultants Ltd, University hospital Ospedali Riuniti, Medizinische Universität Wien = Medical University of Vienna, National Research Council of Italy | Consiglio Nazionale delle Ricerche (CNR), University of Naples Federico II = Università degli studi di Napoli Federico II, Università degli studi di Genova = University of Genoa (UniGe), Vall d'Hebron University Hospital [Barcelona], Nova Southeastern University (NSU), Pôle de pathologie thoracique, CHU Strasbourg-Hopital Civil, Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Pôle Clinique des Voies respiratoires [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), King‘s College London, Università degli studi di Palermo - University of Palermo, Children's hospital Aarau, IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Hospital San Bernardo, Helsinki University Hospital, Odense University Hospital, University Hospitals Leuven [Leuven], Allergy Learning and Consulting, CHU Montpellier, Hospital Sírio Libanês, Allergy and Asthma Center Westend, German Society for Otorhinolaryngology HNS, University Medical Center [Utrecht], Medical University of Łódź (MUL), Hospital Medica Sur, ARIA, University of Copenhagen = Københavns Universitet (UCPH), Research Centre for Prevention and Health (RCPH), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Capital Region of Denmark, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Gentofte University Hospital, Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Università degli Studi di Padova = University of Padua (Unipd), ASST Grande Ospedale Metropolitano Niguarda, Universität Mannheim, Center for Rhinology and Allergology, University Medical Centre Mannheim, Heidelberg University, University of Aberdeen, Research in Real Life (RiRL), Optimum Patient Care Ltd, Singapore, Hospital Infantil Universitario Niño Jesús (HIUNJ), Ludwig-Maximillians University, Medical University of Warsaw - Poland, University College of London [London] (UCL), Royal National Throat, Nose and Ear Institute, University hospital of Zurich [Zurich], MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, University of Edinburgh, Sociedad Latinoamericana de alergia, asma e inmunolgia (SLaai), Federal University of Sao Paulo (Unifesp), Medical University Graz, Allergy Outpatient Clinic Reumannplatz, Complejo Hospitalario de Navarra, University of Amsterdam [Amsterdam] (UvA), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Universidade de Santiago de Compostela [Spain] (USC ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), European Innovation Partnership on Active and Healthy Ageing Reference Site MACVIA-France, European Structural and Development Funds of Region Languedoc Roussillon., Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Consiglio Nazionale delle Ricerche (CNR), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité Asthme et allergologie [CHU Trousseau], Service d'Allergologie pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University of Mannheim, Universidade Federal de São Paulo (UNIFESP), BMC, BMC, University of Naples Federico II, University of Genoa (UNIGE), Service des maladies respiratoires [Rangueil-Larrey], CHU Toulouse [Toulouse], Unité Asthme et allergologie, University of Copenhagen = Københavns Universitet (KU), University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Capital Region of Denmark, Universita degli Studi di Padova, Hospital Infantil Universitario Niño Jesús, Università degli studi di Bari Aldo Moro (UNIBA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), and Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
- Subjects
Pulmonary and Respiratory Medicine ,Gerontology ,Allergen immunotherapy ,medicine.medical_specialty ,Allergy ,Al·lèrgia ,EIP on AHA ,[SDV]Life Sciences [q-bio] ,Immunology ,Alternative medicine ,Immunoteràpia ,Review ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Journal Article ,Immunology and Allergy ,030212 general & internal medicine ,Asthma ,Rhinitis ,business.industry ,Precision medicine ,medicine.disease ,3. Good health ,Integrated care ,[SDV] Life Sciences [q-bio] ,Ageing ,AIRWAYS ICPs ,030228 respiratory system ,General partnership ,Action plan ,Immunotherapy ,business - Abstract
Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4) the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing. ispartof: Clinical and Translational Allergy vol:6 issue:1 pages:41-47 ispartof: location:England status: published
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- 2016
41. Inhibitory effect of prostaglandin I2 on bone marrow kinetics of eosinophils in the guinea pig
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Akos Heinemann, Gunter J. Sturm, Viktoria Konya, Rufina Schuligoi, and Eva M. Sturm
- Subjects
medicine.medical_specialty ,Pathology ,Guinea Pigs ,Immunology ,Prostaglandin ,Bone Marrow Cells ,In Vitro Techniques ,Biology ,Flow cytometry ,Guinea pig ,chemistry.chemical_compound ,Cytochrome P-450 Enzyme System ,Cell Movement ,Internal medicine ,medicine ,Animals ,Immunology and Allergy ,Iloprost ,Cell Shape ,medicine.diagnostic_test ,Extremities ,Chemotaxis ,Cell Biology ,respiratory system ,Eosinophil ,Epoprostenol ,In vitro ,Eosinophils ,Intramolecular Oxidoreductases ,Kinetics ,Endocrinology ,medicine.anatomical_structure ,chemistry ,Bone marrow ,medicine.drug - Abstract
Enhanced eosinophil trafficking from bone marrow to the tissue is a hallmark of allergic diseases. We have shown previously that PGI2 markedly attenuates the locomotion of human eosinophils in vitro. Here, we set out to determine the effect of PGI2 on the trafficking of bone marrow eosinophils in the guinea pig. Shape change of bone marrow eosinophils was determined by flow cytometry, and chemotaxis assays were performed using a transwell migration system. Eosinophil release from bone marrow of guinea pigs was investigated in the isolated, perfused hind-limb preparation. We found that PGI2 prevented the mobilization of eosinophils from bone marrow and attenuated the shape change and chemotactic responses of bone marrow eosinophils. These effects were mimicked by iloprost and were prevented by the IP antagonist CAY10441 and the adenylyl cyclase inhibitor SQ22536. Immunohistochemical staining of bone marrow confirmed the expression of IPs by bone marrow eosinophils. The rate-limiting enzyme of PGI2 formation, PGIS, was found in large mononuclear cells. These data show that IP activation negatively modulates the mobilization and locomotion of bone marrow eosinophils and might therefore also protect against exaggerated recruitment of eosinophils to inflammatory sites.
- Published
- 2011
42. Specificity of conventional and Ves v 5–spiked venom decreases with increasing total IgE
- Author
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Peter Komericki, Gunter J. Sturm, Nora Wutte, Danijela Bokanovic, Ines Schwarz, and Werner Aberer
- Subjects
Text mining ,business.industry ,Immunology ,Immunology and Allergy ,Medicine ,Total ige ,Venom ,Pharmacology ,business - Published
- 2014
43. CD203c-based basophil activation test in allergy diagnosis: Characteristics and differences to CD63 upregulation
- Author
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Eva M. Sturm, Werner Aberer, Gunter J. Sturm, Bettina Kranzelbinder, Akos Heinemann, and Andrea Groselj-Strele
- Subjects
Adult ,Male ,Allergy ,Histology ,Cytochalasin B ,Basophil Degranulation Test ,Platelet Membrane Glycoproteins ,Basophil ,Biology ,Cell Degranulation ,Pathology and Forensic Medicine ,chemistry.chemical_compound ,Downregulation and upregulation ,Antigens, CD ,Anti-Allergic Agents ,Hypersensitivity ,medicine ,Dimethindene ,Humans ,Pyrophosphatases ,Arthropod Venoms ,Desloratadine ,CD63 ,Phosphoric Diester Hydrolases ,Tetraspanin 30 ,Interleukin ,Cell Biology ,Immunoglobulin E ,Loratadine ,Middle Aged ,Bridged Bicyclo Compounds, Heterocyclic ,medicine.disease ,Basophils ,Up-Regulation ,Basophil activation ,medicine.anatomical_structure ,chemistry ,Dimetindene ,Immunology ,Thiazolidines ,Female ,Interleukin-3 ,medicine.drug - Abstract
Background: The basophil activation test (BAT) based on CD203c upregulation has been validated as a reliable tool for the diagnosis of IgE-mediated allergies. Nevertheless, CD203c-based BAT is hardly comparable with that of CD63-based tests, as the mechanisms of CD203c versus CD63 induction differ considerably. The aim of the present study was to identify potent influencing factors of the CD203cbased BAT and to emphasize differences between CD63 and CD203c detection. Methods: CD203c-based BAT was determined in 82 healthy controls and in 79 allergic patients. The effects of interleukin (IL)-3 and degranulation enhancing substances were investigated and compared with CD63 upregulation. Furthermore, the influence of different storage conditions and incubation times was evaluated and the impact of antiallergic drugs on the test results was assessed. Results: CD203c and CD63 expression was rapidly upregulated reaching a maximum after 20–30 min. Basophil CD203c upregulation assayed after storage times up to 48 h declined already after 4 h. IL-3 treatment increased CD203c and CD63 baseline levels and decreased basophil CD203c responses in a dose-dependent manner. In contrast, cytochalasin B and latrunculin B did not affect CD203c responses but decreased CD63-based BAT. Finally, therapeutic concentrations of dimetindene and desloratadine did not affect CD203c upregulation. Conclusion: CD203c-based basophil activation test should be performed preferentially within 4 h after taking the blood samples. Priming and degranulation-enhancing factors are not required for CD203cbased BAT. In contrast to skin testing, CD203c-based BAT can be performed in patients undergoing antiallergic treatment. V C 2010 International Clinical Cytometry Society
- Published
- 2010
44. The basophil activation test in the diagnosis of allergy: technical issues and critical factors
- Author
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Andrea Groselj-Strele, Werner Aberer, Bettina Kranzelbinder, Eva M. Sturm, Gunter J. Sturm, and Akos Heinemann
- Subjects
Allergy ,Immunology ,Wasp Venoms ,Platelet Membrane Glycoproteins ,Immunologic Tests ,Basophil ,Biology ,chemistry.chemical_compound ,Antigens, CD ,Hypersensitivity ,medicine ,Animals ,Dimethindene ,Humans ,Immunology and Allergy ,Desloratadine ,CD63 ,Tetraspanin 30 ,Loratadine ,medicine.disease ,Hymenoptera ,Antibodies, Anti-Idiotypic ,Basophils ,Bee Venoms ,Basophil activation ,medicine.anatomical_structure ,chemistry ,Dimetindene ,Monoclonal ,Histamine H1 Antagonists ,biology.protein ,Interleukin-3 ,Antibody ,medicine.drug - Abstract
Background: The basophil activation test (BAT) is a widely validated and reliable tool especially for the diagnosis of hymenoptera venom allergy. Nevertheless, several pitfalls have to be considered and outcomes may differ because of diverse in-house protocols and commercially available kits. We aimed to identify the factors that may influence results of the CD63-based BAT. Methods: Basophil responses to monoclonal anti-IgE (clone E124.2.8) and bee and wasp venom were determined by BAT based on CD63. The effect of stimulating factors such as, IL-3, cytochalasin B and prewarming of the samples was investigated. Furthermore, we compared two different flow cytometer systems and evaluated the influence of storage time, different staining protocols and anti-allergic drugs on the test results. Results: Interleukin-3 enhanced the reactivity of basophils at 300 pM, but not at 75 and 150 pM. Prewarming of samples and reagents did not affect basophil reactivity. CD63 expression assayed after storage time of up to 48 h showed that basophil reactivity already started to decline after 4 h. Basophils stained with HLA-DR-PC5 and CD123-PE antibodies gated as HLA-DRneg/CD123pos cells showed the highest reactivity. No effect on test outcomes was observed at therapeutic doses of dimetindene and desloratadine. Finally, slight differences in the percentage of activated basophils, depending on the cytometer system used, were found. Conclusion: Basophil activation test should be performed as early as possible after taking the blood sample, preferably within 4 h. In contrast to the skin test, BAT can be performed in patients undergoing treatment with antihistamines. For reasons of multiple influencing factors, BAT should be performed only at validated laboratories.
- Published
- 2009
45. Prostaglandin E2 Inhibits Eosinophil Trafficking through E-Prostanoid 2 Receptors
- Author
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Gunter J. Sturm, Bernhard A. Peskar, Rufina Schuligoi, Eva M. Sturm, Akos Heinemann, Petra Schratl, Viktoria Konya, and Irmgard Th. Lippe
- Subjects
Eotaxin ,medicine.medical_treatment ,Prostaglandin E2 receptor ,Receptor expression ,Guinea Pigs ,Immunology ,Pharmacology ,Biology ,Dinoprostone ,Allergic inflammation ,Mice ,Phosphatidylinositol 3-Kinases ,Eosinophil migration ,medicine ,Animals ,Humans ,Receptors, Prostaglandin E ,Immunology and Allergy ,Alprostadil ,Enzyme Inhibitors ,Cells, Cultured ,Protein Kinase C ,Eosinophil cationic protein ,Receptors, Prostaglandin E, EP2 Subtype ,respiratory system ,Eosinophil ,Immunohistochemistry ,Eosinophils ,Chemotaxis, Leukocyte ,medicine.anatomical_structure ,lipids (amino acids, peptides, and proteins) ,Prostaglandin E - Abstract
The accumulation of eosinophils in lung tissue is a hallmark of asthma, and it is believed that eosinophils play a crucial pathogenic role in allergic inflammation. Prostaglandin (PG) E2 exerts anti-inflammatory and bronchoprotective mechanisms in asthma, but the underlying mechanisms have remained unclear. In this study we show that PGE2 potently inhibits the chemotaxis of purified human eosinophils toward eotaxin, PGD2, and C5a. Activated monocytes similarly attenuated eosinophil migration, and this was reversed after pretreatment of the monocytes with a cyclooxygenase inhibitor. The selective E-prostanoid (EP) 2 receptor agonist butaprost mimicked the inhibitory effect of PGE2 on eosinophil migration, whereas an EP2 antagonist completely prevented this effect. Butaprost, and also PGE2, inhibited the C5a-induced degranulation of eosinophils. Moreover, selective kinase inhibitors revealed that the inhibitory effect of PGE2 on eosinophil migration depended upon activation of PI3K and protein kinase C, but not cAMP. In animal models, the EP2 agonist butaprost inhibited the rapid mobilization of eosinophils from bone marrow of the in situ perfused guinea pig hind limb and prevented the allergen-induced bronchial accumulation of eosinophils in OVA-sensitized mice. Immunostaining showed that human eosinophils express EP2 receptors and that EP2 receptor expression in the murine lungs is prominent in airway epithelium and, after allergen challenge, in peribronchial infiltrating leukocytes. In summary, these data show that EP2 receptor agonists potently inhibit eosinophil trafficking and activation and might hence be a useful therapeutic option in eosinophilic diseases.
- Published
- 2008
46. Asymptomatic Sensitization to Hymenoptera Venom Is Related to Total Immunoglobulin E Levels
- Author
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Christian Schuster, Gunter J. Sturm, Andrea Groselj-Strele, Michaela Wiednig, Bettina Kranzelbinder, and Werner Aberer
- Subjects
Adult ,Male ,Allergy ,animal structures ,Immunology ,Wasp Venoms ,Venom ,Cross Reactions ,Immunoglobulin E ,complex mixtures ,Asymptomatic ,Atopy ,Young Adult ,Antibody Specificity ,Hypersensitivity ,medicine ,Animals ,Humans ,Immunology and Allergy ,Arthropod Venoms ,Sensitization ,biology ,Brassica rapa ,fungi ,General Medicine ,Middle Aged ,biology.organism_classification ,medicine.disease ,Hymenoptera ,Bee Venoms ,medicine.anatomical_structure ,Aculeata ,biology.protein ,Female ,Antibody ,medicine.symptom - Abstract
Background: The detection of specific serum immunoglobulin E (sIgE) to Hymenoptera venoms is an established diagnostic tool to diagnose insect venom hypersensitivity. However, the specificity of sIgE detection is a debated issue. Methods: In 145 subjects, total IgE (tIgE) and sIgE to Hymenoptera venoms as well as sIgE to rapeseed as a marker of cross-reactive carbohydrate determinants were measured. In addition, an atopy score was determined for each patient. We looked for a possible association between tIgE and the presence of sIgE in subjects with a negative history of large local or systemic reactions to insect stings. Results: Fifteen of 65 subjects (23.1%) with low levels of tIgE (Conclusion: Specific antibodies are frequently seen in individuals with high tIgE, but appear to be largely irrelevant in clinical terms. This might lead to misdiagnosis in persons with an inconclusive sting history.
- Published
- 2008
47. Influence of total IgE levels on the severity of sting reactions in Hymenoptera venom allergy
- Author
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Eva M. Sturm, Christian Schuster, Gunter J. Sturm, Akos Heinemann, Andrea Groselj-Strele, Werner Aberer, and Michaela Wiednig
- Subjects
Adult ,Male ,Allergy ,Vomiting ,Bronchoconstriction ,Immunology ,Venom ,Unconsciousness ,Immunoglobulin E ,Severity of Illness Index ,Immunopathology ,Severity of illness ,Hypersensitivity ,Animals ,Humans ,Immunology and Allergy ,Medicine ,Anaphylaxis ,Skin Tests ,biology ,business.industry ,Age Factors ,Insect Bites and Stings ,Total ige ,medicine.disease ,Hymenoptera ,Bee Venoms ,Sting ,biology.protein ,Female ,Tryptases ,medicine.symptom ,business - Abstract
Detection of specific IgE for Hymenoptera venoms and skin tests are well established diagnostic tools for the diagnosis of insect venom hypersensitivity. The aim of our study was to analyze the effect of total IgE levels on the outcome of generalized anaphylactic reactions after a Hymenoptera sting.Two hundred and twenty patients allergic to bee, wasp, or European hornet venom were included in the study. Their specific and total IgE levels, serum tryptase levels, skin tests, and sting history were analyzed.In patients with mild reactions (grade I, generalized skin symptoms) we observed higher total IgE levels (248.0 kU/l) compared to patients with moderate reactions (grade II, moderate pulmonary, cardiovascular, or gastrointestinal symptoms; 75.2 kU/l) and severe reactions (grade III, bronchoconstriction, emesis, anaphylactic shock, or loss of consciousness; 56.5 kU/l; P0.001). Accordingly, 25% of the patients with low levels of total IgE (50 kU/l), but no individual with total IgE levels250 kU/l, developed loss of consciousness (P = 0.001). Additionally, specific IgE levels were related to total IgE levels: Specific IgE levels increased from 1.6 to 7.1 kU/l in patients with low (50 kU/l) and high (250 kU/l) total IgE levels, respectively (P0.001). Specific IgE levels correlated inversely to the clinical reaction grades, however, this trend was not statistically significant (P = 0.083).Patients with Hymenoptera venom allergy and high levels (250 kU/l) of total IgE, predominantly develop grade I and grade II reactions and appear to be protected from grade III reactions. However, this hypothesis should be confirmed by extended studies with sting challenges.
- Published
- 2007
48. Anaphylaxis with clonal mast cells in normal looking skin - a new entity?
- Author
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Werner Aberer, Elisabeth Aberer, Andrea Berghold, Agnes Bretterklieber, Gunter J. Sturm, Christine Beham-Schmid, and R. Brezinschek
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Immunology ,Tryptase ,Autopsy ,Cell Count ,Clonal Evolution ,Basal (phylogenetics) ,Young Adult ,Antigen ,Bone Marrow ,medicine ,Immunology and Allergy ,Humans ,IL-2 receptor ,Mast Cells ,Systemic mastocytosis ,Anaphylaxis ,Aged ,Skin ,biology ,business.industry ,Immunoglobulin E ,Middle Aged ,medicine.disease ,Immunohistochemistry ,medicine.anatomical_structure ,biology.protein ,Female ,Tryptases ,Bone marrow ,business ,Biomarkers ,Mastocytosis - Abstract
Background Patients with elevated basal tryptase (sBT) >15 μg/l and anaphylaxis may have an underlying mastocytosis. A monoclonal mast cell activation syndrome with aberrant mast cells (MC) at extracutaneous sites has been described in patients with severe hypotension or anaphylaxis. Methods As MC in patients with elevated sBT might be altered in the skin as well, we studied MC in normal neck skin in anaphylaxis and urticaria patients with elevated sBT. Results A mean of 93.1 (SD 19.1) MC/mm² was counted in normal neck skin in 14 patients with anaphylaxis, 84.0 (SD 13.6) in seven patients with urticaria, 142.0 (SD 24.0) in two patients with eczema, 124.4 (SD 43.2) in five patients with systemic mastocytosis (SM) in comparison with autopsy skin (39.1 MC/mm², SD 12.4). In five of 14 (35.7%) of the anaphylaxis and three of five (60%) SM patients more than 25% of MC were spindle shaped and expressed CD25 antigen. Conclusions We could show for the first time that the normal skin can harbour clonal MC in anaphylaxis patients. Analogous to the criteria for mastocytosis, we suggest a skin score criteria including an elevated number of MC, spindle shape, CD25 expression, c-Kit mutation and sBT values >20 μg/l. In patients with anaphylaxis and elevated sBT, skin should be biopsied and, as with the approach for mastocytosis diagnosis in the bone marrow, MC should be analysed for their number, clonality and c-Kit mutation. This approach should be confirmed in further studies. Patients with aberrant skin MC should be handled as mastocytosis patients.
- Published
- 2015
49. 5-Oxo-6,8,11,14-eicosatetraenoic acid is a potent chemoattractant for human basophils
- Author
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Rufina Schuligoi, Eva M. Sturm, Heinz Stammberger, Doris Lang-Loidolt, Julia F. Royer, Akos Heinemann, Rainer Amann, Gunter J. Sturm, and Bernhard A. Peskar
- Subjects
Neutrophils ,Eicosatetraenoic acid ,Immunology ,Arachidonic Acids ,Biology ,Basophil ,Granulocyte ,Monocytes ,chemistry.chemical_compound ,medicine ,Humans ,Immunology and Allergy ,Inducer ,RNA, Messenger ,Receptor ,Cell Shape ,Messenger RNA ,Chemotactic Factors ,Osmolar Concentration ,Chemotaxis ,Flow Cytometry ,Basophils ,Eosinophils ,Chemotaxis, Leukocyte ,medicine.anatomical_structure ,Pertussis Toxin ,chemistry ,Biochemistry ,Receptors, Eicosanoid ,Calcium ,Histamine - Abstract
Background 5-Oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is a chemoattractant for eosinophils and neutrophils, and the messenger RNA for its receptor, the oxo-eicosatetraenoic acid receptor (OXE), has been detected in several tissues. Objectives This study aimed at clarifying the role of 5-oxo-ETE in the regulation of basophil function. Methods Basophil responses were determined in assays of flow-cytometric shape change, Ca 2+ flux, chemotaxis, and histamine release. Messenger RNA for OXE was detected by real-time PCR. Results We observed that human eosinophils were 3 to 10 times more sensitive to 5-oxo-ETE than neutrophils in flow-cytometric shape change and Ca 2+ flux assays, as estimated from the half-maximal responses of the cells. Basophils responded to 5-oxo-ETE in the shape change assay with a sensitivity similar to that of eosinophils. 5-Oxo-ETE was a weak inducer of Ca 2+ flux in basophils and did not cause histamine release but was a highly effective chemoattractant for basophils in the low nanomolar concentration range in a pertussis toxin–sensitive manner. In agreement with these functional studies, the messenger RNA for the 5-oxo-ETE receptor, OXE, was detectable in basophils as in monocytes, eosinophils, and neutrophils, but not in fibroblasts. Specimens from sinus mucosa, tonsils, and adenoids also contained detectable levels of messenger RNA for OXE. Conclusion Our data suggest that 5-oxo-ETE is potentially involved in the regulation of basophil recruitment and might hence be a useful therapeutic target in atopic disease.
- Published
- 2005
50. Stem cell factor stimulates the chemotaxis, integrin upregulation, and survival of human basophils
- Author
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Gunter J. Sturm, Bernhard A. Peskar, Martina Ofner, Eva M. Sturm, Akos Heinemann, Adele Hartnell, and Charlotte L. Weller
- Subjects
Chemokine CCL11 ,Integrins ,Cell Survival ,Immunology ,Complement C5a ,chemical and pharmacologic phenomena ,Stem cell factor ,In Vitro Techniques ,Basophil ,parasitic diseases ,medicine ,Chemokine CCL8 ,Humans ,Immunology and Allergy ,Chemokine CCL4 ,Protein kinase A ,Macrophage inflammatory protein ,Stem Cell Factor ,CD11b Antigen ,Chemotactic Factors ,biology ,Kinase ,Drug Synergism ,hemic and immune systems ,Chemotaxis ,Macrophage Inflammatory Proteins ,Molecular biology ,Basophils ,Monocyte Chemoattractant Proteins ,Up-Regulation ,Chemotaxis, Leukocyte ,Proto-Oncogene Proteins c-kit ,medicine.anatomical_structure ,Imatinib mesylate ,Integrin alpha M ,Chemokines, CC ,biology.protein ,Interleukin-3 ,Signal Transduction - Abstract
Background Little is known about the mechanisms that regulate the selective recruitment of basophils to sites of allergic inflammation. Objective Here we examine the role of stem cell factor (SCF) in the regulation of basophil function. Methods Human basophils were isolated from peripheral blood, and their migration was investigated in chemotaxis assays. Apoptosis was detected by means of annexin V and propidium iodide staining. The expression of cell-surface molecules was measured by means of flow cytometry. Results SCF amplified the chemotactic responsiveness of human peripheral blood basophils to the chemoattractants eotaxin, monocyte chemotactic protein 2 and macrophage inflammatory protein 1α, and C5a, without being chemotactic or chemokinetic by itself. SCF synergized with chemoattractants in causing basophil upregulation of the integrin CD11b, and this effect was inhibited by a c-kit antibody, the tyrosine kinase inhibitor imatinib mesylate (STI-571), and a phosphatidylinositol 3 kinase inhibitor but not by inhibitors of p38 mitogen-activated protein kinase or mitogen-activated protein kinase/extracellular signal–regulated kinase kinase. Basophils bound fluorescence-labeled SCF and expressed its receptor, c-kit, which was markedly upregulated in culture for 24 to 48 hours in the presence of IL-3. Moreover, SCF prolonged basophil survival in concert with IL-3 by delaying apoptosis. These effects of SCF were selective for basophils because chemotaxis and CD11b upregulation of eosinophils or neutrophils were unchanged. Conclusion SCF might be an important selective modulator of basophil function through a phosphatidylinositol 3 kinase–dependent pathway.
- Published
- 2005
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