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1. Anaphylaxis and Coronavirus Disease 2019 vaccine: a danger relationship?

Author

Pascal Demoly, Gianenrico Senna, Mariana Castells, Marco Caminati, and Luciana Kase Tanno

Subjects
Male, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Immunology, adverse reaction, Context (language use), Polyethylene Glycols, coronavirus disease 2019, vaccine, Pandemic, Hypersensitivity, anaphylaxis, medicine, Adverse Drug Reaction Reporting Systems, Animals, Humans, Immunology and Allergy, Sex Characteristics, business.industry, Anaphylactic reactions, allergy, medicine.disease, Vaccination, polyethylene glycol, Female, Severe acute respiratory syndrome due to coronavirus vaccine, Allergists, business, Anaphylaxis
Abstract

Purpose of review Anaphylactic reactions reported after Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) RNA vaccines were expected to be more frequent in atopic subjects and attributed to its polyethylene glycol component. Recent findings Anaphylaxis to SARS-CoV2 RNA vaccines is no more frequent than in any vaccine and direct proofs for the role of its polyethylene glycol component are lacking. Summary Vaccines against coronavirus disease 2019 (COVID-19) are an essential global intervention to control the current pandemic situation. Anaphylactic reactions have rapidly been reported after SARS-CoV2 RNA vaccines. This risk is now measured at 2.5-11/1 000 000 in the context of vaccine safety surveillance programs and only one case was documented to be due to polyethylene glycol. Suggestions for its role are indirect. The COVID-19 vaccination is rolling out vastly and surveillance programs are key to monitor severe adverse reactions, such as anaphylaxis. Anaphylaxis due to vaccine is extremely rare and specific cases should receive individualized investigation and care, highlighting the key role of allergists in the vaccination programmes.

Published
2021

2. Blood pressure measurements could be reduced in number during the drug provocation test

Author

Marion Menanteau, Witchaya Srisuwatchari, Pascal Demoly, Anca Mirela Chiriac, and A. Gauthier

Subjects
Adult, Male, Drug, Adolescent, media_common.quotation_subject, Immunology, Provocation test, Drug allergy, Blood Pressure, Drug Hypersensitivity, Young Adult, medicine, Humans, Immunology and Allergy, Aged, media_common, Aged, 80 and over, business.industry, Blood Pressure Determination, Middle Aged, medicine.disease, Blood pressure, Anesthesia, Female, business, Anaphylaxis
Published
2021

3. Biologicals for the prevention of anaphylaxis

Author

Luciana Kase Tanno and Pascal Demoly

Subjects
Biological Products, medicine.medical_specialty, Epinephrine, business.industry, Immunology, Biologic therapies, Anaphylactic reactions, Omalizumab, Allergens, medicine.disease, Food and drug administration, Biological drugs, Desensitization, Immunologic, Humans, Immunology and Allergy, Medicine, Combined therapy, business, Intensive care medicine, Anaphylaxis, medicine.drug
Abstract

PURPOSE OF REVIEW To review the use of biological agents (BA) in the treatment of anaphylaxis in the view of the new knowledge in the field to support the quality of care and prevention. RECENT FINDINGS Some BA, as a single medication or as combined therapy to food or venom immunotherapy, are effectively able to reduce most of the severe anaphylactic reactions. SUMMARY Anaphylaxis is a recognized clinical emergency, which requires prompt identification and treatment. Several biologic therapies and new devices are emerging as a potential preventive treatment for anaphylaxis. However, adrenaline (epinephrine) is still the first-line treatment for any type of anaphylaxis. Biological drugs, such as omalizumab, whereas not US Food and Drug Administration (FDA) nor European Medicines Agency (EMA) approved for anaphylaxis, have been used as therapeutic adjuvants in the preventive treatment of anaphylaxis, but cost-effectiveness should be considered individually.

Published
2021

4. Epidemiology of anaphylaxis

Author

Luciana Kase Tanno and Pascal Demoly

Subjects
medicine.medical_specialty, Quality management, business.industry, media_common.quotation_subject, Public health, Immunology, MEDLINE, medicine.disease, Quality of life (healthcare), International Classification of Diseases, Risk Factors, Health care, Epidemiology, Quality of Life, medicine, Humans, Immunology and Allergy, Quality (business), Public Health, Intensive care medicine, business, Anaphylaxis, media_common
Abstract

Purpose of review To understand the current global epidemiological data of anaphylaxis and identify potential strategies to improve patients' care and prevention. Recent findings Anaphylaxis mortality and morbidity statistics (MMS) may gain new perspectives with the implementation of the International Classification of Diseases (ICD)-11 in the forthcoming years. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk, and support decision-making to facilitate healthcare planning and implementation of public health measures to prevent anaphylaxis. Summary Anaphylaxis is a complex noncommunicable diseases with adverse impact on health-related quality of life of patients and their carriers and a significant proportion of deaths may be preventable. It requires an integrated holistic plan to improve quality of healthcare and gathering accurate and comparable epidemiological data is key. Morbidity related to anaphylaxis seems to be increasing worldwide whereas mortality of anaphylaxis appears to be low and stable, but this still has great challenges in capturing quality anaphylaxis MMS. Improving the quality of epidemiological data related to anaphylaxis should clarify some areas of uncertainty about risk factors, leading to better targeting of strategies to protect those patients at risk. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to anaphylaxis in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and better facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.

Published
2021

6. Global implementation of the world health organization's International Classification of Diseases (ICD)‐11: The allergic and hypersensitivity conditions model

Author

Luciana Kase Tanno, Antonella Muraro, Nikolaos G. Papadopoulos, Edgardo Jares, Thomas B. Casale, Francis Thien, Todd A. Mahr, Ruby Pawankar, David M. Lang, Ioana Agache, Bryan Martin, Juan Carlos Sisul, Isabella Annesi-Maesano, Gary W.K. Wong, Mario Sánchez-Borges, Nicolas Molinari, Robert J.G. Chalmers, Ignacio Ansontegui, Ana Luiza Bierrenbach, Pascal Demoly, James L. Sublett, Motohiro Ebisawa, Robert Jacob, Maximiliano Gómez, Nenad Kostanjsek, and Lanny J. Rosenwasser

Subjects
0301 basic medicine, medicine.medical_specialty, Hierarchy, Health management system, business.industry, Immunology, World Health Organization, medicine.disease, World health, Terminology, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, 030228 respiratory system, International Classification of Diseases, Drug Hypersensitivity Syndrome, Epidemiology, medicine, Humans, Immunology and Allergy, Medical emergency, business, Anaphylaxis
Abstract

The International Classification of Diseases (ICD) provides a common language for use worldwide as a diagnostic and classification tool for epidemiology, clinical purposes and health management. Since its first edition, the ICD has maintained a framework distributing conditions according to topography, with the result that some complex conditions, such as allergies and hypersensitivity disorders (A/H) including anaphylaxis, have been poorly represented. The change in hierarchy in ICD-11 permitted the construction of the pioneer section addressed to A/H, which may result in more accurate mortality and morbidity statistics, including more accurate accounting for mortality due to anaphylaxis, strengthen classification, terminology and definitions. The ICD-11 was presented and adopted by the 72nd World Health Assembly in May 2019 and the implementation is ongoing worldwide. We here present the outcomes from an online survey undertaken to reach out the allergy community worldwide in order to peer review the terminology, classification and definitions of A/H introduced into ICD-11 and to support their global implementation. Data are presented here for 406 respondents from 74 countries. All of the sub-sections of the new A/H section of the ICD-11 had been considered with good accuracy by the majority of respondents. We believe that, in addition to help during the implementation phase, all the comments provided will help to improve the A/H classification and to increase awareness by different disciplines of what actions are needed to ensure more accurate epidemiological data and better clinical management of A/H patients.

Published
2020

7. How molecular allergology can shape the management of allergic airways diseases

Author

Davide Caimmi, Pascal Demoly, Enrica Manca, Elena Carboni, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli Studi di Foggia - University of Foggia, and Università degli Studi 'Magna Graecia' di Catanzaro [Catanzaro, Italie] (UMG)

Subjects
Allergen immunotherapy, Allergy, MESH: Allergens, MESH: Asthma, Immunology, MESH: Molecular Diagnostic Techniques, Disease, Cross Reactions, Immunologic Tests, Immunoglobulin E, medicine.disease_cause, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Cross Reactions, 03 medical and health sciences, 0302 clinical medicine, Allergen, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, MESH: Desensitization, Immunologic, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Sensitization, MESH: Treatment Outcome, Asthma, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, MESH: Humans, biology, business.industry, MESH: Immunoglobulin E, Allergens, medicine.disease, Rhinitis, Allergic, 3. Good health, Treatment Outcome, medicine.anatomical_structure, Molecular Diagnostic Techniques, 030228 respiratory system, Desensitization, Immunologic, MESH: Immunologic Tests, MESH: Rhinitis, Allergic, biology.protein, Personalized medicine, business
Abstract

International audience; In allergy, personalized medicine passes through the assessment of molecular allergens sensitization profiles. Such technique may help to better diagnose and treat patients suffering from allergic respiratory diseases.Recent findings: Different laboratory tests are available today to assess sensitization to molecular allergens, from singleplex assays, to unspecific, screening multiplex assays, mainly performed through microarrays or macroarrays. It is important to collect both results from specific IgE toward allergen extracts and toward molecular allergens, to collect the most complete information on the patient's profile, and therefore to highlight genuine sensitization, and exclude cross-reaction and sensitization because of pan-allergens. Being able to know the exact molecular sensitization profile of the patient, also helps predicting the possible evolution of the disease, and targeting the most appropriate allergen immunotherapy treatment to prescribe.Summary: Even though a cost-effective analysis of running multiple assays in allergic patients has not been performed yet, such technique proved to be more efficient in detecting the appropriate treatment in each patient and in analyzing the true sensitization profile in patients suffering from allergic rhinitis, conjunctivitis, and asthma.

Published
2020

8. Anaphylaxis and Pregnancy: A Systematic Review and Call for Public Health Actions

Author

Pascal Demoly, Gianenrico Senna, Michael Schatz, Sophie Carra, María José Torres, Florence Fuchs, P.M. Mertes, Mariana Castells, Luciana Kase Tanno, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Kaiser Permanente, CHU Strasbourg, Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Università degli studi di Verona = University of Verona (UNIVR), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], and Fuchs, Florent

Subjects
medicine.medical_specialty, Epidemiology, medicine.medical_treatment, MEDLINE, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH: Pregnancy, Pregnancy, medicine, Humans, Immunology and Allergy, Caesarean section, Anaphylaxis, MESH: Humans, Cesarean Section, business.industry, Public health, Prevention, MESH: Infant, Newborn, Infant, Newborn, medicine.disease, Management, Pregnancy Complications, MESH: Anaphylaxis, MESH: Cesarean section, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Epinephrine, Mortality data, Perioperative anaphylaxis, MESH: Pregnancy complications, Emergency medicine, Female, Public Health, business, MESH: Public Health, MESH: Female, medicine.drug
Abstract

International audience; Background: Although rare, anaphylaxis during pregnancy implies a risk to both mothers and newborns.Objective: This systematic review is intended to identify key issues in the diagnosis and management of this condition to support prevention strategies and decrease the risk for death related to anaphylaxis during pregnancy.Methods: We searched MEDLINE, Cochrane, LILACS, SciELO, and Science Direct databases for manuscripts concerning the term "anaphylaxis during pregnancy," without language restrictions. We screened studies, extracted data, and assessed the risk for bias independently in duplicate.Results: We selected 12 articles. Frequency of anaphylaxis during maternity was estimated to be 1.5 to 3.8 per 100,000 pregnancies. Only one study provided anaphylaxis mortality data in pregnant women; the rate of anaphylaxis-related maternal mortality was estimated at 0.05/100,000 live births. No standard definition of anaphylaxis severity has been used. A total of 49% to 74% of anaphylaxis cases were described during caesarean section. Beta-lactam antibiotics (58%), latex (25%), and anesthetic agents (17%) were the main causes. In 17% of reports, causative agents were proven by allergy testing. Moreover, 72% of articles proposed the same management and treatment for a clinical episode of anaphylaxis during pregnancy as for nonpregnant patients, and the use of epinephrine in the patient's care during anaphylaxis in pregnancy.Conclusions: Few studies address anaphylaxis during pregnancy. Most have been produced by nonallergy specialists. Collaboration among different specialists involved in the care of pregnant women should be established to support preventive strategies and reduce avoidable deaths.

Published
2021

9. Diagnostic performance of serial serum total tryptase measurement to differentiate positive from negative allergy testing among patients with suspected perioperative hypersensitivity

Author

Jean-Marc Malinovsky, R. Stenger, Pascal Demoly, Yoann Ehrhard, Charles Tacquard, Anna Borushko, Anca-Mirela Chiriac, Simon Viville, Witchaya Srisuwatchari, P.M. Mertes, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Siriraj Hospital, Mahidol University, Mahidol University [Bangkok], CHU Strasbourg, Belarusian Medical Academy of Post-Graduate Education [Minsk] (BelMAPGE), Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims), Médecine de précision par intégration de données et inférence causale (PREMEDICAL), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Desbrest de santé publique (IDESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
MESH: Drug Hypersensitivity, medicine.medical_specialty, Allergy, MESH: Tryptases, Tryptase measurement, drug hypersensitivity reaction, Immunology, Drug allergy, tryptase, Tryptase, Allergy testing, perioperative hypersensitivity, Gastroenterology, Perioperative Care, Drug Hypersensitivity, diagnostic performance, Internal medicine, Immunology and Allergy, Medicine, Humans, MESH: Perioperative Care, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Anaphylaxis, MESH: Humans, biology, business.industry, Perioperative, medicine.disease, Work-up, Hypersensitivity reaction, MESH: Anaphylaxis, MESH: France, biology.protein, Tryptases, France, business
Abstract

International audience; Background: Serum total tryptase has been shown to increase during acute allergic reactions (acute tryptase, TA ); however, few studies have investigated the values of TA or a combination of TA and baseline tryptase (TB ) to discriminate positive from negative testing in perioperative hypersensitivity reaction (POH) allergy work-up. The aim of this study was to determine the diagnostic performance of TA in order to differentiate positive from negative allergy testing suspected POH and analyse the diagnostic performance of serial tryptase levels using several formulas.Methods: All patients from the University hospital of Montpellier and Strasbourg, France, who presented with suspected POH and underwent complete drug allergy work-up between March 2011 and December 2019 with available TA and TB were included. Four formulas, including a change in TA > 11 (F1), or >2 + 1.2 × TB (F2), or >3 + TB (F3), or >120%TB (F4), were applied.Results: One hundred and sixty-two patients were included, and 131 of them (80.8%) had Grade III or IV reactions. Ninety patients had positive allergy testing. The optimal cut-off value of TA to distinguish positive from negative allergy testing patients was 9.8 μg/L with an AUC of 0.817 (95% CI: 0.752-0.882, p < .001). The 93% PPV threshold for TA was 33 μg/L (95.8% specificity). Paired tryptase levels according to formulas F2 and F3 yielded the highest Youden index (0.54 and 0.53, respectively).Conclusion: The optimal cut-off point for TA for distinguishing positive from negative allergy testing suspected POH was 9.8 μg/L. TA value of 33 μg/L was required to achieve >90% PPV.

Published
2021

10. Cephalosporin Hypersensitivity: Descriptive Analysis, Cross-reactivity, and Risk Factors

Author

Marie Delpuech, Djamila Ouali, Nidhal Touati, Barbara Cardoso, Anca-Mirela Chiriac, Nathalie El Kara, Raphaelle Bazire, Pascal Demoly, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Hospital de Sao Bernardo [Setùbal], Université de Montpellier (UM), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Herrada, Anthony, Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
medicine.medical_specialty, Allergy, medicine.drug_class, Beta-lactam, Provocation test, Cephalosporin, Population, Penicillins, Cross Reactions, Drug Hypersensitivity, 03 medical and health sciences, Skin test, 0302 clinical medicine, Risk Factors, Internal medicine, Epidemiology, polycyclic compounds, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, education, Child, Skin Tests, education.field_of_study, business.industry, Cross-reactivity, Odds ratio, medicine.disease, Penicillin, 3. Good health, Anti-Bacterial Agents, Cephalosporins, Hypersensitivity reaction, 030228 respiratory system, Drug provocation test, France, business, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, medicine.drug
Abstract

International audience; Background: Cephalosporins, which belong to the beta-lactam therapeutic class, are increasingly used throughout the world. Few large studies on this issue have been conducted, and most of them have been performed as part of penicillin hypersensitivity studies.Objective: We described our 26-year experience exploring cephalosporin drug hypersensitivity, from which we identified epidemiological and cross-reactivity data.Methods: We included 476 patients who reported drug hypersensitivity reaction (DHR) to cephalosporin and underwent an allergy workup between January 1992 and July 2018 in the Allergy Unit of the University Hospital of Montpellier (France). According to their structural side chain R1 homology, we worked with 4 classes of cephalosporins. Logistic regression analysis was used to search for risk factors for hypersensitivity to cephalosporin (positive skin test [ST] or drug provocation test [DPT] results).Results: Cephalosporin hypersensitivity was proven in 22.3% of the patients referred in our Unit, according to positive ST (51.9%) or DPT to the culprit drug (48.1%). One in 5 patients were children, and cephalosporin hypersensitivity was confirmed in 15% (47.6% of them by means of ST). In the cephalosporin hypersensitive population, initial reactions were mostly immediate (68.9%) and anaphylactic (72.7%). Cross-reactivity with aminopenicillins was the most frequent pattern of cross-reactivity. In multivariate analysis, immediate reactions (odds ratio [OR] = 3, 95% confidence interval [CI] [1.6-5.5], P < .001), anaphylactic shock (OR = 6.5, 95% CI [3.3-13.1], P < .001) and anaphylaxis (OR = 3.1, 95% CI [1.6-6.1], P < .001), and multiple reactions to the same or several cephalosporins (OR = 2.0, 95% CI [1-3.5], P = .04) were statistically associated with confirmed DHR. DPT was generally safe, but elicited anaphylaxis in 20% of patients. Systemic reactions during skin testing occurred in 9.1% of positive patients, almost always related to anaphylactic index reactions. Nonimmediate confirmed DHR to cephalosporins were rare and occurred in less than 10% of the positive patients.Conclusion: Almost a quarter of the tested patients were confirmed as hypersensitive to cephalosporins; sensitivity of skin testing was 51.9%, and thus, half of the positive patients needed a DPT to prove the diagnosis.

Published
2021

11. SARS-CoV-2 Vaccination and Anaphylaxis: Recommendations of the French Allergy Community and the Montpellier World Health Organization Collaborating Center

Author

Luciana Kase Tanno, Pascal Demoly, Etienne Beaudoin, Frédéric Bérard, Alain Didier, Herrada, Anthony, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Allergy, Coronavirus disease 2019 (COVID-19), MESH: Covid-19, MESH: Hypersensitivity, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Immunology, Context (language use), Review, 03 medical and health sciences, [SDV.IMM.VAC] Life Sciences [q-bio]/Immunology/Vaccinology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intervention (counseling), vaccine, Drug Discovery, Pandemic, medicine, anaphylaxis, Pharmacology (medical), 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Pharmacology, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Drug hypersensitivity, business.industry, COVID-19, medicine.disease, allergy, MESH: Anaphylaxis, MESH: France, Vaccination, Infectious Diseases, SARS-CoV-2 vaccination, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, recommendations, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Covid-19 Vaccines, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Anaphylaxis
Abstract

International audience; Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Anaphylactic reactions have been reported after SARS-CoV2 RNA vaccines. Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction. This risk is estimated at 1/1,000,000 in the context of vaccine safety surveillance programs. The COVID-19 vaccination is rolling-out vastly in different courtiers and surveillance programs are key to monitor severe adverse reactions, such as anaphylaxis. Anaphylaxis due to vaccine is extremely rare and specific cases should receive individualized investigation and care. The here presented recommendations and follow-up from the French allergy community and the Montpellier WHO Collaborating Center in order to support the vaccination program and intends to support to healthcare professionals in their daily basis.

Published
2021

12. Bronchodilator response and lung function decline:Associations with exhaled nitric oxide with regard to sex and smoking status

Author

Thorainn Gislasson, Angelo Corsico, Simone Accordini, Dennis Nowak, Joost Weyler, Rune Nielsen, Össur Ingi Emilsson, Isabelle Pin, Deborah Jarvis, Vivi Schlunnsen, Elisabet Nerpin, Francisco Gómez Real, Christer Janson, José Antonio Gullón, Diogenes S. Ferreira, Giulia Squillacioti, Andrei Malinovschi, Joachim Heinrich, Rain Jõgi, Ane Johannessen, Anna-Carin Olin, Bertil Forsberg, Chantal Raherison Semjen, Antonio Pereira-Vega, Alessandro Marcon, Pascal Demoly, Isabel Urrutia, Judith Garcia-Aymerich, Mario Olivieri, Commission of the European Communities, Uppsala University, Dalarna University, School of Public Health and Preventive Medicine [Melbourne, Australia], Universidade Federal do Parana [Curitiba] (UFPR), Universidade Federal do Paraná (UFPR), University of Antwerp (UA), Aarhus University [Aarhus], Tartu University Hospital [Tartu, Estonia], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Landspitali National University Hospital of Iceland, University of Iceland [Reykjavik], CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Université de Montpellier (UM), Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Ludwig-Maximilians University [Munich] (LMU), German Research Center for Environmental Health - Helmholtz Center München (GmbH), University of Melbourne, German Center for Lung Research, Foundation IRCCS Policlinico San Matteo, University of Pavia, University of Verona (UNIVR), University of Turin, Haukeland University Hospital, University of Bergen (UiB), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Galdakao Hospital, Hospital Juan Ramón Jiménez, University of Gothenburg (GU), Umeå University, Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), and Imperial College London

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.drug_class, Bronchodilatation, Epidemiology, FeNO, Lung function, Respiratory Medicine and Allergy, Immunology, Article, 03 medical and health sciences, FEV1/FVC ratio, 0302 clinical medicine, Bronchodilator, Internal medicine, medicine, Immunology and Allergy, 030223 otorhinolaryngology, Respiratory health, Asthma, Lungmedicin och allergi, business.industry, 1103 Clinical Sciences, RC581-607, respiratory system, medicine.disease, 3. Good health, respiratory tract diseases, 030228 respiratory system, Feno, Lung Function, Exhaled nitric oxide, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Smoking status, Human medicine, Immunologic diseases. Allergy, business
Abstract

Background: Fractional exhaled nitric oxide (FeNO) is a marker of type-2 inflammation used both to support diagnosis of asthma and follow up asthma patients.The associations of FeNO with lung function decline and bronchodilator (BD) response have been studied only scarcely in large populations. Objectives: To study the association between FeNO and a) retrospective lung function decline over 20 years, and b) lung function response to BD among asthmatic subjects compared with non-asthmatic subjects and with regards to current smoking and sex. Methods: Longitudinal analyses of previous lung function decline and FeNO level at follow-up and cross-sectional analyses of BD response and FeNO levels in 4257 participants (651 asthmatics) from the European Community Respiratory Health Survey. Results: Among asthmatic subjects, higher percentage declines of FEV1 and FEV1/FVC were associated with higher FeNO levels (p¼0.001 for both) at follow-up. These correlations were found mainly among non-smoking individuals (p ¼ 0.001) and females (p ¼ 0.001) in stratified analyses. Percentage increase in FEV1 after BD was positively associated with FeNO levels in non-asthmatic subjects. Further, after stratified for sex and smoking separately, a positive association was seen between FEV1 and FeNO levels in non-smokers and women, regardless of asthma status. Conclusions: We found a relationship between elevated FeNO and larger FEV1 decline over 20 years among subjects with asthma who were non-smokers or women. The association between elevated FeNO levels and larger BD response was found in both non-asthmatic and asthmatic subjects, mainly in women and non-smoking subjects. The coordination of ECRHS III was supported by the Medical Research Council (Grant Number 92091).We acknowledge support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.

Published
2021

13. Beta-lactam-induced immediate hypersensitivity reactions: A genome-wide association study of a deeply phenotyped cohort

Author

Neil H. Shear, Antonino Romano, Anca Mirela Chiriac, Matthew R. Nelson, Peter S. Friedmann, Alla Nakonechna, Rocco Luigi Valluzzi, S. Barrett, Jose A. Cornejo-Garcia, Miguel Blanca, Paola Nicoletti, Munir Pirmohamed, Daniel F. Carr, Pascal Demoly, Aris Floratos, Yufeng Shen, Natalia Blanca-López, Elizabeth J. Phillips, Cristiano Caruso, Laurence McEvoy, Francesco Gaeta, María José Torres, Rebecca Pavlos, Icahn School of Medicine at Mount Sinai [New York] (MSSM), SEMA4, University of Liverpool, University of Southampton, University of Toronto, Sunnybrook Health Sciences Centre, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hospital Universitario Infanta Leonor [Madrid], Instituto de Investigación Biomédica [Malaga, Spain] (IBIMA), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Columbia University [New York], The University of Western Australia (UWA), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Murdoch University, Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Oasi Maria Santissima Srl [Troina, Italy], Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Herrada, Anthony, Fondazione Policlinico Universitario Agostino Gemelli [Rome], Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hospital Regional Universitario de Málaga [Spain]

Subjects
0301 basic medicine, Hypersensitivity, Immediate, Male, Allergy, Linkage disequilibrium, BL, β-Lactam, Genome-wide association study, Cohort Studies, 0302 clinical medicine, QTL, Quantitative trait loci, Immunology and Allergy, Medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, SNP, Single nucleotide polymorphism, Middle Aged, 3. Good health, Anti-Bacterial Agents, Phenotype, Delayed hypersensitivity, penicillins, 030220 oncology & carcinogenesis, Cohort, Female, Anaphylaxis, Drug Allergy, Urticaria, and Angioedema, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Adult, medicine.medical_specialty, Immunology, Penicillins, Polymorphism, Single Nucleotide, HLA-DQ alpha-Chains, Drug Hypersensitivity, 03 medical and health sciences, Internal medicine, anaphylaxis, Humans, Genetic Predisposition to Disease, Risk factor, pharmacogenomics, business.industry, β-lactams, Odds ratio, medicine.disease, allergy, Cephalosporins, 030104 developmental biology, cephalosporins, business, Type I hypersensitivity, OR, Odds ratio, Genome-Wide Association Study, HLA-DRB1 Chains
Abstract

International audience; Background: β-lactam antibiotics are associated with a variety of immune-mediated or hypersensitivity reactions, including immediate (type I) reactions mediated by antigen-specific IgE.Objective: We sought to identify genetic predisposing factors for immediate reactions to β-lactam antibiotics.Methods: Patients with a clinical history of immediate hypersensitivity reactions to either penicillins or cephalosporins, which were immunologically confirmed, were recruited from allergy clinics. A genome-wide association study was conducted on 662 patients (the discovery cohort) with a diagnosis of immediate hypersensitivity and the main finding was replicated in a cohort of 98 Spanish cases, recruited using the same diagnostic criteria as the discovery cohort.Results: Genome-wide association study identified rs71542416 within the Class II HLA region as the top hit (P = 2 × 10-14); this was in linkage disequilibrium with HLA-DRB1∗10:01 (odds ratio, 2.93; P = 5.4 × 10-7) and HLA-DQA1∗01:05 (odds ratio, 2.93, P = 5.4 × 10-7). Haplotype analysis identified that HLA-DRB1∗10:01 was a risk factor even without the HLA-DQA1∗01:05 allele. The association with HLA-DRB1∗10:01 was replicated in another cohort, with the meta-analysis of the discovery and replication cohorts showing that HLA-DRB1∗10:01 increased the risk of immediate hypersensitivity at a genome-wide level (odds ratio, 2.96; P = 4.1 × 10-9). No association with HLA-DRB1∗10:01 was identified in 268 patients with delayed hypersensitivity reactions to β-lactams.Conclusions: HLA-DRB1∗10:01 predisposed to immediate hypersensitivity reactions to penicillins. Further work to identify other predisposing HLA and non-HLA loci is required.

Published
2021

14. Drug Allergy Management on the Move

Author

Pascal Demoly and Allison Ramsey

Subjects
Drug Hypersensitivity, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Drug allergy, Immunology and Allergy, Medicine, Humans, business, medicine.disease, Virology
Published
2021

15. Delayed hypersensitivity to antiepileptic drugs in children

Author

Sophia Tsabouri, Ozge Soyer, Antonino Romano, Marina Atanaskovic-Markovic, Pascal Demoly, Natalia Blanca-López, Jean-Christoph Roger J-P Caubet, George Du Toit, Eva Rebelo Gomes, Francesca Mori, Semanur Kuyucu, Azienda Ospedaliero Universitaria A. Meyer [Firenze, Italy], Hospital Universitario Infanta Leonor [Madrid], Hôpitaux Universitaires de Genève (HUG), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université de Montpellier (UM), Evelina London Children's Hospital, King‘s College London, Centro Hospitalar do Porto, Mersin University, Oasi Maria SS Institute, Hacettepe University = Hacettepe Üniversitesi, University of Ioannina, University of Belgrade [Belgrade], Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Herrada, Anthony

Subjects
drug allergy diagnosis, medicine.medical_specialty, Drug discontinuation, medicine.medical_treatment, Immunology, Patch testing, Drug Hypersensitivity, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, children, Risk Factors, In vivo, Humans, Immunology and Allergy, Medicine, Hypersensitivity, Delayed, 030212 general & internal medicine, Granulysin, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Child, Intensive care medicine, Skin, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, ELISPOT, Intradermal testing, Antiepileptic drugs hypersensitivity, Intradermal Tests, medicine.disease, 3. Good health, Anticonvulsant, 030228 respiratory system, Delayed hypersensitivity, Concomitant, Pediatrics, Perinatology and Child Health, Anticonvulsants, business, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology
Abstract

International audience; Background: Antiepileptic drugs (AEDs) are widely used for the treatment of epilepsy, but they can be associated with the development of mainly delayed/non-immediate hypersensitivity reactions (HRs). Although these reactions are usually cutaneous, self-limited, and spontaneously resolve within days after drug discontinuation, sometime HR reactions to AEDs can be severe and life-threatening.Aim: This paper seeks to show examples on practical management of AED HRs in children starting from a review of what it is already known in literature.Results: Risk factors include age, history of previous AEDs reactions, viral infections, concomitant medications, and genetic factors. The diagnostic workup consists of in vivo (intradermal testing and patch testing) and in vitro tests [serological investigation to exclude the role of viral infection, lymphocyte transformation test (LTT), cytokine detection in ELISpot assays, and granulysin (Grl) in flow cytometry. Treatment is based on a prompt drug discontinuation and mainly on the use of glucocorticoids.Conclusion: Dealing with AED HRs is challenging. The primary goal in the diagnosis and management of HRs to AEDs should be trying to accurately identify the causal trigger and simultaneously identify a safe and effective alternative anticonvulsant. There is therefore an ongoing need to improve our knowledge of HS reactions due to AED medications and in particular to improve our diagnostic capabilities.

Published
2021

16. Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions

Author

Anca Mirela Chiriac, Rik Schrijvers, and Pascal Demoly

Subjects
medicine.medical_specialty, Allergy, business.industry, medicine.drug_class, Drug allergy, Medicine (miscellaneous), medicine.disease, 030218 nuclear medicine & medical imaging, Iodinated contrast media, Hypersensitivity reaction, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Negative Skin Test, Number needed to treat, Immunology and Allergy, Medicine, Corticosteroid, Premedication, business, Intensive care medicine
Abstract

Purpose of the review Premedication using antihistamines and/or corticosteroids has been widely used to prevent reoccurrence of immediate hypersensitivity reactions (iHR) after iodinated contrast media (ICM). However, efficacy has been debated, especially in high-risk patients. Novel findings on the role and risks of premedication and preventive strategies are summarized. Recent findings The rate and severity of iHR occurring despite premedication indicate that premedication is not a panacea and the intensity usually reflects that of the initial reaction. Next, the number needed to treat (NNT) to prevent one serious ICM-mediated event using corticosteroid-based premedication is high and associated with a diagnostic delay. Randomly changing the ICM has been suggested as an additional preventive measure, whilst others used a skin test–based approach to identify a subgroup of ICM allergic patients and negative skin test–based alternatives with a high negative predictive value. Summary Growing evidence indicates the need to discriminate between non-allergic iHR that are most likely non-obligatory and susceptible to premedication, and rare type I allergic iHR that can be identified using skin testing, especially in those with a severe iHR. Although premedication reduces reoccurrence of mild iHR, it is not always efficacious and should be balanced against side effects, a high NNT and an uncertain efficacy physicians should not blindly rely on. Future work should evaluate combined approaches of an allergy-driven ICM selection and endotype-driven premedication regimens in patients with non-allergic iHR.

Published
2019

17. Are outcome measures in allergic diseases relevant for the WHO's International Classification of Diseases in allergology?

Author

Pascal Demoly, Luciana Kase Tanno, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hospital Sírio-Libanês [São Paulo, Brazil], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hôpital Arnaud de Villeneuve [CHRU Montpellier]

Subjects
medicine.medical_specialty, Allergy, education, Immunology, MEDLINE, World Health Organization, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, History, 21st Century, 03 medical and health sciences, 0302 clinical medicine, International Classification of Diseases, Hypersensitivity, medicine, Humans, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Intensive care medicine, 030304 developmental biology, 0303 health sciences, business.industry, Outcome measures, MESH: Hypersensitivity / classification, Hypersensitivity / epidemiology, International Classification Of Diseases / trends, History, 20th Century, medicine.disease, 3. Good health, 030228 respiratory system, [SDV.IMM]Life Sciences [q-bio]/Immunology, business, Anaphylaxis
Abstract

International audience; To review and understand the impact of the outcome measures of allergic and hypersensitivity conditions for the WHO's International Classification of Diseases (ICD) and its impact in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention.Recent findings: The pioneer chapter addressed to allergic and hypersensitivity conditions in the 11th version of the WHO's ICD is the result of the evidence-based academic technical actions consistently following of collaborations of the allergy community and integrated international initiatives in order to reach quality outcomes measures of allergies worldwide.Summary: Allergic and hypersensitivity conditions are increasing worldwide, however, they have never been well represented in the international classification systems, such as the ICD. The ALLERGY in ICD-11 initiative has been launched in 2012 in order to gather a better representation of these conditions in the ICD-11. As a result of the evidence-based academic technical actions acknowledged by the Joint Allergy Academies and the WHO, the pioneer chapter Allergy and hypersensitivity conditions has been constructed. This framework can be considered a milestone in the history of the allergy specialty. More reliable, accurate and comparable epidemiological data will be able to provide a big picture of these conditions and will support improvements in many levels of the health system. As knowledge derived from populations is key information for more realistic decision-making, the construction of the new section addressed to allergic and hypersensitivity conditions in the ICD-11 will allow the collection of more accurate epidemiological data to support quality management of patients, and better facilitate healthcare planning to implement public health measures to prevent and reduce the morbidity and mortality attributable to these conditions.

Published
2019

18. Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms

Author

Thorarinn Gislason, Christer Janson, Eva Lindberg, Thor Aspelund, Jennifer L. Perret, Bryndis Benediktsdottir, Pascal Demoly, Torben Sigsgaard, Karl A. Franklin, Deborah Jarvis, Andrei Malinovschi, Judith Garcia-Aymerich, Bénédicte Leynaert, Francisco Gómez Real, Shadi Amid Hägg, Kjell Torén, Össur Ingi Emilsson, Uppsala University, Umeå University, Sahlgrenska Academy at University of Gothenburg, University of Iceland [Reykjavik], University of Bergen (UiB), Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Section of Environment Occupation & Health, Aarhus University [Aarhus], Department of Public Health Sciences, Kings College, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Department of Medical Sciences, Respiratory Medicine & Allergology, and Commission of the European Communities

Subjects
OBSTRUCTIVE-SLEEP-APNEA, Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Respiratory Medicine and Allergy, Population, lcsh:Medicine, Disease, Nocturnal, Gastroenterology, DISEASE, GASTROESOPHAGEAL-REFLUX, 03 medical and health sciences, AGE, 0302 clinical medicine, Internal medicine, Epidemiology, medicine, EPIDEMIOLOGY, Respiratory system, education, COMMON, POPULATION, Lung function, Lungmedicin och allergi, RISK, education.field_of_study, business.industry, ASTHMATIC-PATIENTS, musculoskeletal, neural, and ocular physiology, lcsh:R, Reflux, Original Articles, medicine.disease, nervous system diseases, respiratory tract diseases, 3. Good health, Obstructive sleep apnea, 030228 respiratory system, population characteristics, Sleep, business, psychological phenomena and processes, 030217 neurology & neurosurgery
Abstract

Introduction The study aim was to examine the association of snoring and nocturnal gastro-oesophageal reflux (nGOR) with respiratory symptoms and lung function, and if snoring and/or nGOR associated with a steeper decline in lung function. Methods Data from the third visit of the European Community Respiratory Health Survey (ECRHS) was used for cross-sectional analysis. Pre- and post-bronchodilator spirometry was performed, and information on sleep, nGOR and respiratory symptoms was collected (n=5715). Habitual snoring and nGOR were assessed by questionnaire reports. Pre-bronchodilator spirometry from ECRHS I, II and III (20 years follow-up) were used to analyse lung function changes by multivariate regression analysis. Results Snoring and nGOR were independently associated with a higher prevalence of wheeze, chest tightness, breathlessness, cough and phlegm. The prevalence of any respiratory symptom was 79% in subjects with both snoring and nGOR versus 56% in those with neither (p, Middle-aged adults with habitual snoring have a steeper decline in lung function over 10 years compared to controls. Habitual snorers with nocturnal gastro-oesophageal reflux have a higher prevalence of nocturnal respiratory symptoms than controls. http://ow.ly/YsiK30odcMY

Published
2019

19. Allergy and coronavirus disease (COVID-19) international survey: Real-life data from the allergy community during the pandemic

Author

Liang Lu Wang, Alessandro Fiocchi, Michael Levin, James L. Sublett, José Antonio Ortega-Martell, Mario Sánchez-Borges, Motohiro Ebisawa, Yoon-Seok Chang, Luciana Kase Tanno, Manana Chikhladze, Luis Caraballo, Ignacio J. Ansotegui, Jonathan Berstein, Bryan Martin, Pascal Demoly, Giovanni Passalacqua, Sandra Nora González-Díaz, Gianenrico Senna, Marco Caminati, Jean-François Fontaine, Philip W. Rouadi, Anahí Yáñez, Mário Morais-Almeida, Gary Wong, David B. Peden, Gestionnaire, Hal Sorbonne Université, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), World Health Organisation (WHO), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Ohio State University [Columbus] (OSU), University of Cincinnati (UC), Hospital CUF Descobertas, University of Cape Town, IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Centro Médico Docente La Trinidad, Clínica el Avila, University of Cartagena, The Chinese University of Hong Kong [Hong Kong], Universidad Autónoma del Estado de Hidalgo (UAEH), Beirut Eye & ENT Specialist Hospital (BESH), Investigaciones en Alergia y Enfermedades Respiratorias (InAER), Peking Union Medical College Hospital [Beijing] (PUMCH), University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Akaki Tsereteli State University, Universidad Autonoma de Nuevo Leon [Mexique] (UANL), Centre Hospitalier Universitaire de Reims (CHU Reims), University of Louisville, Seoul National University [Seoul] (SNU), Università degli studi di Genova = University of Genoa (UniGe), Hospital Quirónsalud Bizkaia [Bilbao], Sagamihara National Hospital [Kanagawa, Japan], Università degli studi di Verona = University of Verona (UNIVR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), University of Genoa (UNIGE), and University of Verona (UNIVR)

Subjects
Allergy, [SDV]Life Sciences [q-bio], Asia Pacific, AP, Asia Pacific, Coding (therapy), Disease, WHO, LABA, long-acting beta-agonist, 0302 clinical medicine, prevention, EMA, European Medicines Agency, Pandemic, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, 030223 otorhinolaryngology, World Allergy Organization, CDC, Centers for Disease Control and Prevention, Allergen immunotherapy, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, AFR/ME, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, treatment, AIT, Food and Drug Administration, 3. Good health, Europe, WAO, inhaled steroids, LA, ANAFORCAL, French Association for Continuing Education in Allergology, AFR/ME, Africa and Middle East, AIT, Allergen immunotherapy, COVID-19, DRESS, Drug Reaction with Eosinophilia and Systemic Symptoms, EMA, European Medicines Agency, EU, Europe, FDA, Food and Drug Administration, ICD, International Classification of Diseases, LA, Latin America, NA, North America, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, WAO, World Allergy Organization, WHO, World Health Organization, allergen immunotherapy, allergy, asthma, biological agents, coronavirus, FDA, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, severe acute respiratory syndrome coronavirus 2, Pulmonary and Respiratory Medicine, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, Immunology, LABA, Context (language use), World Health Organization, Article, 03 medical and health sciences, Biological agents, International Classification of Diseases, medicine, Centers for Disease Control and Prevention, Social media, Africa and Middle East, SARS-CoV-2, business.industry, ICD, ANAFORCAL, Drug Reaction with Eosinophilia and Systemic Symptoms, medicine.disease, Asthma, Coronavirus, long-acting beta-agonist, Latin America, 030228 respiratory system, Family medicine, North America, French Association for Continuing Education in Allergology, NA, Inhaled steroids, Prevention, Treatment, Allergists, DRESS, EU, business, lcsh:RC581-607, AP, CDC
Abstract

International audience; Background: The COVID-19 outbreak brought an unprecedented challenge to the world. Knowledge in the field has been increasing exponentially and the main allergy societies have produced guidance documents for better management of allergic patients during this period. However, few publications so far have provided real-life data from the allergy community concerning allergy practice during the COVID-19 outbreak. Therefore, we proposed an international survey on the management of allergic patients during the current pandemic.Methods: We performed an online survey undertaken to reach out the worldwide allergy community by e-mail and social media. The web-based questionnaire contained 24 questions covering demographic data from the participants, clinical practice during this period, and questions related to the new international classification and coding tools addressed for COVID-19. It was circulated for 8 weeks and had anonymous and volunteer context.Results: Data are presented for 635 participants from 78 countries of all continents. Allergists with long-term professional experience were the main audience. As expected, we received many responses as "I have no data" or "I don't know" to the questions of the survey. However, most with more experience on managing allergic patients during the pandemic agreed that patients suffering from allergic or hypersensitivity conditions have no increased risk of contracting COVID-19 or developing SARS CoV-2. Also, participants mentioned that none of the allergy treatments (inhaled corticosteroids, allergen immunotherapy, biological agents) increased the risk of contracting COVID-19 infection including severe presentations.Conclusion: The data presented are a starting point in the process of getting feedback on all the recommendations provided by the allergy societies; it could also be the basis of new strategies to support health professionals while new COVID-19 specific treatments and vaccines are being explored. The information here presented intends to be helpful to the community but represents a course of action in a highly specific situation due to the state of emergency, and it should be helpful to health systems.

Published
2021

20. Immediate flare-up–like reaction of skin tests to betalactams with lymphangitis during drug provocation test

Author

Anca Mirela Chiriac, Maria De Filippo, Pascal Demoly, Jean-Luc Bourrain, Omar Ali Al Ali, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Fondazione IRCCS Policlinico San Matteo [Pavia], Università di Pavia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM), CCSD, Accord Elsevier, Università degli Studi di Pavia = University of Pavia (UNIPV), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)

Subjects
Drug, MESH: Drug Hypersensitivity, medicine.medical_specialty, media_common.quotation_subject, MESH: Pharmaceutical Preparations, Provocation test, Lymphangitis, beta-Lactams, Beta-lactam, Drug Hypersensitivity, 030207 dermatology & venereal diseases, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, MESH: Skin Tests, MESH: beta-Lactams, MESH: Anti-Bacterial Agents, Immunology and Allergy, Flare up, Medicine, Humans, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, ComputingMilieux_MISCELLANEOUS, media_common, Skin Tests, MESH: Humans, business.industry, MESH: Lymphangitis, medicine.disease, Dermatology, 3. Good health, Anti-Bacterial Agents, 030228 respiratory system, chemistry, Pharmaceutical Preparations, business, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology
Abstract

International audience; No abstract available

Published
2021

21. A Proposal from the Montpellier World Health Organization Collaborating Centre for Better Management and Prevention of Anaphylaxis

Author

Guillaume Pouessel, Todd A. Mahr, Bryan Martin, Mario Sánchez-Borges, Edgardo Jares, Dermot Ryan, Ignacio J. Ansotegui, Maximiliano Gómez, Salome Allichon, James L. Sublett, Jean Marie Renaudin, Patricia Latour Staffeld, Nidhal Touati, David M. Lang, Pascal Demoly, E. Beaudouin, Yoon-Seok Chang, Ioana Agache, Luciana Kase Tanno, Paul A. Greenberger, Antonella Muraro, Thomas B. Casale, Motohiro Ebisawa, Francis Thien, Victoria Cardona, Ruby Pawankar, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hospital Sírio-Libanês [São Paulo, Brazil], Ohio State University [Columbus] (OSU), Sagamihara National Hospital [Kanagawa, Japan], Hospital Quirónsalud Bizkaia [Bilbao], Centro Médico Docente La Trinidad, Vall d'Hebron University Hospital [Barcelona], Northwestern University Feinberg School of Medicine, University of Edinburgh, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Réseau d'allergo-vigilance, Partenaires INRAE, Faculty of Medicine, Nursing and Health Sciences - Monash university [Victoria], Monash university, Seoul National University [Seoul] (SNU), Seoul National University Bundang Hospital (SNUBH), Nippon Medical School [Tokyo, Japon], Hospital San Bernardo, Catholic University of Salta, LIBRA Foundation and CMP SA Buenos Aires, Centro Avanzado de Alergia y Asma de Santo Domingo, Transylvania University, Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), University of Louisville, University of South Florida [Tampa] (USF), and Cleveland Clinic

Subjects
medicine.medical_specialty, Allergy, Epinephrine, Epidemiology, MESH: Epinephrine, Best practice, Compromise, media_common.quotation_subject, Adrenaline/epinephrine autoinjector, World Health Organization, MESH: World Health Organization, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Baseline (configuration management), Anaphylaxis, media_common, MESH: Humans, business.industry, Public health, Prevention, medicine.disease, Classification, Management, Treatment, MESH: Anaphylaxis, 030228 respiratory system, Action (philosophy), MESH: Emergency Service, Hospital, Action plan, Medical emergency, Emergency Service, Hospital, business
Abstract

International audience; Since the first description of anaphylaxis in 1902, its clinical importance as an emergency condition has been recognized worldwide. Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction characterized by rapid onset and the potential to endanger life through respiratory or circulatory compromise. It is usually, although not always, associated with skin and mucosal changes. Although the academic/scientific communities have advocated to promote greater awareness and protocols for the management of anaphylaxis based on best evidence, there are few efforts documenting feedback as to the success of these efforts. In this article, we review the key unmet needs related to the diagnosis and management of anaphylaxis, and propose a public health initiative for prevention measures and a timetable action plan that intends to strengthen the collaboration among health professionals and especially primary care physicians dealing with anaphylaxis, which can encourage enhanced quality of care of patients with anaphylaxis. More than calling for a harmonized action for the best management of anaphylaxis to prevent undue morbidity and mortality, the Montpellier World Health Organization Collaborating Centre here proposes an action plan as a baseline for a global initiative against anaphylaxis. We strongly believe that these collaborative efforts are a strong public health and societal priority that is consistent with the overarching goals of providing optimal care of allergic patients and best practices of allergology.

Published
2021

22. Cumulative Occupational Exposures and Lung Function Decline in Two Large General Population Cohorts

Author

Josep M. Antó, Deborah Jarvis, Roberto Bono, Simona Villani, Dennis Nowak, Hayat Bentouhami, Jan Paul Zock, Bénédicte Leynaert, Theodore Lytras, Kjell Torén, Isabel Urrutia, Joachim Heinrich, Bertil Forsberg, Isabelle Pin, Joost Weyler, Chantal Raherison Semjen, Jesús Martínez-Moratalla, Vivi Schlünssen, Giulia Squillacioti, Dirk Keidel, Nicole Probst-Hensch, Øistein Svanes, Torben Sigsgaard, Rain Jõgi, Pascal Demoly, Mathias Holm, Paul D. Blanc, Antonio Pereira Vega, John Watkins, Mario Olivieri, Amar Mehta, Anne-Elie Carsin, Anna Beckmeyer-Borowko, David Vernez, Thorarinn Gislason, Dan Norbäck, Roel Vermeulen, José Antonio Gullón, Manolis Kogevinas, Geza Benke, A. Sonia Buist, Hans Kromhout, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), Swiss Tropical and Public Health Institute [Basel], University of Basel (Unibas), CIBER de Epidemiología y Salud Pública (CIBERESP), IMIM-Hospital del Mar, Generalitat de Catalunya, Utrecht University [Utrecht], University of Antwerp (UA), Klinikum der Universitat Munchen, Ludwig-Maximilians-Universität München (LMU), German Center for Lung Research, Galdakao Hospital, Complejo Hospitalario Universitario de Albacete, Universidad de Castilla-La Mancha = University of Castilla-La Mancha (UCLM), Hospital Juan Ramón Jiménez, Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de médecine aiguë spécialisée, CHU Grenoble-Hôpital Michallon, Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Università degli Studi di Pavia = University of Pavia (UNIPV), Landspitali National University Hospital of Iceland, University of Iceland [Reykjavik], University of Bergen (UiB), Sahlgrenska University Hospital [Gothenburg], Umeå University, Uppsala University, University of Copenhagen = Københavns Universitet (UCPH), Université de Lausanne = University of Lausanne (UNIL), Monash University [Melbourne], Tartu University Hospital [Tartu, Estonia], Sahlgrenska Academy at University of Gothenburg [Göteborg], Aarhus University [Aarhus], Università degli studi di Verona = University of Verona (UNIVR), University of California [San Francisco] (UC San Francisco), University of California (UC), Cardiff University, Università degli studi di Torino = University of Turin (UNITO), Oregon Health and Science University [Portland] (OHSU), Imperial College London, and Herrada, Anthony

Subjects
longitudinal studies, lung function, occupational disease, occupational exposure, spirometry, Vital Capacity, Spirometry, Lung function, Occupational Exposure, Occupational Disease, Longitudinal studies, VENTILATORY FUNCTION, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Occupational Exposure, Cohort Studies, 0302 clinical medicine, Forced Expiratory Volume, Medicine, 030212 general & internal medicine, Lung, MESH: Cohort Studies, Original Research, RISK, education.field_of_study, medicine.diagnostic_test, WORKERS, Occupational Diseases, SWISS, Occupational exposure, BURDEN, Adult, MESH: Occupational Diseases, Pulmonary and Respiratory Medicine, MESH: Bayes Theorem, Population, AMERICAN THORACIC SOCIETY, Occupational disease, MEDLINE, MESH: Forced Expiratory Volume, OBSTRUCTIVE PULMONARY-DISEASE, 03 medical and health sciences, Environmental health, Humans, COPD, MESH: Lung, education, MESH: Humans, business.industry, Bayes Theorem, MESH: Adult, AIR-POLLUTION, MESH: Vital Capacity, medicine.disease, respiratory tract diseases, 030228 respiratory system, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Human medicine, business, FOLLOW-UP
Abstract

International audience; Rationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up.Objectives: To examine the potential association in two large cohorts: the ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults).Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 = -15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio = -0.52%, -0.43%, and -0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts.Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.

Published
2021

23. Essential oils: what is the clinical tolerance in asthmatic patients?

Author

Pascal Demoly, C Neukirch, Davide Caimmi, Herrada, Anthony, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)

Subjects
Pulmonary and Respiratory Medicine, Traditional medicine, business.industry, review, asthma, medicine.disease, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Terpene, Essential oils, volatile organic compounds, Pediatrics, Perinatology and Child Health, Hypersensitivity, Oils, Volatile, medicine, Humans, Immunology and Allergy, Asthmatic patient, limonene, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, business, terpenes, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Asthma
Abstract

International audience; Essential oils in air-spray form are being more and more used for several purposes, even by allergic and asthmatic patients. Available data on the potentially dangerous effects of volatile organic compounds and terpenes contained in essential oils are scarce, and sometimes difficult to compare. Through the present work, we evaluated the clinical tolerance of asthmatic patients exposed to compounds emitted by an essential oils spray, and compared previous and new data available in the scientific literature, focusing on the aspects that may influence clinical results.

Published
2021

24. Association between lung function decline and obstructive sleep apnoea : the ALEC study

Author

Thorarinn Gislason, Deborah Jarvis, Christer Janson, Anna-Carin Olin, Dinh S Bui, Karl A. Franklin, Thor Aspelund, Bryndis Benediktsdottir, Judith Garcia-Aymerich, Pascal Demoly, Össur Ingi Emilsson, Fredrik Sundbom, Mirjam Ljunggren, Eva Lindberg, Uppsala University, Landspitali National University Hospital of Iceland, University of Iceland [Reykjavik], Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), University of Melbourne, Imperial College London, University of Gothenburg (GU), Umeå University, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CERRAMON, Laura, Uppsala Universitet [Uppsala], National Heart and Lung Institute [London] (NHLI), Royal Brompton and Harefield NHS Foundation Trust-Imperial College London, and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Vital capacity, Respiratory Medicine and Allergy, Respiratory System, Vital Capacity, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Sleep apnoea, 0302 clinical medicine, Risk Factors, Forced Expiratory Volume, Surveys and Questionnaires, YOUNG-ADULTS, Epidemiology, EPIDEMIOLOGY, Lung, POPULATION, INDEX, Lungmedicin och allergi, education.field_of_study, Sleep Apnea, Obstructive, medicine.diagnostic_test, Lung function decline, WOMEN, Middle Aged, 3. Good health, DAYTIME SLEEPINESS, Population study, Female, medicine.symptom, Life Sciences & Biomedicine, Spirometry, medicine.medical_specialty, Population, Clinical Neurology, PRESSURE, 03 medical and health sciences, FEV1/FVC ratio, INFLAMMATION, Wheeze, Internal medicine, medicine, Humans, education, Asthma, Science & Technology, business.industry, Sleep Breathing Physiology and Disorders • Original Article, 1103 Clinical Sciences, medicine.disease, Lung function, nervous system diseases, respiratory tract diseases, 030228 respiratory system, Otorhinolaryngology, 1701 Psychology, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurosciences & Neurology, Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Purpose To study changes in lung function among individuals with a risk of obstructive sleep apnoea (OSA), and if asthma affected this relationship. Methods We used data from the European Community Respiratory Health Survey II and III, a multicentre general population study. Participants answered questionnaires and performed spirometry at baseline and 10-year follow-up (n = 4,329 attended both visits). Subjects with high risk for OSA were identified from the multivariable apnoea prediction (MAP) index, calculated from BMI, age, gender, and OSA symptoms at follow-up. Asthma was defined as having doctor’s diagnosed asthma at follow-up. Primary outcomes were changes in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from baseline to follow-up. Results Among 5108 participants at follow-up, 991 (19%) had a high risk of OSA based on the MAP index. Participants with high OSA risk more often had wheeze, cough, chest tightness, and breathlessness at follow-up than those with low OSA risk. Lung function declined more rapidly in subjects with high OSA risk (low vs high OSA risk [mean ± SD]: FEV1 = − 41.3 ± 24.3 ml/year vs − 50.8 ± 30.1 ml/year; FVC = − 30.5 ± 31.2 ml/year vs − 45.2 ± 36.3 ml/year). Lung function decline was primarily associated with higher BMI and OSA symptoms. OSA symptoms had a stronger association with lung function decline among asthmatics, compared to non-asthmatics. Conclusion In the general population, a high probability of obstructive sleep apnoea was related to faster lung function decline in the previous decade. This was driven by a higher BMI and more OSA symptoms among these subjects. The association between OSA symptoms and lung function decline was stronger among asthmatics.

Published
2021

25. Perception and control of allergic rhinitis in primary care

Author

Pascal Maigret, Pascal Demoly, Isabelle Bosse, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Chercheur indépendant, and Medical department Menarini, Rungis

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Adolescent, genetic structures, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Treatment outcome, Primary care, Disease, Article, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, Perception, Throat, Surveys and Questionnaires, Respiratory signs and symptoms, medicine, Humans, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Nose, Asthma, media_common, lcsh:RC705-779, Respiratory tract diseases, Primary Health Care, business.industry, Public Health, Environmental and Occupational Health, Mean age, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, Rhinitis, Allergic, 3. Good health, medicine.anatomical_structure, Cross-Sectional Studies, Treatment Outcome, 030228 respiratory system, Female, business, Attitude to Health
Abstract

International audience; Perception of a chronic illness is a driver of patient behaviour that may impact treatment outcomes. The cross-sectional PETRA study was designed to describe the links between disease perception, patient behaviour and treatment outcomes in adults with allergic rhinitis (AR). Overall, 687 French general practitioners (GPs) included 1929 analysable patients (mean age: 39 years; intermittent/persistent symptoms: 46.2/52.3%). Of the patients, 14.1% had also been diagnosed with asthma; 71.7% had uncontrolled AR (ARCT score < 20), and 53.6% had a good perception of their illness (BIPQ score < 5). Factors significantly associated with poor perception of AR were ENT (ear/nose/throat) complications, nasal pruritus, uncontrolled AR and asthma. A strong negative correlation was observed between the BIPQ and ARCT scores: the poorer the patient's perception, the less the AR was controlled. Although no causal relationship could be drawn, GP-driven improvement of AR perception could lead to better control of symptoms. npj Primary Care Respiratory Medicine (2020) 30:37 ; https://doi.

Published
2020

26. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies

Author

Bousquet, Jean, Cristol, Jean-Paul, Czarlewski, Wienczyslawa, Anto, Josep M, Martineau, Adrian, Haahtela, Tari, Fonseca, Susana C, Iaccarino, Guido, Blain, Hubert, Fiocchi, Alessandro, Canonica, G Walter, Fonseca, Joao A, Vidal, Alain, Choi, Hak-Jong, Kim, Hyun Ju, Le Moing, Vincent, Reynes, Jacques, Sheikh, Aziz, Akdis, Cezmi A, Zuberbier, Torsten, Amir Hamzah Abdul Latiff, Baharudin, Abdullah, Werner, Aberer, Nancy, Abusada, Ian, Adcock, Alejandro, Afani, Ioana, Agache, Xenofon, Aggelidis, Jenifer, Agustin, Cezmi, A Akdis, Mübeccel, Akdis, Mona, Al-Ahmad, Abou Al-Zahab Bassam, Hussam, Alburdan, Oscar, Aldrey-Palacios, Emilio Alvarez Cuesta, Hiba Alwan Salman, Ashraf, Alzaabi, Salma, Amade, Gene, Ambrocio, Rosana, Angles, Isabella, Annesi-Maesano, Ignacio, J Ansotegui, Josep, M Anto, Paula Ara Bardajo, Stefania, Arasi, Margarete, Arrais, Hasan, Arshad, Maria-Cristina, Artesani, Estrella, Asayag, Francesca, Avolio, Khuzama, Azhari, Claus, Bachert, Diego, Bagnasco, Ilaria, Baiardini, Nissera, Bajrović, Petros, Bakakos, Sergio Bakeyala Mongono, Christine, Balotro-Torres, Sergio, Barba, Cristina, Barbara, Elsa, Barbosa, Bruno, Barreto, Joan, Bartra, Xavier, Basagana, Eric, D Bateman, Lkhagvaa, Battur, Anna, Bedbrook, Martín Bedolla Barajas, Bianca, Beghé, Antra, Bekere, Elizabeth, Bel, Ali Ben Kheder, Mikael, Benson, Elena-Camelia, Berghea, Karl-Christian, Bergmann, Roberto, Bernardini, David, Bernstein, Mike, Bewick, Slawomir, Bialek, Artur, Białoszewski, Thomas, Bieber, Nils, E Billo, Maria-Beatrice, Bilo, Carsten, Bindslev-Jensen, Leif, Bjermer, Hubert, Blain, Irina, Bobolea, Malgorzata Bochenska Marciniak, Christine, Bond, Attilio, Boner, Matteo, Bonini, Sergio, Bonini, Sinthia, Bosnic-Anticevich, Isabelle, Bosse, Sofia, Botskariova, Jacques, Bouchard, Louis-Philippe, Boulet, Rodolphe, Bourret, Philippe, Bousquet, Fulvio, Braido, Andrew, Briggs, Christopher, E Brightling, Jan, Brozek, Luisa, Brussino, Roland, Buhl, Roxana, Bumbacea, Rosalva, Buquicchio, María-Teresa Burguete Cabañas, Andrew, Bush, William, W Busse, Jeroen, Buters, Fernan, Caballero-Fonseca, Moïses, A Calderon, Mario, Calvo, Paulo, Camargos, Thierry, Camuzat, R Canevari, F, Antonio, Cano, G Walter Canonica, Arnaldo, Capriles-Hulett, Luis, Caraballo, Vicky, Cardona, Kai-Hakon, Carlsen, Jonas Carmona Pirez, Jorge, Caro, Warner, Carr, Pedro, Carreiro-Martins, Fredelita, Carreon-Asuncion, Ana-Maria, Carriazo, Carme Carrion, Y Ribas, Thomas, Casale, Mary-Ann, Castor, Elizabeth, Castro, G Caviglia, A, Lorenzo, Cecchi, Alfonso Cepeda Sarabia, Maciej, Chalubinski, Ramanathan, Chandrasekharan, Yoon-Seok, Chang, Victoria, Chato-Andeza, Lida, Chatzi, Christina, Chatzidaki, Niels, H Chavannes, Claudia Chaves Loureiro, Aurora-Alejandra Chavez Garcia, Marta, Chelninska, Yuzhi, Chen, Lei, Cheng, Sharon, Chinthrajah, Tomas, Chivato, Ekaterine, Chkhartishvili, George, Christoff, Henry, Chrystyn, Derek, K Chu, Antonio, Chua, Alexander, Chuchalin, Kian Fan Chung, Alberto, Cicerán, Cemal, Cingi, Giorgio, Ciprandi, Ieva, Cirule, Ana-Carla, Coelho, Enrico, Compalati, Jannis, Constantinidis, Jaime Correia de Sousa, Elisio Manuel Costa, David, Costa, María Del Carmen Costa Domínguez, André, Coste, Cottini, M, Linda, Cox, Carlos, Crisci, Maria Angiola Crivellaro, Alvaro, A Cruz, John, Cullen, Adnan, Custovic, Biljana, Cvetkovski, Wienczyslawa, Czarlewski, Gennaro, D'Amato, Jane da Silva, Ronald, Dahl, Sven-Erik, Dahlen, Vasilis, Daniilidis, Louei Darjazini Nahhas, Ulf, Darsow, Janet, Davies, Frédéric de Blay, Giulia De Feo, Eloisa De Guia, José-Ricardo De la Torre Navarrete, Chato De Los Santos, Esteban De Manuel Keenoy, Govert De Vries, Diana, Deleanu, Pascal, Demoly, Judah, Denburg, Philippe, Devillier, Alain, Didier, Sanja Dimic Janjic, Maria, Dimou, Anh Tuan Dinh-Xuan, Ratko, Djukanovic, Maria Do Ceu Texeira, Dejan, Dokic, Margarita Gabriela Domínguez Silva, Habib, Douagui, Nikolaos, Douladiris, Maria, Doulaptsi, Gérard, Dray, Ruta, Dubakiene, Eve, Dupas, Stephen, Durham, Marzia, Duse, Mark, Dykewicz, Didier, Ebo, Natalija, Edelbaher, Thomas, Eiwegger, Patrik, Eklund, Yehia, El-Gamal, Zeinab, A El-Sayed, Shereen, S El-Sayed, Magda, El-Seify, Regina, Emuzyte, Lourdes, Enecilla, Marina, Erhola, Heidilita, Espinoza, Jesús Guillermo Espinoza Contreras, John, Farrell, Lenora, Fernandez, Paola Fimbres Jimenez, Antje Fink Wagner, Alessandro, Fiocchi, Wytske, J Fokkens, Lenia, Folletti, Joao, A Fonseca, Jean-François, Fontaine, Francesco, Forastiere, Jose Miguel Fuentes Pèrez, Emily, Gaerlan-Resureccion, Mina, Gaga, José Luis Gálvez Romero, Amiran, Gamkrelidze, Alexis, Garcia, Cecilia Yvonne García Cobas, María de la Luz Hortensia García Cruz, Valeria Garcia Ortiz, Jacques, Gayraud, Matteo, Gelardi, Bilun, Gemicioglu, Dimitra, Gennimata, Sonya, Genova, José, Gereda, Roy Gerth van Wijk, Antonio, Giuliano, René-Maximiliano, Gomez, Miguel-Ange Gonzalez Ballester, Sandra González Diaz, Maia, Gotua, Christos, Grigoreas, Ineta, Grisle, Marta, Guidacci, Nick, Guldemond, Zdenek, Gutter, Antonieta, Guzmán, Tari, Haahtela, Ramsa, Halloum, David, Halpin, Eckard, Hamelmann, Suleiman, Hammadi, Richard, Harvey, Enrico, Heffler, Joachim, Heinrich, Adnan, Hejjaoui, Birthe, Hellquist-Dahl, Luiana Hernández Velázquez, Mark, Hew, Elham, Hossny, Peter, Howarth, Martin, Hrubiško, Yunuen Rocío Huerta Villalobos, Marc, Humbert, Salina, Husain, Michael, Hyland, Guido, Iaccarino, Moustafa, Ibrahim, Nataliya, Ilina, Maddalena, Illario, Cristoforo, Incorvaia, Antonio, Infantino, Carla, Irani, Zhanat, Ispayeva, Juan Carlos Ivancevich, Edgardo Ej Jares, Deborah, Jarvis, Ewa, Jassem, Klemen, Jenko, Rubén Darío Jiméneracruz Uscanga, Sebastian, L Johnston, Guy, Joos, Maja, Jošt, Kaja, Julge, Ki-Suck, Jung, Jocelyne, Just, Marek, Jutel, Igor, Kaidashev, Omer, Kalayci, Fuat, Kalyoncu, Jeni, Kapsali, Przemyslaw, Kardas, Jussi, Karjalainen, Carmela, A Kasala, Michael, Katotomichelakis, Loreta, Kavaliukaite, Kazi, S Bennoor, Thomas, Keil, Paul, Keith, Musa, Khaitov, Nikolai, Khaltaev, You-Young, Kim, Bruce, Kirenga, Jorg, Kleine-Tebbe, Ludger, Klimek, Fanny, W Ko, Bernard Koffi N'Goran, Evangelia, Kompoti, Peter, Kopač, Gerard, Koppelman, Anja Koren Jeverica, Seppo, Koskinen, Mitja, Košnik, Tomasz, Kostka, Kosta, V Kostov, Marek, L Kowalski, Tanya, Kralimarkova, Karmen Kramer Vrščaj, Helga, Kraxner, Samo, Kreft, Vicky, Kritikos, Dmitry, Kudlay, Mikael, Kuitunen, Inger, Kull, Piotr, Kuna, Maciej, Kupczyk, Violeta, Kvedariene, Marialena, Kyriakakou, Nika, Lalek, Massimo, Landi, Stephen, Lane, Désiree, E Larenas-Linnemann, Susanne, Lau, Daniel, Laune, Jorge, Lavrut, Lan, Le, Martina, Lenzenhuber, Gualtiero, Leo, Marcus, Lessa, Michael, Levin, Jing, Li, Philip, Lieberman, Giuseppe, Liotta, Brian, Lipworth, Xuandao, Liu, Rommel, Lobo, Karin, C Lodrup Carlsen, Carlo, Lombardi, Renaud, Louis, Stelios, Loukidis, Olga, Lourenço, Jorge, A Luna Pech, Bojan, Madjar, Enrico, Maggi, Antoine, Magnan, Bassam, Mahboub, Alpana, Mair, Anke-Hilse Maitland van der Zee, Mika, Makela, Michael, Makris, Hans-Jorgen, Malling, Mariana, Mandajieva, Patrick, Manning, Manolis, Manousakis, Pavlos, Maragoudakis, Gianluigi, Marseglia, Gailen, Marshall, Mohammad Reza Masjedi, Jorge, F Máspero, Juan José Matta Campos, Marcus, Maurer, Sandra, Mavale-Manuel, Cem, Meço, Erik, Melén, Giovanni, Melioli, Elisabete, Melo-Gomes, Eli, O Meltzer, Enrica, Menditto, Andrew, Menzies-Gow, Hans, Merk, Jean-Pierre, Michel, Yann, Micheli, Neven, Miculinic, Luís, Midão, Florin, Mihaltan, Nikolaos, Mikos, Manlio, Milanese, Branislava, Milenkovic, Dimitrios, Mitsias, Bassem, Moalla, Giuliana, Moda, María Dolores Mogica Martínez, Yousser, Mohammad, Frances-Montserrat, Moharra, Mostafa, Moin, Mathieu, Molimard, Isabelle, Momas, Monique, Mommers, Alessandro, Monaco, Stephen, Montefort, Lucia-Elvira, Montenegro, Riccardo, Monti, Dory, Mora, Mario, Morais-Almeida, Ralph, Mösges, Badr Eldin Mostafa, Joaquim, Mullol, Lars, Münter, Antonella, Muraro, Ruth, Murray, Antonio, Musarra, Tihomir, Mustakov, Robert, Naclerio, Kari, C Nadeau, Rachel, Nadif, Alla, Nakonechna, Leyla, Namazova-Baranova, Gretchen, Navarro-Locsin, Hugo, Neffen, Kristof, Nekam, Angelos, Neou, Eustachio, Nettis, Daniel, Neuberger, Laurent, Nicod, Stefania, Nicola, Verena, Niederberger-Leppin, Marek, Niedoszytko, Antonio, Nieto, Ettore, Novellino, Elizabete, Nunes, Dieudonné, Nyembue, Robyn, E O'Hehir, Cvetanka, Odjakova, Ken, Ohta, Yoshitaka, Okamoto, Kimi, Okubo, Brian, Oliver, Gabrielle, L Onorato, Maria Pia Orru, Solange, Ouédraogo, Kampadilemba, Ouoba, Francisco-Javier, Padilla, Pier Luigi Paggiaro, Aris, Pagkalos, Pajno, Giovanni Battista, Gianni, Pala, P Palaniappan, S, Isabella, Pali-Schöll, Susanna, Palkonen, Stephen, Palmer, Carmen Panaitescu Bunu, Petr, Panzner, Nikos, G Papadopoulos, Vasilis, Papanikolaou, Alberto, Papi, Bojidar, Paralchev, Giannis, Paraskevopoulos, Hae-Sim, Park, Giovanni, Passalacqua, Vincenzo, Patella, Ian, Pavord, Ruby, Pawankar, Soren, Pedersen, Susete, Peleve, Simona, Pellegino, Ana, Pereira, Mariana, Pereira, Tamara, Pérez, Andrea, Perna, Diego, Peroni, Oliver, Pfaar, Nhân, Pham-Thi, Bernard, Pigearias, Isabelle, Pin, Konstantina, Piskou, Constantinos, Pitsios, Davor, Plavec, Dagmar, Poethig, Wolfgang, Pohl, Antonija Poplas Susic, Todor, A Popov, Fabienne, Portejoie, Paul, Potter, Lars, Poulsen, Alexandra, Prados-Torres, Fotis, Prarros, David, Price, Emmanuel, Prokopakis, Francesca, Puggioni, Elisa, Puig-Domenech, Robert, Puy, Klaus, Rabe, Silvia, Rabotti, Filip, Raciborski, Josephine, Ramos, Cristina, Recalcati, Marysia, T Recto, Shereen, M Reda, Frederico, S Regateiro, Norbert, Reider, Sietze, Reitsma, Susana, Repka-Ramirez, Erminia, Ridolo, Janet, Rimmer, Daniela Rivero Yeverino, José Angelo Rizzo, Carlos, Robalo-Cordeiro, Graham, Roberts, Karen, Robles, Nicolas, Roche, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Giovanni, Rolla, Christine, Rolland, Regina, Roller-Wirnsberger, Miguel Roman Rodriguez, Antonino, Romano, Jan, Romantowski, Philippe, Rombaux, Joel, Romualdez, Jose, Rosado-Pinto, Nelson, Rosario, Lanny, Rosenwasser, Oliviero, Rossi, Menachem, Rottem, Philip, W Rouadi, Nikoleta, Rovina, Irma Rozman Sinur, Mauricio, Ruiz, Lucy Tania Ruiz Segura, Dermot, Ryan, Hironori, Sagara, Daiki, Sakai, Daiju, Sakurai, Wafaa, Saleh, Johanna, Salimaki, Konstantinos, Samitas, Boleslaw, Samolinski, María Guadalupe Sánchez Coronel, Mario, Sanchez-Borges, Jaime, Sanchez-Lopez, Melissa, Sansonna, Codrut, Sarafoleanu, Faradiba Sarquis Serpa, Joaquin, Sastre, Eleonora, Savi, Agne, Savonyte, Bisher, Sawaf, Glenis, K Scadding, Sophie, Scheire, Peter, Schmid-Grendelmeier, Juan Francisco Schuhl, Holger, Schunemann, Maria, Schvalbová, Jorgen, Schwarze, Nicola, Scichilone, Gianenrico, Senna, Cecilia, Sepúlveda, Elie, Serrano, Sara, Shamai, Aziz, Sheikh, Mike, Shields, Vasil, Shishkov, Nikos, Siafakas, Alexander, Simeonov, Estelle Fer Simons, Juan Carlos Sisul, Brigita, Sitkauskiene, Ingelbjorg, Skrindo, Tanja Soklič Košak, Dirceu, Solé, Martin, Sondermann, Talant, Sooronbaev, Manuel, Soto-Martinez, Manuel, Soto-Quiros, Barnaro Sousa Pinto, Milan, Sova, Michael, Soyka, Krzysztof, Specjalski, Annette, Sperl, Otto, Spranger, Sofia, Stamataki, Lina, Stefanaki, Cristiana, Stellato, Rafael, Stelmach, Timo, Strandberg, Petra, Stute, Abirami, Subramaniam, Charlotte Suppli Ulrik, Michael, Sutherland, Silvia, Sylvestre, Aikaterini, Syrigou, Luis Taborda Barata, Nadejda, Takovska, Rachel, Tan, Frances, Tan, Vincent, Tan, Ing Ping Tang, Masami, Taniguchi, Line, Tannert, Pongsakorn, Tantilipikorn, Jessica, Tattersall, Filippo, Tesi, Uta, Thieme, Carel, Thijs, Mike, Thomas, Teresa, To, Ana Maria Todo-Bom, Alkis, Togias, Peter-Valentin, Tomazic, Vesna, Tomic-Spiric, Sanna, Toppila-Salmi, Maria-José Torres Jaen, Elina, Toskala, Massimo, Triggiani, Nadja, Triller, Katja, Triller, Ioanna, Tsiligianni, Uberti, M, Ruxandra, Ulmeanu, Jure, Urbancic, Marilyn Urrutia Pereira, Martina, Vachova, Felipe, Valdés, Rudolf, Valenta, Marylin Valentin Rostan, Antonio, Valero, Arunas, Valiulis, Mina, Vallianatou, Erkka, Valovirta, Michiel Van Eerd, Eric Van Ganse, Marianne van Hage, Olivier, Vandenplas, Tuula, Vasankari, Dafina, Vassileva, Cesar Velasco Munoz, Maria Teresa Ventura, Cécilia, Vera-Munoz, Frédéric, Viart, Dilyana, Vicheva, Pakit, Vichyanond, Petra, Vidgren, Giovanni, Viegi, Claus, Vogelmeier, Leena Von Hertzen, Theodoros, Vontetsianos, Dimitris, Vourdas, Vu Tran Thien Quan, Martin, Wagenmann, Samantha, Walker, Dana, Wallace, Yun De Wang, Susan, Waserman, Katrin, Wehner, Magnus, Wickman, Sian, Williams, Dennis, Williams, Nicola, Wilson, Gary, Wong, Kent, Woo, Lucyna, Wozniak, John, Wright, Piotr, Wroczynski, Paraskevi, Xepapadaki, Plamen, Yakovliev, Masao, Yamaguchi, Kwok, Yan, Yoke Yeow Yap, Mais, Yassin, Barbara, Yawn, Panayiotis, Yiallouros, Arzu, Yorgancioglu, Shigemi, Yoshihara, Ian, Young, Osman, B Yusuf, Asghar, Zaidi, Fares, Zaitoun, Petra, Zalud, Heather, Zar, T Zedda, M, Mario, E Zernotti, Luo, Zhang, Nanshan, Zhong, Mihaela, Zidarn, Torsten, Zuberbier, Celia, Zubrinich, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Humboldt University Of Berlin, Berlin Institute of Health (BIH), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Central Hospital [Finland] (HUCH), Departamento de Geociencias, Ambiente e Ordenamento do Territorio (DGAOT), Universidade do Porto = University of Porto, University of Naples Federico II = Università degli studi di Napoli Federico II, Euromov (EuroMov), Université de Montpellier (UM), IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), Center of Research in Health Technologies and Information Systems (CINTESIS), AgroParisTech, World Institute of Kimchi [Gwangju], Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et 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), University of Edinburgh, Universität Zürich [Zürich] = University of Zurich (UZH), Humboldt-Universität zu Berlin, 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), 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), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), University of Helsinki, Universidade do Porto, University of Naples Federico II, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), MORNET, Dominique, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Bousquet J., Cristol J.-P., Czarlewski W., Anto J.M., Martineau A., Haahtela T., Fonseca S.C., Iaccarino G., Blain H., Fiocchi A., Canonica G.W., Fonseca J.A., Vidal A., Choi H.-J., Kim H.J., Le Moing V., Reynes J., Sheikh A., Akdis C.A., Zuberbier T., Abdul Latiff A.H., Abdullah B., Aberer W., Abusada N., Adcock I., Afani A., Agache I., Aggelidis X., Agustin J., Akdis M., Al-Ahmad M., Al-Zahab Bassam A., Alburdan H., Aldrey-Palacios O., Alvarez Cuesta E., Alwan Salman H., Alzaabi A., Amade S., Ambrocio G., Angles R., Annesi-Maesano I., Ansotegui I.J., Ara Bardajo P., Arasi S., Arrais M., Arshad H., Artesani M.-C., Asayag E., Avolio F., Azhari K., Bachert C., Bagnasco D., Baiardini I., Bajrovic N., Bakakos P., Bakeyala Mongono S., Balotro-Torres C., Barba S., Barbara C., Barbosa E., Barreto B., Bartra J., Basagana X., Bateman E.D., Battur L., Bedbrook A., Bedolla Barajas M., Beghe B., Bekere A., Bel E., Ben Kheder A., Benson M., Berghea E.-C., Bergmann K.-C., Bernardini R., Bernstein D., Bewick M., Bialek S., Bialoszewski A., Bieber T., Billo N.E., Bilo M.-B., Bindslev-Jensen C., Bjermer L., Bobolea I., Bochenska Marciniak M., Bond C., Boner A., Bonini M., Bonini S., Bosnic-Anticevich S., Bosse I., Botskariova S., Bouchard J., Boulet L.-P., Bourret R., Bousquet P., Braido F., Briggs A., Brightling C.E., Brozek J., Brussino L., Buhl R., Bumbacea R., Buquicchio R., Burguete Cabanas M.-T., Bush A., Busse W.W., Buters J., Caballero-Fonseca F., Calderon M.A., Calvo M., Camargos P., Camuzat T., Canevari F., Cano A., Canonican G.W., Capriles-Hulett A., Caraballo L., Cardona V., Carlsen K.-H., Carmona Pirez J., Caro J., Carr W., Carreiro-Martins P., Carreon-Asuncion F., Carriazo A.-M., CarrionyRibas C., Casale T., Castor M.-A., Castro E., Caviglia A.G., Cecchi L., Cepeda Sarabia A., Chalubinski M., Chandrasekharan R., Chang Y.-S., Chato-Andeza V., Chatzi L., Chatzidaki C., Chavannes N.H., Chaves Loureiro C., Chavez Garcia A.-A., Chelninska M., Chen Y., Cheng L., Chinthrajah S., Chivato T., Chkhartishvili E., Christoff G., Chrystyn H., Chu D.K., Chua A., Chuchalin A., Chung K.F., Ciceran A., Cingi C., Ciprandi G., Cirule I., Coelho A.-C., Compalati E., Constantinidis J., Correia de Sousa J., Costa E.M., Costa D., del Carmen Costa Dominguez M., Coste A., Cottini M., Cox L., Crisci C., Crivellaro M.A., Cruz A.A., Cullen J., Custovic A., Cvetkovski B., D'Amato G., da Silva J., Dahl R., Dahlen S.-E., Daniilidis V., Darjazini Nahhas L., Darsow U., Davies J., de Blay F., De Feo G., De Guia E., De la Torre Navarrete J.-R., De los Santos C., De Manuel Keenoy E., De Vries G., Deleanu D., Demoly P., Denburg J., Devillier P., Didier A., Dimic Janjic S., Dimou M., Dinh-Xuan A.T., Djukanovic R., Do Ceu Texeira M., Dokic D., Dominguez Silva M.G., Douagui H., Douladiris N., Doulaptsi M., Dray G., Dubakiene R., Dupas E., Durham S., Duse M., Dykewicz M., Ebo D., Edelbaher N., Eiwegger T., Eklund P., El-Gamal Y., El-Sayed Z.A., El-Sayed S.S., El-Seify M., Emuzyte R., Enecilla L., Erhola M., Espinoza H., Espinoza Contreras J.G., Farrell J., Fernandez L., Fimbres Jimenez P., Fink Wagner A., Fokkens W.J., Folletti L., Fontaine J.-F., Forastiere F., Fuentes Perez J.M., Gaerlan-Resureccion E., Gaga M., Galvez Romero J.L., Gamkrelidze A., Garcia A., Garcia Cobas C.Y., de la Luz Hortensia Garcia Cruz M., Ortiz V.G., Gayraud J., Gelardi M., Gemicioglu B., Gennimata D., Genova S., Gereda J., Gerth van Wijk R., Giuliano A., Gomez R.-M., Gonzalez Ballester M.-A., Gonzalez Diaz S., Gotua M., Grigoreas C., Grisle I., Guidacci M., Guldemond N., Gutter Z., Guzman A., Halloum R., Halpin D., Hamelmann E., Hammadi S., Harvey R., Heffler E., Heinrich J., Hejjaoui A., Hellquist-Dahl B., Hernandez Velazquez L., Hew M., Hossny E., Howarth P., Hrubisko M., Huerta Villalobos Y.R., Humbert M., Husain S., Hyland M., Ibrahim M., Ilina N., Illario M., Incorvaia C., Infantino A., Irani C., Ispayeva Z., Ivancevich J.C., Jares E.E., Jarvis D., Jassem E., Jenko K., Jimeneracruz Uscanga R.D., Johnston S.L., Joos G., Jost M., Julge K., Jung K.-S., Just J., Jutel M., Kaidashev I., Kalayci O., Kalyoncu F., Kapsali J., Kardas P., Karjalainen J., Kasala C.A., Katotomichelakis M., Kavaliukaite L., Bennoor K.S., Keil T., Keith P., Khaitov M., Khaltaev N., Kim Y.-Y., Kirenga B., Kleine-Tebbe J., Klimek L., Ko F.W., Koffi N'Goran B., Kompoti E., Kopac P., Koppelman G., Koren Jeverica A., Koskinen S., Kosnik M., Kostka T., Kostov K.V., Kowalski M.L., Kralimarkova T., Kramer Vrscaj K., Kraxner H., Kreft S., Kritikos V., Kudlay D., Kuitunen M., Kull I., Kuna P., Kupczyk M., Kvedariene V., Kyriakakou M., Lalek N., Landi M., Lane S., Larenas-Linnemann D.E., Lau S., Laune D., Lavrut J., Le L., Lenzenhuber M., Leo G., Lessa M., Levin M., Li J., Lieberman P., Liotta G., Lipworth B., Liu X., Lobo R., Lodrup Carlsen K.C., Lombardi C., Louis R., Loukidis S., Lourenco O., Luna Pech J.A., Madjar B., Maggi E., Magnan A., Mahboub B., Mair A., Maitland van der Zee A.-H., Makela M., Makris M., Malling H.-J., Mandajieva M., Manning P., Manousakis M., Maragoudakis P., Marseglia G., Marshall G., Masjedi M.R., Maspero J.F., Matta Campos J.J., Maurer M., Mavale-Manuel S., Meco C., Melen E., Melioli G., Melo-Gomes E., Meltzer E.O., Menditto E., Menzies-Gow A., Merk H., Michel J.-P., Micheli Y., Miculinic N., Midao L., Mihaltan F., Mikos N., Milanese M., Milenkovic B., Mitsias D., Moalla B., Moda G., Mogica Martinez M.D., Mohammad Y., Moharra F.-M., Moin M., Molimard M., Momas I., Mommers M., Monaco A., Montefort S., Montenegro L.-E., Monti R., Mora D., Morais-Almeida M., Mosges R., Mostafa B.E., Mullol J., Munter L., Muraro A., Murray R., Musarra A., Mustakov T., Naclerio R., Nadeau K.C., Nadif R., Nakonechna A., Namazova-Baranova L., Navarro-Locsin G., Neffen H., Nekam K., Neou A., Nettis E., Neuberger D., Nicod L., Nicola S., Niederberger-Leppin V., Niedoszytko M., Nieto A., Novellino E., Nunes E., Nyembue D., O'Hehir R.E., Odjakova C., Ohta K., Okamoto Y., Okubo K., Oliver B., Onorato G.L., Orru M.P., Ouedraogo S., Ouoba K., Padilla F.-J., Paggiaro P.L., Pagkalos A., Pajno G., Pala G., Palaniappan S., Pali-Scholl I., Palkonen S., Palmer S., Panaitescu Bunu C., Panzner P., Papadopoulos N.G., Papanikolaou V., Papi A., Paralchev B., Paraskevopoulos G., Park H.-S., Passalacqua G., Patella V., Pavord I., Pawankar R., Pedersen S., Peleve S., Pellegino S., Pereira A., Pereira M., Perez T., Perna A., Peroni D., Pfaar O., Pham-Thi N., Pigearias B., Pin I., Piskou K., Pitsios C., Plavec D., Poethig D., Pohl W., Poplas Susic A., Popov T.A., Portejoie F., Potter P., Poulsen L., Prados-Torres A., Prarros F., Price D., Prokopakis E., Puggioni F., Puig-Domenech E., Puy R., Rabe K., Rabotti S., Raciborski F., Ramos J., Recalcati C., Recto M.T., Reda S.M., Regateiro F.S., Reider N., Reitsma S., Repka-Ramirez S., Ridolo E., Rimmer J., Rivero Yeverino D., Rizzo J.A., Robalo-Cordeiro C., Roberts G., Robles K., Roche N., Rodriguez Gonzalez M., Rodriguez Zagal E., Rolla G., Rolland C., Roller-Wirnsberger R., Roman Rodriguez M., Romano A., Romantowski J., Rombaux P., Romualdez J., Rosado-Pinto J., Rosario N., Rosenwasser L., Rossi O., Rottem M., Rouadi P.W., Rovina N., Rozman Sinur I., Ruiz M., Ruiz Segura L.T., Ryan D., Sagara H., Sakai D., Sakurai D., Saleh W., Salimaki J., Samitas K., Samolinski B., Sanchez Coronel M.G., Sanchez-Borges M., Sanchez-Lopez J., Sansonna M., Sarafoleanu C., Sarquis Serpa F., Sastre J., Savi E., Savonyte A., Sawaf B., Scadding G.K., Scheire S., Schmid-Grendelmeier P., Schuhl J.F., Schunemann H., Schvalbova M., Schwarze J., Scichilone N., Senna G., Sepulveda C., Serrano E., Shamai S., Shields M., Shishkov V., Siafakas N., Simeonov A., Simons E.F., Sisul J.C., Sitkauskiene B., Skrindo I., Soklic Kosak T., Sole D., Sondermann M., Sooronbaev T., Soto-Martinez M., Soto-Quiros M., Pinto B.S., Sova M., Soyka M., Specjalski K., Sperl A., Spranger O., Stamataki S., Stefanaki L., Stellato C., Stelmach R., Strandberg T., Stute P., Subramaniam A., Suppli Ulrik C., Sutherland M., Sylvestre S., Syrigou A., Taborda Barata L., Takovska N., Tan R., Tan F., Tan V., Tang I.P., Taniguchi M., Tannert L., Tantilipikorn P., Tattersall J., Tesi F., Thieme U., Thijs C., Thomas M., To T., Todo-Bom A.M., Togias A., Tomazic P.-V., Tomic-Spiric V., Toppila-Salmi S., Torres Jaen M.-J., Toskala E., Triggiani M., Triller N., Triller K., Tsiligianni I., Uberti M., Ulmeanu R., Urbancic J., Urrutia Pereira M., Vachova M., Valdes F., Valenta R., Valentin Rostan M., Valero A., Valiulis A., Vallianatou M., Valovirta E., Van Eerd M., Van Ganse E., van Hage M., Vandenplas O., Vasankari T., Vassileva D., Velasco Munoz C., Ventura M.T., Vera-Munoz C., Viart F., Vicheva D., Vichyanond P., Vidgren P., Viegi G., Vogelmeier C., Von Hertzen L., Vontetsianos T., Vourdas D., Tran Thien Quan V., Wagenmann M., Walker S., Wallace D., De Wang Y., Waserman S., Wehner K., Wickman M., Williams S., Williams D., Wilson N., Wong G., Woo K., Wozniak L., Wright J., Wroczynski P., Xepapadaki P., Yakovliev P., Yamaguchi M., Yan K., Yap Y.Y., Yassin M., Yawn B., Yiallouros P., Yorgancioglu A., Yoshihara S., Young I., Yusuf O.B., Zaidi A., Zaitoun F., Zalud P., Zar H., Zedda M.T., Zernotti M.E., Zhang L., Zhong N., and Zidarn M.

Subjects
MAPK/ERK pathway, ARIA group, Allergy, [SDV]Life Sciences [q-bio], NF-KAPPA-B, debelost, Review, Pharmacology, Resveratrol, PROTECTS, chemistry.chemical_compound, 0302 clinical medicine, RESPIRATORY SYNDROME CORONAVIRUS, ENDOPLASMIC-RETICULUM STRESS, Medicine and Health Sciences, Immunology and Allergy, Medicine, OXIDATIVE STRESS, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, 2. Zero hunger, 0303 health sciences, RESPIRATORY, INSULIN-RESISTANCE, Muscle cell proliferation, SULFORAPHANE, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, SIGNALING PATHWAY, Signal transduction, Life Sciences & Biomedicine, Pulmonary and Respiratory Medicine, NRF2 ACTIVATORS, MUSCLE-CELL PROLIFERATION, Immunology, 610 Medicine & health, Lung injury, Settore MED/10 - Malattie Dell'Apparato Respiratorio, ACUTE LUNG INJURY, 03 medical and health sciences, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, udc:616.9, odpornost proti inzulinu, SULFORAPHANE PROTECTS, Transcription factor, PI3K/AKT/mTOR pathway, 030304 developmental biology, Science & Technology, business.industry, SARS-CoV-2, food, medicine.disease, chemistry, hranila, SYNDROME CORONAVIRUS, business, hrana, GREEN TEA
Abstract

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.

Published
2020

27. Digital Allergy Card: Design and Users’ Perceptions

Author

Linnea Ung, Pascal Demoly, Jorick Lartigau, Anca M. Chiriac, Roxana Ologeanu-Taddei, and Rhode Ghislaine Nguewo Ngassam

Subjects
Allergy, genetic structures, business.industry, Users perceptions, Health care, Internet privacy, medicine, business, medicine.disease, Psychology, mHealth
Abstract

This paper presents the design and the users’ perceptions of a Digital Allergy Card for recording, sharing and tracing information on drug allergies.

Published
2020

28. Anaphylaxis in children

Author

Luciana Kase Tanno, Pascal Demoly, Hospital Sírio-Libanês [São Paulo, Brazil], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Université de Montpellier (UM)

Subjects
medicine.medical_specialty, Allergy, Pediatrics, Epinephrine, Immunology, Mucocutaneous zone, Laryngeal Edema, 03 medical and health sciences, 0302 clinical medicine, prevention, Risk Factors, Epidemiology, Case fatality rate, medicine, anaphylaxis, Animals, Humans, Immunology and Allergy, 030212 general & internal medicine, adrenaline/epinephrine auto-injectors, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Child, Asthma, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, treatment, business.industry, food and beverages, Allergens, medicine.disease, 3. Good health, Hypersensitivity reaction, Milk, 030228 respiratory system, classification, Pediatrics, Perinatology and Child Health, Cattle, Female, epidemiology, business, Food Hypersensitivity, Anaphylaxis, management, medicine.drug
Abstract

International audience; Anaphylaxis in children is a potential acute life-threatening systemic hypersensitivity reaction. Anaphylaxis fatality rate is estimated to be 0.65% to 2%. Food is the main anaphylaxis trigger in children, notably cow's milk, peanuts, and tree nuts. Mucocutaneous manifestations are observed in more than 90% of cases, but it is not essential for diagnosis. Deaths are rather secondary to the laryngeal edema, observed in 40%-50% of cases. Personal history of asthma, allergy to particular foods such as peanuts and tree nuts, and adolescence are known risk factors for anaphylaxis and more severe reactions. Epinephrine (adrenaline) is the medication of choice for the first-aid treatment of anaphylaxis. However, adrenaline auto-injectors (AAIs) are commercially available in only 32% of world countries. There are still considerable unmet needs in the field of anaphylaxis in children. Therefore, the Montpellier WHO Collaborating Centre aims to start the global action plan applied to anaphylaxis.

Published
2020

29. Practical Guidance for the Evaluation and Management of Drug Hypersensitivity: Specific Drugs

Author

Parul H. Kothari, Johnson T. Wong, Sarita U. Patil, David L. Hepner, Iris M. Otani, Meredith A. Dilley, Craig D. Platt, Margee Louisias, Kimberly G. Blumenthal, Sara Barmettler, Knut Brockow, Alberta L. Wang, Catherine M. Biggs, Dinah Foer, Ana Dioun Broyles, Elizabeth J. Phillips, Stephanie L. Logsdon, Antonino Romano, Ari J. Fried, Timothy Kyin, Matthew P. Giannetti, Kathleen Lee-Sarwar, Michelle C. Maciag, Timothy Lax, Anca Mirela Chiriac, Miriam Verdú, Pascale Dewachter, Samantha Minnicozzi, David I. Hong, Mariana Castells, Josefina Cernadas, Rebecca G. Breslow, Christina S.K. Yee, Kathleen M. Buchheit, Cosby A. Stone, Katherine N. Cahill, Allison E. Norton, Joyce T. Hsu, Jocelyn R. Farmer, Rima Rachid, Aleena Banerji, Andrew J. MacGinnitie, Anna R. Wolfson, Pascal Demoly, Min Jung Lee, Tito Rodriguez, Miguel Park, Matthieu Picard, María José Torres, Joseph X. Zhou, Paige G. Wickner, Patrick J. Brennan, Sarah L. Garon, Elena Crestani, Anne Y. Liu, Boston Children's Hospital, Harvard Medical School [Boston] (HMS), Massachusetts General Hospital [Boston], University of British Columbia (UBC), Brigham & Women’s Hospital [Boston] (BWH), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Hospital de São João [Porto], Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Université de Montpellier (UM), Groupe Hospitalier Universitaire Paris Seine-Saint-Denis (GHUPSSD), University of Virginia [Charlottesville], Beth Israel Deaconess Medical Center [Boston] (BIDMC), Hoag Medical Group [Newport Beach], Stanford University, Cincinnati Children's Hospital Medical Center, Monroe Carell Jr. Children's Hospital at Vanderbilt [Nashville], University of California [San Francisco] (UCSF), University of California, Mayo Clinic [Rochester], Hôpital Maisonneuve-Rosemont, Al-Rashed Allergy Center [Kuwait City], Oasi Maria Santissima Srl [Troina, Italy], Hospital Regional Universitario de Málaga [Spain], Hospital Universitario de Ceuta, and Technical University of Munich (TUM)

Subjects
Drug, MESH: Drug Hypersensitivity, medicine.medical_specialty, media_common.quotation_subject, medicine.medical_treatment, MESH: Pharmaceutical Preparations, Food and drug administration, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, medicine, Immunology and Allergy, MESH: Desensitization, Immunologic, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, media_common, Desensitization (medicine), Radiocontrast Media, MESH: Humans, business.industry, medicine.disease, 3. Good health, 030228 respiratory system, Intradermal test, Aspirin exacerbated respiratory disease, Penicilloyl polylysine, business, Adverse drug reaction
Abstract

International audience

Published
2020

30. Diagnostic procedures & practices in drug allergy/hypersensitivity: a survey of 13 Asian countries

Author

Wen-Hung Chung, Min-Moon Tang, Jiu Yao Wang, Amir Hamzah Abdul Latiff, Luo Zhang, Iris Rengganis, Ticha Rerkpattanapipat, Philip H. Li, Bernard Yu-Hor Thong, Mizuho Nagao, Jie Shen Fok, Pascal Demoly, Masao Yamaguchi, Ruby Pawankar, Francis Thien, Yi-Giien Tsai, Wasu Kamchaisatian, Hye Ryun Kang, James Yun, Mariana Castells, Ting Fan Leung, Takao Fujisawa, Yoon-Seok Chang, Joo-Yoon Ho, Byung Keun Kim, Michaela Lucas, Hospital Kuala Lumpur, Box Hill Hospital, Monash University [Melbourne], Tan Tock Seng Hospital [Singapore, Singapore], The University of Sydney, Nepean Hospital, Queen Mary Hospital, Queen mary Hospital, The University of Hong Kong (HKU), Seoul National University [Seoul] (SNU), Seoul National University Hospital, Teikyo University School of Medicine, Sir Charles Gairdner Hospital, The University of Western Australia (UWA), Seoul National University Bundang Hospital (SNUBH), Korea University Anam Hospital [Seoul], Mie National Hospital [Tsu], Universitas Indonesia (UI ), Cipto Mangunkusumo Hospital [Jakarta], Kaohsiung Medical University, Chang Gung Memorial Hospital [Taipei] (CGMH), Chang Gung University, Ramathibodi Hospital [Bangkok, Thailand], Mahidol University [Bangkok], Samitivej Children's Hospital [Bangkok], The Chinese University of Hong Kong [Hong Kong], Hanyang University, Beijing Tongren Hospital, Capital University of Medical Sciences [Beijing] (CUMS), Pantai Hospital [Kuala Lumpur], Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université de Montpellier (UM), National Cheng Kung University Hospital [Tainan], Nippon Medical School [Tokyo, Japon], Tan Tock Seng Hospital, Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), and Herrada, Anthony

Subjects
Allergy, medicine.medical_specialty, Provocation test, Drug allergy, Dermatology, Penicillins, 03 medical and health sciences, 0302 clinical medicine, Abacavir, Pharmacogenetics, Skin tests, medicine, Immunology and Allergy, 030212 general & internal medicine, Medical prescription, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Anaphylaxis, Asthma, business.industry, Contrast media, COVID-19, medicine.disease, 3. Good health, Coronavirus, 030228 respiratory system, Pharmacogenetics, Original Article, business, Skin tests, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, medicine.drug
Abstract

International audience; Background: The issues and challenges in the diagnosis of drug allergy/hypersensitivity among children and adults in Asia are likely to be different from non-Asian countries.Objective: To study the diagnostic modalities used in the evaluation and management of drug allergy/drug hypersensitivity reactions (DHRs) among member societies of the Asia Pacific Association of Allergy, Asthma and Clinical Immunology (APAAACI).Methods: A questionnaire comprising 41 questions was circulated electronically to member societies and individual members of APAAACI between January 23, 2020 and March 6, 2020.Results: Twenty-six respondents from 15 member societies and 1 individual member responded. European DHR guidelines were most commonly used. Skin prick and intradermal testing was used by 100%, with only 60% having access to commercial penicillin skin test reagents. In vitro-specific IgE tests were used by 75%, and basophil activation test by 56.3% for immediate DHR. Patch tests were used by 75% in contrast to lymphocyte transformation tests by 25% for nonimmediate DHR. Drug provocation tests were used by 68.8%, the most common indication being to exclude hypersensitivity where history/symptoms were not suggestive of drug hypersensitivity/allergy (93.3%). Human leukocyte antigen (HLA) genotype testing was mandatory among 25% respondents before new carbamazepine prescriptions, and 8.3% for allopurinol prescriptions.Conclusions: There was increased use of skin testing for iodinated contrast media hypersensitivity and patch testing for nonimmediate DHR. HLA genotype testing prior to new carbamazepine, allopurinol and abacavir prescriptions remain variable despite strong associations for severe cutaneous adverse reactions with Asian ethnicity. Results of this survey form a useful framework for developing educational and training needs and for improving access to drug allergy diagnostic and treatment modalities across APAAACI member societies.

Published
2020

32. Food allergy logogram to facilitate the diagnosis of food allergy in primary care

Author

Radek Gawlik, Liz Angier, Dermot Ryan, Luciana Kase Tanno, E. Clark, Janwillem W. H. Kocks, Kerstin Romberg, Myriam Mamodaly, Bertine Flokstra de Blok, Tina Van Der Velde, Clara Gaudin, and Pascal Demoly

Subjects
Background information, medicine.medical_specialty, Allergy, business.industry, digestive, oral, and skin physiology, Drug allergy, Primary care, medicine.disease, Integrated care, Key terms, Intolerances, Food allergy, Family medicine, Medicine, business
Abstract

Background: Allergy management in primary care is currently not optimal in most European countries which is attributed to educational gaps as reported by general practitioners (GPs). Aim: The aim of the logograms is to provide clarity and to facilitate the diagnostic process of 5 common allergic problems encountered in primary care (asthma, anaphylaxis, food allergy, drug allergy and urticaria). This abstract focuses on food allergy. Methods: Existing (inter)national guidelines and questionnaires on the diagnosis of food allergy were identified. The resulting food allergy logogram was based on a pragmatic primary care interpretation of existing literature. The food allergy logogram evolved during 5 in-depth interdisciplinary discussions with the international Task Force including GPs, allergy specialists, researchers and clinical fellows. Results: The food allergy logogram consists of 3 schematic flow diagrams: 1)differentiating food allergy from food intolerances, 2)determining the likelihood of food allergy, 3)risk-assessment of food allergy. If desired by the GP, more information behind the food allergy logogram is available in two layers about key terms in the food allergy logogram and background information. Conclusion: Based on existing mainly specialist guidelines, we developed a simple and pragmatic food allergy logogram for primary care in order to support GPs in making a (provisional) allergy diagnosis. Further steps are peer validation and computerization of the logograms. Ultimately, a trial should be undertaken to confirm the utility of the logograms in primary care. This may in future facilitate improved integrated care in allergy and improvement of both patient outcomes and experience of services.

Published
2020

33. BIOLOGICAL TREATMENTS IN ALLERGY: PRESCRIPTION AND MANAGEMENT OF HYPERSENSITIVITY REACTIONS

Author

Luciana Kase Tanno, María José Torres, Mario Sánchez-Borges, S. Lefevre, Cintia Bassani, Yoon-Seok Chang, Bryan Martin, Bernard Yu-Hor Thong, Frédéric de Blay, Leyla Barakat, Maria di Filippo, Alain Didier, Jean-François Fontaine, Motohiro Ebisawa, Marco Caminati, Mário Morais-Almeida, Ignacio J. Ansotegui, Davide Caimmi, Isabelle Bosse, Elizabeth J. Phillips, Pascal Demoly, and Lanny J. Rosenwasser

Subjects
medicine.medical_specialty, Allergy, business.industry, medicine.medical_treatment, Specialty, Pillar, medicine.disease, Clinical Practice, Internal medicine, medicine, Allergists, Medical prescription, business, Anaphylaxis, Desensitization (medicine)
Abstract

Background: Allergy is witnessing major advances, in particular with the advent of biological therapies for treating allergic diseases. Given the novelty of these therapeutics, we aimed to explore by a worldwide survey, the prescription and the management of hypersensitivity reactions (HR) of biological agents (BA) in Allergy. Method: We built up an anonymous online questionnaire, sent out by mail and social media and circulated for 40 days. Results: 348 responses were from 59 countries, with a majority from Europe (62.6%). 97% of responders practiced allergy and 48.5%, exclusively so. Allergy was mentioned as a full specialty in 69.5 % of cases. 71% of responders confirmed the right of prescription of BA for allergists in their country and 78.4 % prescribed BA in their clinical practice. Europe included almost all the allergists who did not have the right of prescribing BA (95.5%), specifically France (91%). The most prescribed BA were Anti IgE (78.1%) and anti IL5 (43.9%). The most declared HR to BA were local reactions (74.1%) followed by anaphylaxis like symptoms (6.8%) and delayed exanthemas (5.1%). Desensitization was considered in 18.9% of cases. These HR were reported in 48.8% of cases. Conclusion: Although BA are now a pillar in the treatment of allergic diseases and allergists are familiar with management of HR associated with BA, their prescription is not authorized for allergists in all countries. BA showed to be generally safe but HR, which may be severe, could occur with a lack of consensus on the management.

Published
2020

34. Drug allergy in primary care: systematic review to support quality of management and optimization of healthcare pathways

Author

Bertine De Flokstra Blok, Luciana Kase Tanno, Radek Gawlik, Elisabeth Angier, Pascal Demoly, Dermot Ryan, Jantina L. van der Velde, Myriam Mamodaly, Clara Gaudin, and Janwillem W. H. Kocks

Subjects
Pulmonary and Respiratory Medicine, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, business.industry, media_common.quotation_subject, Immunology, Drug allergy, Primary care, medicine.disease, Health care, medicine, Immunology and Allergy, Quality (business), Intensive care medicine, business, lcsh:RC581-607, media_common
Published
2020

35. The disease burden in patients with respiratory allergies induced by house dust mites: a year-long observational survey in three European countries

Author

Carmen Vidal, Oliviero Rossi, Andrea Matucci, Pascal Demoly, Service d'allergologie et de pneumologie [Hôpital Arnaud de Villeneuve], Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), and Complejo Hospitalario Universitario de Santiago de Compostela [Saint-Jacques-de-Compostelle, Espagne] (CHUS)

Subjects
Pulmonary and Respiratory Medicine, Allergy, Immunology, Irritability, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, House dust mite, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, medicine, Immunology and Allergy, In patient, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, 10. No inequality, Disease burden, Asthma, biology, business.industry, Research, Burden of disease, Respiratory allergy, RC581-607, medicine.disease, biology.organism_classification, 030228 respiratory system, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Observational study, Immunologic diseases. Allergy, medicine.symptom, business, Long-term observational survey, Demography
Abstract

International audience; Background: House dust mite (HDM) allergens constitute the most frequent cause of persistent allergic rhinitis and asthma. The symptoms vary throughout the year but typically peak in spring, autumn and (to a lesser extent) mid-winter.Methods: We performed a 13-month, observational, multicentre survey of adult patients with a self-reported history of moderate-to-severe, poorly controlled, physician-diagnosed HDM respiratory allergy in three European countries (France, Italy and Spain). After screening and inclusion, 28 detailed, fortnightly telephone interviews were used to gather extensive data on the participants' symptom prevalence and intensity, medical consultations, disease burden and medication use from late May 2012 to early July 2013. This report focuses on the disease burden.Results: Of the 22,995 screened participants, 313 met the inclusion criteria and completed the post-inclusion questionnaire (n = 114 in Italy, 92 in France and 107 in Spain). The median time since the first symptoms of HDM allergy was ≥ 13 years in each country. A relevant minority of the participants suffered from symptoms of HDM allergy every day or almost every day of the year (14% in Italy, 46% in France and 37% in Spain). According to the fortnightly telephone interviews, the most frequently impacted disease burden variables were sleep, daytime tiredness and irritability, with the highest values in spring 2012, autumn 2012 and spring 2013 (mirroring symptom intensities). Professional activities were more affected than social activities. The burden data were heterogeneous: around a quarter of participants were strongly or very strongly affected but most of the remaining participants were only rarely bothered or not bothered.Conclusions: In a 13-month, fortnightly survey of patients in France, Italy and Spain with a self-reported history of moderate-to-severe, poorly controlled, HDM-induced allergic rhinitis and asthma, we found that a relevant minority of participants regularly reported a severe or very severe impact of their allergy on tiredness, sleep and professional activities (including time off work). The disease burden peaked in autumn and late spring.

Published
2020

36. Describing the status of reproductive ageing simply and precisely: A reproductive ageing score based on three questions and validated with hormone levels

Author

Deborah Jarvis, Bryndis Benediktsdottir, Kai Triebner, Nerea Muniozguren Agirre, Joachim Heinrich, Ane Johannessen, Steinar Hustad, Vivi Schlünssen, Francisco Gómez Real, Svein Magne Skulstad, Karl A. Franklin, Mathias Holm, Bénédicte Leynaert, Pascal Demoly, Cecilie Svanes, Francisco Rodríguez, Eva Lindberg, Jesús Martínez-Moratalla Rovira, Shyamali C. Dharmage, José Luis Sánchez-Ramos, Commission of the European Communities, Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, and University of Iceland

Subjects
Gerontology, Oophorectomy, Research Validity, Aging, Epidemiology, Physiology, Tíðahvörf, Biochemistry, Geographical Locations, Cohort Studies, Follicle-stimulating hormone, Endocrinology, Mathematical and Statistical Techniques, 0302 clinical medicine, QUALITY-OF-LIFE, Surveys and Questionnaires, Medicine and Health Sciences, Longitudinal Studies, 030212 general & internal medicine, Reproductive System Procedures, education.field_of_study, 030219 obstetrics & reproductive medicine, Multidisciplinary, Estradiol, Reproduction, Epidemiology of Aging, Research Assessment, Middle Aged, Europe, Multidisciplinary Sciences, Postmenopause, Menopause, Cohort, Medicine, Science & Technology - Other Topics, Female, Hormone levels, Research Article, Cohort study, Adult, medicine.medical_specialty, General Science & Technology, Science, Population, Surgical and Invasive Medical Procedures, Reproduktionsmedicin och gynekologi, Research and Analysis Methods, 03 medical and health sciences, Obstetrics, Gynecology and Reproductive Medicine, Sex Hormones, medicine, Humans, MENOPAUSE TRANSITION, education, Aged, MENSTRUAL CYCLES, Science & Technology, Endocrine Physiology, Surgical Excision, business.industry, Biology and Life Sciences, medicine.disease, Hormones, Confidence interval, Perimenopause, Reproductive ageing, People and Places, Exponential Functions, Follicle Stimulating Hormone, Physiological Processes, UNFINISHED AGENDA, business, Organism Development, Mathematical Functions, Developmental Biology, Blood sampling
Abstract

Publisher's version (útgefin grein), Objective: Most women live to experience menopause and will spend 4–8 years transitioning from fertile age to full menstrual stop. Biologically, reproductive ageing is a continuous process, but by convention, it is defined categorically as pre-, peri- and postmenopause; categories that are sometimes supported by measurements of sex hormones in blood samples. We aimed to develop and validate a new tool, a reproductive ageing score (RAS), that could give a simple and yet precise description of the status of reproductive ageing, without hormone measurements, to be used by health professionals and researchers. Methods: Questionnaire data on age, menstrual regularity and menstrual frequency was provided by the large multicentre population-based RHINE cohort. A continuous reproductive ageing score was developed from these variables, using techniques of fuzzy mathematics, to generate a decimal number ranging from 0.00 (nonmenopausal) to 1.00 (postmenopausal). The RAS was then validated with sex hormone measurements (follicle stimulating hormone and 17β-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC). Results: The RAS, developed from questionnaire data of the RHINE cohort, defined with high precision and accuracy the menopausal status as confirmed by interview and hormone data in the ECRHS cohort. The area under the ROC curve was 0.91 (95% Confidence interval (CI): 0.90–0.93) to distinguish nonmenopausal women from peri- and postmenopausal women, and 0.85 (95% CI: 0.83–0.88) to distinguish postmenopausal women from nonmenopausal and perimenopausal women. Conclusions: The RAS provides a useful and valid tool for describing the status of reproductive ageing accurately, on a continuous scale from 0.00 to 1.00, based on simple questions and without requiring blood sampling. The score allows for a more precise differentiation than the conventional categorisation in pre-, peri- and postmenopause. This is useful for epidemiological research and clinical trials., We thank all participants, field workers and coordinators of the RHINE study and the ECRHS for their efforts as well as Ersilia Bifulco and Sandra Suske from the Core Facility for Metabolomics at the University of Bergen where the hormone measurements were performed. Further we are very grateful for the support of the Department of Applied Mathematics of the University of Málaga (Spain) and we want to thank Elinor Bartle for revising grammar and language.

Published
2020

37. TACKLING ANAPHYLAXIS: A PROPOSAL FROM THE MONTPELLIER WORLD HEALTH ORGANIZATION COLLABORATING CENTRE FOR BETTER MANAGEMENT AND PREVENTION OF ANAPHYLAXIS

Author

Yoon-Seok Chang, Mario Sánchez-Borges, Etienne Beaudouin, Ruby Pawankar, Tood Mahr, Thomas B. Casale, James L. Sublett, Antonella Muraro, Guillaume Pouessel, Pascal Demoly, Nidhal Touati, J.-M. Renaudin, Bryan Martin, Maximiliano Gómez, Patricia Latour, Dermot Ryan, Ignacio J. Ansotegui, Luciana Kase Tanno, Paul A. Greenberger, David M. Lang, Ioana Agache, Francis Thien, Victoria Cardona, M. Ebisawa, Edgardo Jares, and Salome Allichon

Subjects
medicine.medical_specialty, Allergy, business.industry, Best practice, Compromise, media_common.quotation_subject, Public health, medicine.disease, Action (philosophy), Action plan, medicine, Medical emergency, Baseline (configuration management), business, Anaphylaxis, media_common
Abstract

Since the first description of anaphylaxis in 1902, its clinical importance as an emergency condition has been recognized worldwide. Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction characterized by rapid onset and the potential to endanger life through respiratory or circulatory compromise. It is usually, although not always, associated with skin and mucosal changes. Although the academic/scientific communities have advocated to promote greater awareness and protocols for management of anaphylaxis based on best evidence, there are few efforts documenting feedback as to the success of these efforts. In this document, we review the key unmet needs related to the diagnosis and management of anaphylaxis, propose a public health initiative for prevention measures and a timetable action plan which intends to strengthen the collaboration among health professionals and especially primary care physicians dealing with anaphylaxis that can encourage enhanced quality of care of patients with anaphylaxis. More than calling for harmonized action for best management of anaphylaxis to prevent undue morbidity and mortality, the Montpellier World Health Organization Collaborating Centre here proposes an action plan as a baseline for a global initiative against anaphylaxis. We strongly believe these collaborative efforts are a strong public health and societal priority that is consistent with the overarching goals of providing optimal care of allergic patients and best practices of allergology.

Published
2020

38. Genetic variants associated with T cell–mediated cutaneous adverse drug reactions: a PRISMA‐compliant systematic review—An EAACI position paper

Author

M. Gotua, Pascal Demoly, Marina Atanaskovic-Markovic, Knut Brockow, Munir Pirmohamed, Antonino Romano, Josefina Cernadas, Vincent Yip, Cristobalina Mayorga, Andreas J. Bircher, Abderrahim Oussalah, Jean-Christoph Roger J-P Caubet, Ingrid Terreehorst, Annick Barbaud, Jose Julio Laguna, Jean-Louis Guéant, Luciana Kase-Tanno, Miguel Blanca, Alla Nakonechna, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Biochimie – Biologie moléculaire et Nutrition [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), University of Liverpool, Royal Liverpool and Broadgreen University Hospital NHS Trust, Institute of Translational Medicine, University of Liverpool, Instituto de Investigación Biomédica [Malaga, Spain] (IBIMA), Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga [Spain], Service de dermatologie et allergologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hospital de São João [Porto], Hospital Lusíadas Porto, Tbilisi State University, Technische Universität München [München] (TUM), Geneva University Hospitals and Geneva University, University Hospital Basel [Basel], University of Belgrade [Belgrade], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hospital Sírio-Libanês [São Paulo, Brazil], Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Hospital Central de la Cruz Roja San Jose y Santa Adela, Clinica G.B. Morgagni (Fondazione Mediterranea), Ear, Nose and Throat, AII - Inflammatory diseases, Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Salvy-Córdoba, Nathalie, Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Allergy Unit [Cruz Roja-Madrid], Faculté de Médecine [Nancy], Université de Lorraine (UL), Royal Liverpool University Hospital, and University of Liverpool-Royal Liverpool and Broadgreen University Hospital NHS Trust

Subjects
0301 basic medicine, MESH: Carbamazepine, MESH: Drug Hypersensitivity, Genetic variants, T-Lymphocytes, Dapsone, 0302 clinical medicine, systematic review, Abacavir, human leukocyte antigen genes, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, media_common, ddc:618, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, 3. Good health, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Carbamazepine, Pharmaceutical Preparations, Drug Hypersensitivity Syndrome, T cell-mediated drug hypersensitivity reactions, T cell–mediated drug hypersensitivity reactions, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, medicine.drug, Drug, Nevirapine, media_common.quotation_subject, MESH: Pharmaceutical Preparations, Immunology, Human leukocyte antigen, Drug Hypersensitivity, 03 medical and health sciences, MESH: Drug Hypersensitivity Syndrome, medicine, Humans, cutaneous adverse drug reactions, MESH: Humans, business.industry, genetic variants, Cutaneous adverse drug reactions, [SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology, medicine.disease, Toxic epidermal necrolysis, 030104 developmental biology, Human leukocyte antigen genes, MESH: T-Lymphocytes, 030228 respiratory system, HLA-B Antigens, Stevens-Johnson Syndrome, Systematic review, MESH: HLA-B Antigens, MESH: Stevens-Johnson Syndrome, business, Pharmacogenetics, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology
Abstract

International audience; Drug hypersensitivity reactions (DHRs) are associated with high global morbidity and mortality. Cutaneous T cell-mediated reactions classically occur more than 6 hours after drug administration and include life-threatening conditions such as toxic epidermal necrolysis, Stevens-Johnson syndrome, and hypersensitivity syndrome. Over the last 20 years, significant advances have been made in our understanding of the pathogenesis of DHRs with the identification of human leukocyte antigens as predisposing factors. This has led to the development of pharmacogenetic screening tests, such as HLA-B*57:01 in abacavir therapy, which has successfully reduced the incidence of abacavir hypersensitivity reactions. We have completed a PRISMA-compliant systematic review to identify genetic associations that have been reported in DHRs. In total, 105 studies (5554 cases and 123 548 controls) have been included in the review reporting genetic associations with carbamazepine (n = 31), other aromatic antiepileptic drugs (n = 24), abacavir (n = 11), nevirapine (n = 14), trimethoprim-sulfamethoxazole (n = 11), dapsone (n = 4), allopurinol (n = 10), and other drugs (n = 5). The most commonly reported genetic variants associated with DHRs are located in human leukocyte antigen genes and genes involved in drug metabolism pathways. Increasing our understanding of genetic variants that contribute to DHRs will allow us to improve diagnosis, develop new treatments, and predict and prevent DHRs in the future.

Published
2020

39. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper

Author

Tari Haahtela, Sandra Nora González Díaz, Martti Anton Antila, Marek L. Kowalski, Nelson Augusto Rosário Filho, Didier G. Ebo, Lanny J. Rosenwasser, Victoria Cardona, Eleonora Savi, Wen Chin Chiang, Jean Bousquet, Luciana Kase Tanno, Torsten Zuberbier, Roy Gerth van Wijk, Oliver Pfaar, Luis Caraballo, Ignacio J. Ansotegui, Olga Patricia Monge Ortega, Giovanni Melioli, Antonino Romano, Marta Ferrer Puga, Bernard Yu-Hor Thong, Pascal Demoly, Gianenrico Senna, Alexei Gonzalez-Estrada, Erika Jensen-Jarolim, Olga Sánchez, Motohiro Ebisawa, Ruby Pawankar, R. Maximiliano Gómez, Giovanni Passalacqua, Giorgio Walter Canonica, Lawrence M. DuBuske, Mimi L.K. Tang, David A. Fischer, Robert A. Wood, Lars K. Poulsen, Rudolf Valenta, Enrico Scala, Harald Renz, Ayse Fusun Kalpaklioglu, Juan Carlos Sisul, Dennis K. Ledford, Mario Sanchez Borges, Elisa Villa, Edgardo Jares, John Oppenheimer, Mario Morais Almeida, Hospital Quirónsalud Bizkaia [Bilbao], Humanitas University [Milan] (Hunimed), University of Cartagena, Sagamihara National Hospital, University of Genoa (UNIGE), Antwerp University Hospital [Edegem] (UZA), Vall d'Hebron University Hospital [Barcelona], University of Veterinary Medicine [Vienna] (Vetmeduni), University of Helsinki, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut National de la Santé et de la Recherche Médicale (INSERM), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Universitat Autònoma de Barcelona (UAB), Sorbonne Université - UFR Sciences de la vie (UFR 927 ), Sorbonne Université (SU), Universidad Autonoma de Nuevo Leon [Mexique] (UANL), Mayo Clinic [Jacksonville], University of São Paulo (USP), Medical University of Łódź (MUL), University of South Florida [Tampa] (USF), Philipps Universität Marburg, Nippon Medical School [Tokyo, Japon], Medizinische Universität Wien = Medical University of Vienna, Sechenov First Moscow State Medical University, R Valenta has received research grants from Viravaxx, Vienna, Austria, and serves as a consultant for this company., HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, Internal Medicine, KKÜ, and Kırıkkale Üniversitesi

Subjects
Allergy, AAAAI, American Academy of Allergy Asthma and Immunology, LIPID TRANSFER PROTEIN, kUA/L, kilo Units of Allergen/Liter for allergen-specific IgE antibody assays, SKIN-TESTS, IVD, in vitro diagnostic tool, Mab, Monoclonal Antibody, CCD, Cross-reactive Carbohydrate Determinants, ACAAI, American College of Allergy Asthma and Immunology, HYPERSENSITIVITY REACTIONS, Allergic sensitization, 0302 clinical medicine, Allergen, DBPCFC, Double-Blind Placebo-Controlled Food Challenge, W/v, weight /volume, NSAIDs, Non-Steroidal Anti-Inflammatory Drugs, EAACI, European Academy of Allergy and Immunology, 3. Good health, PPT, Prick-Prick Test, RAST, Radio Allergo Sorbent Test, IMMUNOGLOBULIN-E LEVELS, In vitro tests, IgE, Testes Cutâneos, Pulmonary and Respiratory Medicine, Allergen immunotherapy, H2, Histamine 2 receptor, NMBAs, NeuroMuscular Blocking Agents, AU/mL, Allergenic Units milliLiter, FACS, Fluorescence-Activated Cell Sorting, Hypersensitivity/diagnosis, Immunology, CDER, Center for Drug Evaluation and Research (USA), w/v, weight /volume, Article, Diagnostic strategies, 03 medical and health sciences, ENZYME PRODUCING PLANT, Food allergy, IN-VITRO DIAGNOSIS, Serologic Tests, H1, Histamine 1 receptor, ENPP-3, EctoNucleotide Pyrophosphatase/Phosphodiesterase 3, PPA, Positive Percent Agreement, IDT, Intradermal Test, medicine.disease, ISAC, Immuno-Solid phase Allergen Chip, BAU/mL, Biologic Allergenic Units milliLiter, Basophil activation, HPO, Horseradish Peroxidase, 030228 respiratory system, Human medicine, LAMP-3, Lysosomal-Associated Membrane Protein, lcsh:RC581-607, Imunoglobulina E, [SDV]Life Sciences [q-bio], BASOPHIL ACTIVATION TEST, ELISA, Enzyme Linked Immuno Sorbent Analysis, medicine.disease_cause, FOOD ALLERGY, FcεRI, High affinity IgE receptor, CBA, Cytometric Bead Array, EMEA, European MEdicine Agencies, CL, Chemiluminescence, Immunology and Allergy, 030223 otorhinolaryngology, FEIA, Fluorescent Enzyme Immunoassays, Sensitization, IgE, immunoglobulin E, MBAD, Molecule Based Allergy Diagnostics, ABA, Allergen Bead Array, Ku/l, kilo Units of Allergen/Liter for allergen-specific IgE antibody assays, NPA, Negative Percent Agreement, COMPONENT-RESOLVED DIAGNOSIS, CaFE, Calibrated Fluorescence Enhancement, Hipersensibilidade/diagnóstico, medicine.anatomical_structure, BAT, Basophil Activation Test, lcsh:Immunologic diseases. Allergy, pNPP, p-Nitrophenylphosphate, MRGPRX2, Mas-related G protein receptor 2, Skin tests, mAb, Monoclonal Antibody, SCAR, severe cutaneous adverse drug reactions, Testes Sorológicos, NEUROMUSCULAR BLOCKING-AGENTS, IUIS, International Union of Immunological Societies, sIgE, specific IgE, FDA, Food and Drug Administration (U.S. Department of Health and Human Services), medicine, EIA, Enzyme Immune Assay, AEC, Allergen Exposure Chambers, Skin Tests, Anti-IgE, Antibody against IgE, AP, Alkaline Phosphatase, business.industry, Pnpp, p -Nitrophenylphosphate, SPT, Skin prick test, Cross-reactive carbohydrate determinants, Immunoglobulin E, AIT, allergen immunotherapy, Sige, specific IgE, NIH, National Institutes of Health (USA), 3121 General medicine, internal medicine and other clinical medicine, business
Abstract

Tang, Mimi/0000-0002-3839-5293; Romano, Antonino/0000-0001-9742-9898; Zuberbier, Torsten/0000-0002-1466-8875; Thong, Bernard/0000-0002-6338-8482; EBO, Didier/0000-0003-0672-7529; Scala, Enrico/0000-0002-9391-9168; Monge Ortega, Olga Patricia/0000-0002-6195-417X WOS:000523267300003 PubMed: 32128023 Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen. WAO Board of Directors The authors wish to thank the allergy societies from the membership of the World Allergy Organization who provided critical review of the draft and the WAO Board of Directors for supporting this work.

Published
2020

40. Anaphylaxis to Bovine Serum Albumin Tissue Adhesive in a Non–Meat-Allergic Patient

Author

Davide Caimmi, Pascal Demoly, C. Hilger, Anca-Mirela Chiriac, K. Swiontek, Jean-Luc Bourrain, Evangéline Clark, Michel-Avella, Amandine, Luxembourg Institute of Health (LIH), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Montpellier, Université de Montpellier (UM), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), World Health Organisation (WHO), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), and Bourrain, Jean Luc

Subjects
Male, [SDV]Life Sciences [q-bio], Immunology, Pharmacology, BioGlue, Animals, Humans, Immunology and Allergy, Medicine, Bovine serum albumin, Anaphylaxis, ComputingMilieux_MISCELLANEOUS, Aged, Skin Tests, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, business.industry, Serum Albumin, Bovine, Allergens, Immunoglobulin E, medicine.disease, Pork-cat syndrome, [SDV] Life Sciences [q-bio], Perioperative anaphylaxis, biology.protein, Tissue Adhesives, Adhesive, Symptom Assessment, business, Biomarkers, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; No abstract available

Published
2020

41. Multiple Drug Hypersensitivity Syndrome in a Large Database

Author

Shuchen Zhang, Quentin Landry, Laetitia Ferrando, Pascal Demoly, Anca-Mirela Chiriac, Jean-Luc Bourrain, CCSD, Accord Elsevier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Tongji Medical College [HUST], Huazhong University of Science and Technology [Wuhan] (HUST), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)

Subjects
Drug, MESH: Drug Hypersensitivity, Allergy, [SDV.SP.MED] Life Sciences [q-bio]/Pharmaceutical sciences/Medication, media_common.quotation_subject, Provocation test, Drug allergy, Multiple drug hypersensitivity, computer.software_genre, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Allergy Unit, MESH: Drug Hypersensitivity Syndrome, [SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication, Antibiotics, MESH: Skin Tests, Allergy test, medicine, Immunology and Allergy, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, media_common, Drug provocation tests, MESH: Humans, Database, business.industry, MESH: Retrospective Studies, medicine.disease, MESH: Databases, Factual, MESH: Male, 3. Good health, Drug class, 030228 respiratory system, Drug Hypersensitivity Syndrome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Hypersensitivity, Immediate, business, Skin tests, computer, MESH: Female, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Drug hypersensitivity
Abstract

International audience; Multiple drug hypersensitivity syndrome (MDHS) is defined as confirmed drug hypersensitivity (DH) to at least 2 chemically and pharmacologically unrelated drugs. Reports of MDHS are scarce and poorly specified, and studies that diagnose MDHS on the basis of positive allergy test results are lacking.Objective: To evaluate retrospectively the frequency and characteristics of patients with MDHS in a large database.Methods: We included all patients who consulted and were tested in our Allergy Unit between September 1996 and February 2018 for a suspicion of DH. Clinical history and allergy workup results compiled in our Drug Allergy and Hypersensitivity Database were reviewed, and data of patients with a diagnosis of MDHS were retrieved and analyzed.Results: During this period a total of 9250 patients were explored and 1819 tested positive for at least 1 drug. Forty-five cases, 30 female and 15 male patients cumulating 92 DHs, were confirmed as having MDHS. An immunologic mechanism, as demonstrated by positive skin testing, accounted for 59 DHs. Drug provocation tests were performed to confirm the diagnosis for the remaining 33 DHs. Of the 92 DHs in this series, 38 were classified as type IV and 21 as type I allergies; 33 remained of undetermined mechanism. Drug class occurrences seem to differ from those in monoallergic patients.Conclusions: Our data support the concept of MDHS as a distinct and rare subgroup of DH. The prevalence in our database was 2.5% in the total DH alleged patient population and 0.5% of the demonstrated DHs. Skin testing and drug provocation tests are mandatory for confirming the diagnosis.

Published
2020

42. In-vivo diagnostic test allergens in Europe: A call to action and proposal for recovery plan--An EAACI position paper

Author

Hans Jürgen Hoffmann, Matteo Bonini, Victoria Cardona, Markus Ollert, Oliver Pfaar, Pascal Demoly, Peter Schmid-Grendelmeier, Mohamed H. Shamji, Vera Mahler, Helen A. Brough, Peter Hellings, Torsten Zuberbier, Karin Hoffmann-Sommergruber, Sten Dreborg, Carsten B. Schmidt-Weber, Marek Jutel, Stefan Vieths, Oscar Palomares, Ludger Klimek, Ayse Fusun Kalpaklioglu, Sergio Bonini, Andreas Bonertz, Antonella Muraro, Jean Bousquet, Ioana Agache, Todor A. Popov, Ear, Nose and Throat, KKÜ, University of Zurich, and Klimek, Ludger

Subjects
0301 basic medicine, Allergy, IMPACT, CHILDREN, allergen provocation test, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, GUIDELINES, 0302 clinical medicine, immune system diseases, European Pharmacopoeia, Immunology and Allergy, Reimbursement, 10177 Dermatology Clinic, Diagnostic test, respiratory system, marketing authorization, regulatory framework, skin prick test, skin test allergens, Call to action, Europe, DISEASES, Action plan, 2723 Immunology and Allergy, Skin prick test, Skin test allergens, allergen challenge test, reimbursement, Medical emergency, Life Sciences & Biomedicine, Immunology, Allergen Provocation Test, Marketing Authorization, Regulatory Framework, Skin Prick Test, Skin Test Allergens, 610 Medicine & health, Marketing authorization, LEGISLATION, 03 medical and health sciences, Pharmacovigilance, Hypersensitivity, medicine, Humans, IMMUNOTHERAPY, PROVOCATION, Skin Tests, 2403 Immunology, Science & Technology, Diagnostic Tests, Routine, AVAILABILITY, Allergens, medicine.disease, respiratory tract diseases, 030104 developmental biology, 030228 respiratory system, Position paper, Allergists, Business
Abstract

Bonertz, Andreas/0000-0002-6846-9265; Brough, Helen/0000-0001-7203-0813; Hoffmann, Hans Jurgen/0000-0002-6743-7931; Hoffmann-Sommergruber, Karin/0000-0002-8830-058X; Schmid-Grendelmeier, Peter/0000-0003-3215-3370 WOS:000569864500002 PubMed: 32306414 Diagnostic allergens are defined as medicinal products in the EU. Marketing authorization by national authorities is necessary; however, diagnostic allergens are not homogeneously regulated in different EU member states. Allergen manufacturers argue with increasing costs forcing them to continuously reduce the diagnostic allergen portfolios offered to allergists. In contrast, EAACI and national European Allergy Societies see the need for the availability of a wide range of high-quality diagnostic allergens for in vivo diagnosis of IgE-mediated allergies not only covering predominant but also less frequent allergen sources. In a recent EAACI task force survey, the current practice of allergy diagnosis was shown to rely on skin tests as first option in almost 2/3 of all types of allergic diseases and in 90% regarding respiratory allergies. With the need to ensure the availability of high-quality diagnostic allergens in the EU, an action plan has been set up by EAACI to analyse the current regulatory demands in EU member states and to define possible solutions stated in this document: (a) simplification of authorization for diagnostic allergens; (b) specific regulation of special types of diagnostic allergens; (c) new models beyond the current model of homologous groups; (d) simplification of pharmacovigilance reporting; (e) reduction of regulation fees for diagnostic allergens; (f) reimbursement for diagnostic allergens. Joining forces of allergists, manufacturers and authorities are of high importance to ensure remaining relevant allergens in the EU markets to facilitate a sustainable and comprehensive service for the diagnosis and treatment of allergic diseases.

Published
2020

43. Revisiting Late-Onset Asthma: Clinical Characteristics and Association with Allergy

Author

Pascal Demoly, Santiago Quirce, Enrico Heffler, Ana Moreira-Jorge, Nicola A. Hanania, N. Nenasheva, Francis Nissen, Andrew Menzies-Gow, Hospital Universitario La Paz, Universidad Autonoma de Madrid (UAM), Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione 'Istituto Neurologico Nazionale C. Mondino', Russian Medical Academy for Continuous Medical Education [Moscow], Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Université de Montpellier (UM), Royal Brompton Hospital, Novartis Farmacéutica SA, London School of Hygiene and Tropical Medicine (LSHTM), Baylor College of Medicine (BCM), and Baylor University

Subjects
Pulmonary and Respiratory Medicine, Allergy, Pediatrics, medicine.medical_specialty, diagnosis, Corticosteroid treatment, asthma phenotypes, Inhaled corticosteroids, Review, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, age of onset, parasitic diseases, Immunology and Allergy, Medicine, 0601 history and archaeology, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Association (psychology), Late-onset asthma, Asthma, 060102 archaeology, business.industry, 06 humanities and the arts, asthma, medicine.disease, allergy, 3. Good health, Adult life, 030228 respiratory system, Age of onset, business, allergic asthma
Abstract

International audience; The Global Initiative for Asthma (GINA) 2020 defines late-onset asthma (LOA) as one of the clinical phenotypes of asthma wherein patients, particularly women, present with asthma for the first time in adult life, tend to be non-allergic and often require higher doses of inhaled corticosteroids (ICS) or are relatively refractory to corticosteroid treatment. In this review, we examine the published literature improve the understanding of the following aspects of LOA: 1) the age cut-off for its diagnosis; 2) its distinct clinical phenotypes, characteristics and risk factors; and 3) its association with allergic comorbidities and conditions. Overall, our review reveals that clinicians and researchers have used multiple age cut-offs to define LOA, with cut-off ages ranging from >12 years to ≥65 years. LOA has also been classified into several distinct phenotypes, some of which drastically differ in their clinical characteristics, course and prognosis. Although LOA has traditionally been considered non-allergic in nature, our review indicates that it is commonly associated with allergic features and comorbidities. Our findings suggest that there is an urgent need for the development of more clear clinical practice guidelines that can provide more clarity on the definition and other aspects of LOA. In addition, the association of LOA and allergy needs to be re-examined to frame a more optimal treatment strategy for patients with LOA.

Published
2020

44. BIOLOGICAL TREATMENTS IN ALLERGY: PRESCRIBING PATTERNS AND MANAGEMENT OF HYPERSENSITIVITY REACTIONS

Author

Maria De Filippo, Jean-François Fontaine, María José Torres, Cintia Bassani, Pascal Demoly, Lanny J. Rosenwasser, Elizabeth J. Phillips, Mario Sánchez-Borges, Luciana Kase Tanno, S. Lefevre, Yoon-Seok Chang, Igancio Asontegui, Bryan Martin, Motohiro Ebisawa, Alain Didier, Leyla Barakat, Davide Caimmi, Frédéric de Blay, Isabelle Bosse, Bernard Yu-Hor Thong, Mário Morais-Almeida, Marco Caminati, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Hospital Regional Universitario de Málaga [Spain], Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Vanderbilt University School of Medicine [Nashville], Murdoch University, University of Verona (UNIVR), Seoul National University Bundang Hospital (SNUBH), Seoul National University College of Medicine, Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centro Medico-Docente La Trinidad, Children's Mercy Hospitals and Clinics, CHU Toulouse [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Strasbourg, Service de pneumologie, allergologie, mucoviscidose pédiatrique [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Syndicate of French Allergists [La Rochelle], Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), IMED School of Medicine [Passo Fundo], Fondazione IRCCS Policlinico San Matteo [Pavia], Università di Pavia, Hospital Quiròn Bizkaia Erandio, CUF-Descobertas Hospital, Sagamihara National Hospital, Ohio State University [Columbus] (OSU), Tan Tock Seng Hospital [Singapore, Singapore], and Université de Montpellier (UM)

Subjects
Drug-Related side effects and adverse reactions, Allergy, medicine.medical_specialty, Allergic reaction, atopic eczema, MEDLINE, allergic reaction, Drug Hypersensitivity, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, ComputingMilieux_MISCELLANEOUS, Skin Tests, 030304 developmental biology, Asthma, Drug-Related side effects and adverse reactions, biological therapy, hypersensitivity, allergic reaction, asthma, atopic eczema, 0303 health sciences, business.industry, asthma, medicine.disease, Dermatology, 3. Good health, 030228 respiratory system, biological therapy, Allergists, hypersensitivity, business
Abstract

International audience

Published
2020

45. Allergen immunotherapy: what is the added value of real-world evidence from retrospective claims database studies?

Author

Mathieu Molimard, Pascal Demoly, Philippe Devillier, Hôpital Foch [Suresnes], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris-Saclay, Hôpital Arnaud de Villeneuve, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Arnaud de Villeneuve [CHRU Montpellier], and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Pulmonary and Respiratory Medicine, Allergen immunotherapy, medicine.medical_specialty, Databases, Factual, Real world evidence, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Added value, Immunology and Allergy, Medicine, Humans, Generalizability theory, In patient, Claims database, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Intensive care medicine, 030304 developmental biology, Asthma, PharmacoEpi-Drugs, 0303 health sciences, allergic rhinitis, business.industry, Public Health, Environmental and Occupational Health, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, asthma, medicine.disease, Rhinitis, Allergic, 3. Good health, Treatment Outcome, 030228 respiratory system, Desensitization, Immunologic, Disease Progression, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Introduction: Randomized controlled trials (RCTs) show that allergen immunotherapy (AIT) has proven long-term efficacy in patients with allergic rhinitis (AR). However, RCTs have limited generalizability and there is growing recognition that real-world evidence (RWE) is necessary to provide complementary data to those of RCTs, and corroborate their findings. Until recently, data from the real-world setting investigating the benefits of AIT for the treatment of patients with grass and birch pollen-associated AR were sparse, but new retrospective claims database studies from France and Germany have confirmed the sustained benefits of grass and birch pollen AIT in terms of significantly reduced progression of AR and asthma, and a significantly decreased risk of new-onset asthma.Areas covered: Here, we review the value of RWE used alongside data from traditional RCTs, and its potential strengths and limitations, and summarize the findings of the recent RWE studies investigating the benefits of AIT for the management of patients with grass and birch pollen-associated AR.Expert opinion: There is growing recognition of the necessity and value of RWE as a complement to data acquired in RCTs, to better understand the effects of AIT treatments in a broader, more representative patient population, and to help guide clinical decision-making.

Published
2020

46. Definition von Pollenexpositionszeiten für klinische Studien zur Allergen-Immuntherapie bei polleninduzierter Rhinokonjunktivitis – ein EAACI-Positionspapier

Author

Oliver Pfaar, Lars Jacobsen, Ulf Darsow, Carmen Galán, Stephen R. Durham, Moises A. Calderon, K. C. Bergmann, Uwe Berger, Bernard Clot, Pascal Demoly, Mikhail Sofiev, Ludger Klimek, Michel Thibaudon, Regula Gehrig, Katharina Bastl, Jeroen Buters, and R. Gerth van Wijk

Subjects
medicine.medical_specialty, Allergen immunotherapy, Allergy, Pollen allergen, 010504 meteorology & atmospheric sciences, Context (language use), medicine.disease_cause, 01 natural sciences, Aerobiology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Pollen, otorhinolaryngologic diseases, medicine, Clinical endpoint, Immunology and Allergy, Intensive care medicine, 0105 earth and related environmental sciences, 030203 arthritis & rheumatology, business.industry, food and beverages, medicine.disease, business
Abstract

Background: Clinical efficacy of pollen allergen immunotherapy (AIT) has been broadly documented in randomized controlled trials. The underlying clinical endpoints are analysed in seasonal time periods predefined based on the background pollen concentration. However, any validated or generally accepted definition from academia or regulatory authorities for this relevant pollen exposure intensity or period of time (season) is currently not available. Therefore, this Task Force initiative of the European Academy of Allergy and Clinical Immunology (EAACI) aimed to propose definitions based on expert consensus. Methods: A Task Force of the Immunotherapy and Aerobiology and Pollution Interest Groups of the EAACI reviewed the literature on pollen exposure in the context of defining relevant time intervals for evaluation of efficacy in AIT trials. Underlying principles in measuring pollen exposure and associated methodological problems and limitations were considered to achieve a consensus. Results: The Task Force achieved a comprehensive position in defining pollen exposure times for different pollen types. Definitions are presented for “pollen season”, “high pollen season” (or “peak pollen period”) and “high pollen days”. Conclusion: This EAACI position paper provides definitions of pollen exposures for different pollen types for use in AIT trials. Their validity as standards remains to be tested in future studies.

Published
2018

47. A 300 IR sublingual tablet is an effective, safe treatment for house dust mite-induced allergic rhinitis: An international, double-blind, placebo-controlled, randomized phase III clinical trial

Author

Krzysztof Kowal, Peter S. Creticos, Margitta Worm, Philippe Gevaert, Pascal Demoly, Frédéric de Blay, N. Nenasheva, Oliver Pfaar, Miguel Tortajada-Girbés, Carmen Vidal, Jonathan Corren, Thomas B. Casale, Giovanni Passalacqua, Peter Hellings, Martine Le Gall, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Université de Montpellier (UM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), David Geffen School of Medicine [Los Angeles], University of California [Los Angeles] (UCLA), University of California-University of California, Johns Hopkins University School of Medicine [Baltimore], CHU Strasbourg, Universiteit Gent = Ghent University [Belgium] (UGENT), University Hospitals Leuven [Leuven], Medical University of Bialystok [Bialystok, Pologne], Stallergenes SA (Stallergenes), Stallergenes, Ospedale Policlinico San Martino [Genoa], University of Genoa (UNIGE), Philipps Universität Marburg, Dr Peset University Hospital, Universitat de València (UV), Complejo Hospitalario Universitario de Santiago de Compostela [Saint-Jacques-de-Compostelle, Espagne] (CHUS), Universidade de Santiago de Compostela [Spain] (USC ), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of South Florida [Tampa] (USF), Ear, Nose and Throat, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of California (UC), Universiteit Gent = Ghent University (UGENT), Medical University of Białystok (MUB), Ministry of Health of the Russian Federation (MHRF), Università degli studi di Genova = University of Genoa (UniGe), Philipps Universität Marburg = Philipps University of Marburg, and CERRAMON, Laura

Subjects
0301 basic medicine, Allergen immunotherapy, allergic rhinitis, allergy, house-dust mite, medication score, sublingual immunotherapy, symptom score, tablet, total combined score, Male, Allergy, International Cooperation, Severity of Illness Index, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, house dust mite, biology, Pyroglyphidae, 3. Good health, Female, [SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Adult, medicine.medical_specialty, Adolescent, Drug-Related Side Effects and Adverse Reactions, Immunology, Placebo, 03 medical and health sciences, Young Adult, Double-Blind Method, Internal medicine, medicine, Animals, Humans, Antigens, Dermatophagoides, Asthma, House dust mite, Sublingual Immunotherapy, business.industry, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, medicine.disease, biology.organism_classification, Placebo Effect, Rhinitis, Allergic, Clinical trial, 030104 developmental biology, 030228 respiratory system, Quality of Life, business
Abstract

Background: Allergic rhinitis induced by house dust mites (HDMs) is a highly prevalent but often underdiagnosed and undertreated/untreated chronic disease. It often has a negative impact on sleep, work, leisure activities, and health-related quality of life. Allergen immunotherapy is a proven, safe treatment for respiratory allergies. Objective: We sought to assess the efficacy and safety of a 300 index of reactivity (IR) sublingual tablet formulation of Dermatophagoides pteronyssinus:Dermatophagoides farinae 1:1 extract in adolescents (aged >_12) and adults with moderate to severe HDM-induced allergic rhinitis. Methods: In a phase III, international, double-blind, placebo controlled, randomized clinical trial, participants received approximately 12 months of treatment with placebo or the 300 IR tablet. The primary end point was the average total combined score during 4 weeks at the end of the treatment period. Results: A total of 1607 participants were randomized, and 1476 (including 555 [37.6%] with concomitant mild controlled asthma at inclusion) comprised the full analysis set. Over the primary evaluation period, the least squares mean average total combined score in the 300 IR group (3.62) was significantly lower (P Superscript/Subscript Available

Published
2019

48. Clinical Practice of Allergen Immunotherapy for Allergic Rhinoconjunctivitis and Asthma: An Expert Panel Report

Author

Hendrik Nolte, Constance H. Katelaris, Thomas B. Casale, Remi Gagnon, Jo A Douglass, Harold S. Nelson, Susan Waserman, David I. Bernstein, G. Walter Canonica, Lawrence M. DuBuske, Moises A. Calderon, Yoshitaka Okamoto, Pascal Demoly, Kimihiro Okubo, J. Christian Virchow, and Harold Kim

Subjects
Allergen immunotherapy, medicine.medical_specialty, Allergy, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Immunology and Allergy, Humans, 030212 general & internal medicine, Eosinophilic esophagitis, Intensive care medicine, Asthma, House dust mite, biology, business.industry, Evidence-based medicine, Allergens, medicine.disease, biology.organism_classification, Rhinitis, Allergic, Clinical trial, 030228 respiratory system, Desensitization, Immunologic, business
Abstract

Allergen immunotherapy (AIT) reduces symptoms and medication use associated with allergic rhinitis with or without conjunctivitis and allergic asthma. Although several AIT guidelines exist, there remain unanswered questions about AIT that are relevant to everyday practice. Our objective was to prepare an evidence-based overview addressing the practical aspects of AIT in clinical practice based on published evidence and the experience of international experts in the field. Topics covered include interpretation and translation of clinical trial data into everyday clinical practice (eg, allergen doses and treatment duration), assessment of risk and treatment of local and systemic allergic reactions, recommendations for improvement of AIT guidelines, and identification of appropriate data for seeking regulatory approval, to name a few. Many informational gaps in AIT practice need further evaluation as products and practices evolve.

Published
2019

49. Towards a more precise diagnosis of hypersensitivity to beta‐lactams – an EAACI position paper

Author

Jean-Christoph Roger J-P Caubet, Anca-Mirela Chiriac, Paul Whitaker, Lene H. Garvey, Annick Barbaud, Alla Nakonechna, Andreas J. Bircher, Gülfem Çelik, María José Torres, Antonino Romano, Cristobalina Mayorga, Josefina Cernadas, Pascal Demoly, Knut Brockow, Marina Atanaskovic-Markovic, University of Catania [Italy], School of Medecine [Belgrade], University of Belgrade [Belgrade], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University Hospital Basel [Basel], Department of Dermatology and Allergy Biederstein, Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Geneva University Hospital (HUG), Ankara University School of Medicine [Turkey], Immunoallergy Department [Porto], Centro Hospitalar São João EPE, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Department of Clinical Medicine [Copenhagen], Bispebjerg Hospital-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), Biomedical Research Institute of Málaga (IBIMA), Universidad de Málaga [Málaga] = University of Málaga [Málaga], Allergy and Immunology Clinic [Royal Liverpool and Broadgreen University Hospital], Royal Liverpool and Broadgreen University Hospital NHS Trust, University of Liverpool, Salvy-Córdoba, Nathalie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Universidade do Porto = University of Porto, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)

Subjects
Hypersensitivity, Immediate, medicine.medical_specialty, Allergy, [SDV.IMM] Life Sciences [q-bio]/Immunology, Referral, cross-reactivity, diagnosis, Immunology, Provocation test, Drug allergy, risk stratification, Drug Hypersensitivity, Beta-lactam, 03 medical and health sciences, chemistry.chemical_compound, Allergists, 0302 clinical medicine, medicine, Humans, Immunology and Allergy, guidelines, Child, Intensive care medicine, Skin Tests, 030304 developmental biology, 0303 health sciences, ddc:618, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, beta-lactams, Novelty, allergy, medicine.disease, Anti-Bacterial Agents, 3. Good health, 030228 respiratory system, chemistry, Risk stratification, Position paper, [SDV.IMM]Life Sciences [q-bio]/Immunology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; A recent survey of the European Academy of Allergy and Clinical Immunology (EAACI) Drug Allergy Interest Group (DAIG) on how European allergy specialists deal with beta-lactam (BL) hypersensitivity demonstrated a significant heterogeneity in current practice, suggesting the need to review and update existing EAACI guidelines in order to make the diagnostic procedures as safe and accurate, but also as cost-effective, as possible. For this purpose, a bibliographic search on large studies regarding BL hypersensitivity diagnosis was performed by an EAACI task force, which reviewed and evaluated the literature data using the GRADE system for quality of evidence and strength of recommendation. The updated guidelines provide a risk stratification in BL hypersensitivity according to index reaction(s), as well as an algorithmic approach, based on cross-reactivity studies, in patients with a suspicion of BL hypersensitivity and an immediate need for antibiotic therapy, when referral to an allergist is not feasible. Furthermore, the update addresses availability and concentrations of skin test (ST) reagents, ST and drug provocation test (DPT) protocols, as well as diagnostic algorithms and administration of alternative BL in allergic subjects. Specifically, distinct diagnostic algorithms are suggested depending on risk stratification of the patient into high and low risk based on the morphology and chronology of the reaction, immediate (i.e., occurring within 1 to 6 hours after the last administered dose) or nonimmediate (i.e., occurring more than 1 hour after the initial drug administration), and the reaction severity. Regarding the allergy workup, the main novelty of this document is the fact that in some low-risk nonimmediate reactions ST are not mandatory, especially in children. For DPT, further studies are necessary to provide data supporting the standardization of protocols, especially of those regarding nonimmediate reactions, for which there is currently no consensus.

Published
2019

50. Skin Testing for Suspected Iodinated Contrast Media Hypersensitivity

Author

Yazid Ahmedali, Pascal Demoly, Anca Mirela Chiriac, Christine Breynaert, Jean-Luc Bourrain, Rik Schrijvers, Laboratory of clinical immunology, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d'allergologie et de pneumologie [Hôpital Arnaud de Villeneuve], Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Sorbonne Université (SU)

Subjects
Adult, Male, medicine.medical_specialty, Allergy, Adolescent, [SDV]Life Sciences [q-bio], Provocation test, Drug allergy, Iodine Compounds, Contrast Media, Negative predictive value, Drug Hypersensitivity, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Iodinated contrast, Predictive Value of Tests, Interquartile range, 80 and over, Hypersensitivity, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, Anaphylaxis, Aged, Skin Tests, Aged, 80 and over, business.industry, Radiocontrast, Middle Aged, medicine.disease, Dermatology, 3. Good health, Hypersensitivity reaction, 030228 respiratory system, embryonic structures, Iodinated contrast media, Female, Premedication, business
Abstract

International audience; BACKGROUND: The management of iodinated contrast medium (ICM) hypersensitivity has been a matter of debate. Skin testing to identify a subgroup of ICM allergic patients has been proposed, in addition to complete avoidance, provocation testing, or premedication. OBJECTIVE: The objective of this study was to assess the negative predictive value (NPV) of skin testing for ICM. METHODS: Patients with a hypersensitivity reaction to ICM who underwent skin testing during a 13.5-year period at a single center were evaluated for re-exposure to a negatively skin-tested ICM. Premedication, consisting of second-generation H1-antihistamines twice a day 48 hours before the examination, was advised only for patients with mast cell disorder or chronic urticaria who had negative skin tests. RESULTS: A total of 597 patients tested for 423 (70.9%) immediate, 118 (19.7%) nonimmediate, and 56 (9.4%) hypersensitivity reactions with undetermined chronology were included. Eighty (13.4%) patients were skin test positive. Re-exposure to ICM occurred in 233 (39.0%) patients and was tolerated in 16 of 17 (94.1%) with at least 1 positive skin test and 201 of 216 (93.1%) with all negative skin tests. Reaction intensity was similar in 4, milder in 10, unknown in 1, and worse in 1 patient although this reaction was deemed to be nonallergic in hindsight. Premedication was administered in 20.7% of patients and associated with more reactions (19.4% vs 5.7%, P~= .01). The overall NPV of skin testing for ICM was 93.1% (95% confidence interval [CI] 89.1% to 96.0%), and for immediate and nonimmediate hypersensitivity reactions 94.2% (95% CI 89.6% to 97.2%) and 86.1% (95% CI 72.1% to 94.7%), respectively. We cannot exclude some challenges occurred with a different than the initial culprit ICM, possibly overestimating the NPV. CONCLUSIONS: Skin testing for potential ICM hypersensitivity can identify safe alternative(s) for ICM re-exposure especially in patients with an immediate hypersensitivity reaction and/or skin test-proven ICM drug allergy. Reactions on re-exposure were infrequent, mostly milder, and occurred in some patients despite premedication.

Published
2018

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