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Kulthanan K, Tuchinda P, Eimpunth S, Chuthapisith S, Rushatamukayanunt P, Limphoka P, Panjapakkul W, Pochanapan O, Maurer M. Blue Wheals and Blue Angioedema Induced by Blue Dyes: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3223-3234.e7. [PMID: 37451616 DOI: 10.1016/j.jaip.2023.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/29/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Blue wheals and blue angioedema, the adverse reactions to blue dye injections with or without anaphylaxis, are poorly defined. OBJECTIVE The objective is to review the characteristics (ie, sex and age at onset, interval between blue dye injection and symptom onset, clinical manifestations, duration of blue wheals or angioedema), natural courses, and treatments of blue dye adverse reactions. METHODS A review of the articles published through July 2021 was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. RESULTS Across 523 patients (175 studies) with any adverse reactions to blue dye injections, wheals, angioedema, or both occurred in 193 patients (36.9%). Of these 193 patients, 68 patients (35.2%) developed blue wheals or angioedema, 118 (61.1%) had ordinary wheals or angioedema (nonbluish), and 7 had both (3.6%). We reviewed 169 patients with available data (99 with ordinary lesions and 70 with blue lesions). Patent blue violet had the highest rate of inducing blue wheals or angioedema (odds ratio 4.9). Almost half of the patients with blue wheals or angioedema developed systemic symptoms; and of those with systemic symptoms, all except 1 progressed to anaphylaxis. On-demand treatments with antihistamines, corticosteroids, and epinephrine were commonly used and effective. CONCLUSIONS Using blue dyes can lead to blue wheals or angioedema and systemic reactions. In patients with a history of a severe allergic reaction to a blue dye, repeat administration of a blue dye should be used only after carefully weighing all the risks and benefits.
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Affiliation(s)
- Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Papapit Tuchinda
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sasima Eimpunth
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suebwong Chuthapisith
- Division of Head-Neck and Breast Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pranee Rushatamukayanunt
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pichaya Limphoka
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Waratchaya Panjapakkul
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Oraya Pochanapan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology (ITMP), Allergology and Immunology, Berlin, Germany.
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2
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Baldo BA. Allergic and other adverse reactions to drugs used in anesthesia and surgery. ANESTHESIOLOGY AND PERIOPERATIVE SCIENCE 2023; 1:16. [PMCID: PMC10264870 DOI: 10.1007/s44254-023-00018-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/02/2023] [Accepted: 04/11/2023] [Indexed: 11/13/2023]
Abstract
The list of drugs patients may be exposed to during the perioperative and postoperative periods is potentially extensive. It includes induction agents, neuromuscular blocking drugs (NMBDs), opioids, antibiotics, sugammadex, colloids, local anesthetics, polypeptides, antifibrinolytic agents, heparin and related anticoagulants, blue dyes, chlorhexidine, and a range of other agents depending on several factors related to individual patients’ clinical condition and progress in the postoperative recovery period. To avoid poor or ultrarapid metabolizers to a particular drug (for example tramadol and codeine) or possible adverse drug reactions (ADRs), some drugs may need to be avoided during or after surgery. This will be the case for patients with a history of anaphylaxis or other adverse events/intolerances to a known drug. Other drugs may be ceased for a period before surgery, e.g., anticoagulants that increase the chance of bleeding; diuretics for patients with acute renal failure; antihypertensives relative to kidney injury after major vascular surgery; and serotonergic drugs that together with some opioids may rarely induce serotonin toxicity. Studies of germline variations shown by genotyping and phenotyping to identify a predisposition of genetic factors to ADRs offer an increasingly important approach to individualize drug therapy. Studies of associations of human leukocyte antigen (HLA) genes with some serious delayed immune-mediated reactions are ongoing and variations of drug-metabolizing cytochrome CYP450 enzymes, P-glycoprotein, and catechol-O -methyltransferase show promise for the assessment of ADRs and non-responses to drugs, particularly opioids and other analgesics. Surveys of ADRs from an increasing number of institutions often cover small numbers of patients, are retrospective in nature, fail to clearly identify culprit drugs, and do not adequately distinguish immune-mediated from non-immune-mediated anaphylactoid reactions. From the many surveys undertaken, the large list of agents identified during and after anesthesia and surgery are examined for their ADR involvement. Drugs are classified into those most often involved, (NMBD and antibiotics); drugs that are becoming more frequently implicated, namely antibiotics (particularly teicoplanin), and blue dyes; those becoming less frequently involved; and drugs more rarely involved in perioperative, and postoperative adverse reactions but still important and necessary to keep in mind for the occasional potential sensitive patient. Clinicians should be aware of the similarities between drug-induced true allergic type I IgE/FcεRI- and pseudoallergic MRGPRX2-mediated ADRs, the clinical features of each, and their distinguishing characteristics. Procedures for identifying MRGPRX2 agonists and diagnosing and distinguishing pseudoallergic from allergic reaction mechanisms are discussed.
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Affiliation(s)
- Brian A. Baldo
- Molecular Immunology Unit, Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney, St Leonards, Australia
- Department of Medicine, University of Sydney, Sydney, NSW Australia
- Lindfield, Australia
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3
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Stewart CF, Tomb RM, Ralston HJ, Armstrong J, Anderson JG, MacGregor SJ, Atreya CD, Maclean M. Violet-blue 405-nm Light-based Photoinactivation for Pathogen Reduction of Human Plasma Provides Broad Antibacterial Efficacy Without Visible Degradation of Plasma Proteins. Photochem Photobiol 2021; 98:504-512. [PMID: 34935147 DOI: 10.1111/php.13584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/15/2021] [Indexed: 11/28/2022]
Abstract
In transfusion medicine, bacterial contamination can occur in ex vivo stored blood plasma, and there are continued efforts to improve blood safety and reduce the risk of transfusion-transmitted infections. Visible 405-nm violet-blue light has demonstrated potential for in situ pathogen reduction in ex vivo stored plasma and platelet concentrates. This study investigates the broad-spectrum antibacterial efficacy and compatibility potential of 405-nm light for treatment of blood plasma. Human plasma seeded with bacteria at a range of densities (101 -103 , 104 -106 , 107 -108 CFU mL-1 ) was exposed to 360 J cm-2 405-nm light (1 h at 0.1 W cm-2 ), with this fixed dose selected based on the initial analysis of inactivation kinetics. One-dimensional protein mobility analysis and measurement of advanced oxidation protein products (AOPP) was conducted to evaluate compatibility of the antimicrobial dose with plasma proteins and, identify upper levels at which protein degradation can be detected. Broad-spectrum antibacterial efficacy was observed with a fixed treatment of 360 J cm-2 , with 98.9-100% inactivation achieved across all seeding densities for all organisms, except E. coli, which achieved 95.1-100% inactivation. At this dose (360 J cm-2 ), no signs of protein degradation occurred. Overall, 405-nm light shows promise for broad-spectrum bacterial inactivation in blood plasma, while preserving plasma protein integrity.
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Affiliation(s)
- Caitlin F Stewart
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Rachael M Tomb
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Heather J Ralston
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Jack Armstrong
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - John G Anderson
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Scott J MacGregor
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK
| | - Chintamani D Atreya
- Office of Blood Research and Review, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration, Silver Spring, MD
| | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST), Department of Electronic & Electrical Engineering, University of Strathclyde, Glasgow, UK.,Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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4
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Wiehe A, O'Brien JM, Senge MO. Trends and targets in antiviral phototherapy. Photochem Photobiol Sci 2019; 18:2565-2612. [PMID: 31397467 DOI: 10.1039/c9pp00211a] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Photodynamic therapy (PDT) is a well-established treatment option in the treatment of certain cancerous and pre-cancerous lesions. Though best-known for its application in tumor therapy, historically the photodynamic effect was first demonstrated against bacteria at the beginning of the 20th century. Today, in light of spreading antibiotic resistance and the rise of new infections, this photodynamic inactivation (PDI) of microbes, such as bacteria, fungi, and viruses, is gaining considerable attention. This review focuses on the PDI of viruses as an alternative treatment in antiviral therapy, but also as a means of viral decontamination, covering mainly the literature of the last decade. The PDI of viruses shares the general action mechanism of photodynamic applications: the irradiation of a dye with light and the subsequent generation of reactive oxygen species (ROS) which are the effective phototoxic agents damaging virus targets by reacting with viral nucleic acids, lipids and proteins. Interestingly, a light-independent antiviral activity has also been found for some of these dyes. This review covers the compound classes employed in the PDI of viruses and their various areas of use. In the medical area, currently two fields stand out in which the PDI of viruses has found broader application: the purification of blood products and the treatment of human papilloma virus manifestations. However, the PDI of viruses has also found interest in such diverse areas as water and surface decontamination, and biosafety.
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Affiliation(s)
- Arno Wiehe
- biolitec research GmbH, Otto-Schott-Str. 15, 07745 Jena, Germany. and Institut für Chemie und Biochemie, Freie Universität Berlin, Takustr. 3, 14195 Berlin, Germany
| | - Jessica M O'Brien
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
| | - Mathias O Senge
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
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5
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Abstract
Contrary to economically comparable countries, France has had a versatile policy to process and manufacture therapeutic plasma, and to apply safety measures. This has principally affected the origin of plasma (whole blood supernatant versus apheresis), and the application or not of a chemical process. At the time being, the civilian and Army Forces blood establishments produce more than 99% of the plasma issued for patients in need; safety means consist in a large part of quarantine and, to a lesser extent, to a pathogen reduction technology process (Amotosalen-HCl-UVA). The blood establishments ship plasma to the national manufacturer of blood derivatives. Plasma in France is strictly within the Voluntary Non-Remunerated pathway with no breach to this principle to be expected for both labile components and source plasma. The constant hemovigilance allows reflection to make policies evolving, with respect to safety measures particularly to reduce cases of allergy.
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Affiliation(s)
- O Garraud
- EA3064, faculty of medicine of Saint-Etienne, University of Lyon, 42023, Saint-Etienne, France; Palliative Care, the Ruffec Hospital, 16700, Ruffec, France; The National Institute for Blood Transfusion INTS, 75015, Paris, France.
| | - C Martinaud
- CTSA, département des activités cliniques, 92140, Clamart, France; INSERM UMRS-MD 1197, CTSA, 92140, Clamart, France
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6
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Comparative epidemiology of suspected perioperative hypersensitivity reactions. Br J Anaesth 2019; 123:e16-e28. [PMID: 30916015 DOI: 10.1016/j.bja.2019.01.027] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/24/2018] [Accepted: 01/15/2019] [Indexed: 12/31/2022] Open
Abstract
Suspected perioperative hypersensitivity reactions are rare but contribute significantly to the morbidity and mortality of surgical procedures. Recent publications have highlighted the differences between countries concerning the respective risk of different drugs, and changes in patterns of causal agents and the emergence of new allergens. This review summarises recent information on the epidemiology of perioperative hypersensitivity reactions, with specific consideration of differences between geographic areas for the most frequently involved offending agents.
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Li PH, Wagner A, York M, Rutkowski R, Haque R, Rutkowski K. Blue dye allergy: Pitfalls in diagnosis and how to avoid them. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 6:272-273. [PMID: 28803181 DOI: 10.1016/j.jaip.2017.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 06/07/2017] [Accepted: 06/16/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Philip H Li
- Department of Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam, Hong Kong
| | - Annette Wagner
- Department of Allergy, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Melanie York
- Clinical Immunology & Allergy Unit, Northern General Hospital, Sheffield, United Kingdom
| | - Ryszard Rutkowski
- Department of Respiratory Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Rubaiyat Haque
- Department of Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Krzysztof Rutkowski
- Department of Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
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8
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Montañez MI, Mayorga C, Bogas G, Barrionuevo E, Fernandez-Santamaria R, Martin-Serrano A, Laguna JJ, Torres MJ, Fernandez TD, Doña I. Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis. Front Immunol 2017; 8:614. [PMID: 28611774 PMCID: PMC5446992 DOI: 10.3389/fimmu.2017.00614] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/09/2017] [Indexed: 12/14/2022] Open
Abstract
Anaphylaxis is an acute, life-threatening, multisystem syndrome resulting from the sudden release of mediators by mast cells and basophils. Although anaphylaxis is often under-communicated and thus underestimated, its incidence appears to have risen over recent decades. Drugs are among the most common triggers in adults, being analgesics and antibiotics the most common causal agents. Anaphylaxis can be caused by immunologic or non-immunologic mechanisms. Immunologic anaphylaxis can be mediated by IgE-dependent or -independent pathways. The former involves activation of Th2 cells and the cross-linking of two or more specific IgE (sIgE) antibodies on the surface of mast cells or basophils. The IgE-independent mechanism can be mediated by IgG, involving the release of platelet-activating factor, and/or complement activation. Non-immunological anaphylaxis can occur through the direct stimulation of mast cell degranulation by some drugs, inducing histamine release and leading to anaphylactic symptoms. Work-up of a suspected drug-induced anaphylaxis should include clinical history; however, this can be unreliable, and skin tests should also be used if available and validated. Drug provocation testing is not recommended due to the risk of inducing a harmful reaction. In vitro testing can help to confirm anaphylaxis by analyzing the release of mediators such as tryptase or histamine by mast cells. When immunologic mechanisms are suspected, serum-sIgE quantification or the use of the basophil activation test can help confirm the culprit drug. In this review, we will discuss multiple aspects of drug-induced anaphylaxis, including epidemiology, mechanisms, and diagnosis.
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Affiliation(s)
- Maria Isabel Montañez
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.,Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain
| | - Cristobalina Mayorga
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.,Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Gador Bogas
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Esther Barrionuevo
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | | | - Angela Martin-Serrano
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.,Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain
| | | | - Maria José Torres
- Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain.,Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Tahia Diana Fernandez
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Inmaculada Doña
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
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9
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Mertes PM, Florvaag E. Anaphylaxis in the operating theatre. Presse Med 2017; 45:750-2. [PMID: 27666588 DOI: 10.1016/j.lpm.2016.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Paul-Michel Mertes
- Hôpitaux universitaires de Strasbourg, Nouvel hôpital civil, service d'anesthésie-réanimation chirurgicale, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
| | - Erik Florvaag
- Haukeland university hospital, regional centre for asthma, allergy and hypersensitivity, department of occupational medicine, 5021 Bergen, Norway.
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10
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Figueiredo S, Benhamou D. Use of fresh frozen plasma: from the 2012 French guidelines to recent advances. Transfus Apher Sci 2017; 56:20-25. [DOI: 10.1016/j.transci.2016.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Garraud O. La délivrance des plasmas. Les plasmas d’aujourd’hui et de demain. Transfus Clin Biol 2016; 23:240-244. [DOI: 10.1016/j.tracli.2016.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
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13
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Fryk JJ, Marks DC, Hobson-Peters J, Prow NA, Watterson D, Hall RA, Young PR, Reichenberg S, Sumian C, Faddy HM. Dengue and chikungunya viruses in plasma are effectively inactivated after treatment with methylene blue and visible light. Transfusion 2016; 56:2278-85. [PMID: 27456861 DOI: 10.1111/trf.13729] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/12/2016] [Accepted: 05/20/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Arboviruses, such as dengue viruses (DENV) and chikungunya virus (CHIKV), pose a risk to the safe transfusion of blood components, including plasma. Pathogen inactivation is an approach to manage this transfusion transmission risk, with a number of techniques being used worldwide for the treatment of plasma. In this study, the efficacy of the THERAFLEX MB-Plasma system to inactivate all DENV serotypes (DENV-1, DENV-2, DENV-3, DENV-4) or CHIKV in plasma, using methylene blue and light illumination at 630 nm, was investigated. STUDY DESIGN AND METHODS Pooled plasma units were spiked with DENV-1, DENV-2, DENV-3 DENV-4, or CHIKV and treated with the THERAFLEX MB-Plasma system at four light illumination doses: 20, 40, 60, and 120 (standard dose) J/cm(2) . Pre- and posttreatment samples were collected and viral infectivity was determined. The reduction in viral infectivity was calculated for each dose. RESULTS Treatment of plasma with the THERAFLEX MB-Plasma system resulted in at least a 4.46-log reduction in all DENV serotypes and CHIKV infectious virus. The residual infectivity for each was at the detection limit of the assay used at 60 J/cm(2) , with dose dependency also observed. CONCLUSIONS Our study demonstrated the THERAFLEX MB-Plasma system can reduce the infectivity of all DENV serotypes and CHIKV spiked into plasma to the detection limit of the assay used at half of the standard illumination dose. This suggests this system has the capacity to be an effective option for managing the risk of DENV or CHIKV transfusion transmission in plasma.
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Affiliation(s)
- Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Australia
| | - Jody Hobson-Peters
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Daniel Watterson
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | - Paul R Young
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | | | | | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Australia. .,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
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Cicchetti A, Berrino A, Casini M, Codella P, Facco G, Fiore A, Marano G, Marchetti M, Midolo E, Minacori R, Refolo P, Romano F, Ruggeri M, Sacchini D, Spagnolo AG, Urbina I, Vaglio S, Grazzini G, Liumbruno GM. Health Technology Assessment of pathogen reduction technologies applied to plasma for clinical use. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 14:287-386. [PMID: 27403740 PMCID: PMC4942318 DOI: 10.2450/2016.0065-16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although existing clinical evidence shows that the transfusion of blood components is becoming increasingly safe, the risk of transmission of known and unknown pathogens, new pathogens or re-emerging pathogens still persists. Pathogen reduction technologies may offer a new approach to increase blood safety. The study is the output of collaboration between the Italian National Blood Centre and the Post-Graduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. A large, multidisciplinary team was created and divided into six groups, each of which addressed one or more HTA domains.Plasma treated with amotosalen + UV light, riboflavin + UV light, methylene blue or a solvent/detergent process was compared to fresh-frozen plasma with regards to current use, technical features, effectiveness, safety, economic and organisational impact, and ethical, social and legal implications. The available evidence is not sufficient to state which of the techniques compared is superior in terms of efficacy, safety and cost-effectiveness. Evidence on efficacy is only available for the solvent/detergent method, which proved to be non-inferior to untreated fresh-frozen plasma in the treatment of a wide range of congenital and acquired bleeding disorders. With regards to safety, the solvent/detergent technique apparently has the most favourable risk-benefit profile. Further research is needed to provide a comprehensive overview of the cost-effectiveness profile of the different pathogen-reduction techniques. The wide heterogeneity of results and the lack of comparative evidence are reasons why more comparative studies need to be performed.
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Affiliation(s)
- Americo Cicchetti
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Alexandra Berrino
- Health Technology Assessment Unit of “Gemelli” Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Marina Casini
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Paola Codella
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppina Facco
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Alessandra Fiore
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppe Marano
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Marco Marchetti
- Health Technology Assessment Unit of “Gemelli” Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuela Midolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberta Minacori
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Pietro Refolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Federica Romano
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Matteo Ruggeri
- Postgraduate School of Health Economics and Management (Altems), Catholic University of the Sacred Heart, Rome, Italy
| | - Dario Sacchini
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio G. Spagnolo
- Institute of Bioethics, Catholic University of the Sacred Heart, Rome, Italy
| | - Irene Urbina
- Health Technology Assessment Unit of “Gemelli” Teaching Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefania Vaglio
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Giuliano Grazzini
- Italian National Blood Centre, National Institute of Health, Rome, Italy
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15
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Garraud O, Hamzeh-Cognasse H, Laradi S, Pozzetto B, Cognasse F. Transfusion et inflammation : hier – aujourd’hui – demain. Transfus Clin Biol 2015; 22:168-77. [DOI: 10.1016/j.tracli.2015.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Indexed: 12/11/2022]
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16
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Brockow K, Sánchez-Borges M. Hypersensitivity to contrast media and dyes. Immunol Allergy Clin North Am 2015; 34:547-64, viii. [PMID: 25017677 DOI: 10.1016/j.iac.2014.04.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This article updates current knowledge on hypersensitivity reactions to diagnostic contrast media and dyes. After application of a single iodinated radiocontrast medium (RCM), gadolinium-based contrast medium, fluorescein, or a blue dye, a hypersensitivity reaction is not a common finding; however, because of the high and still increasing frequency of those procedures, patients who have experienced severe reactions are nevertheless frequently encountered in allergy departments. Evidence on allergologic testing and management is best for iodinated RCM, limited for blue dyes, and insufficient for fluorescein. Skin tests can be helpful in the diagnosis of patients with hypersensitivity reactions to these compounds.
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Affiliation(s)
- Knut Brockow
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Biedersteiner Strasse 29, Munich 80802, Germany.
| | - Mario Sánchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Clínica El Avila, 6a transversal de Altamira, piso 8, consultorio 803, Caracas 1060, Venezuela
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Politis C, Kavallierou L, Hantziara S, Parara M, Zervou E, Katsarou O, Hatzitaki M, Fountouli P, Gioka A, Tzioura K, Koumarianos S, Asariotou M, Richardson C. Haemovigilance data on the use of methylene blue virally inactivated fresh frozen plasma with the Theraflex MB-Plasma System in comparison to quarantine plasma: 11 years' experience. Transfus Med 2014; 24:316-20. [PMID: 25262924 DOI: 10.1111/tme.12144] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES/BACKGROUND Haemovigilance is an effective tool for identifying adverse effects of blood components. We analyse cumulative haemovigilance data in order to compare the two secured therapeutic plasmas that have been in use for more than 11 years in Greece - methylene blue-treated fresh frozen plasma (MB-FFP) and quarantine fresh frozen plasma (Q-FFP) - regarding safety and adverse events. METHODS/MATERIALS Data from the centralised active haemovigilance system of Greece for the period 2001-2011 were used to examine the association between FFP types and adverse events. Post-transfusion information on infectious and non-infectious adverse events was analysed. Events were examined by reaction type, severity and imputability to transfusion. RESULTS The incidence of adverse events was higher with Q-FFP (1:3620) than MB-FFP (1 : 24 593) by a factor of 6·79 [95% confidence interval (CI) 2·52-27·8]. Allergic adverse events were also commoner with Q-FFP (1 : 7489) than with MB-FFP (1:24 593), by a factor of 3·28 (95% CI 1·17-13·7). All adverse reactions experienced by the MB plasma recipients were considered to be mild. CONCLUSION Haemovigilance over 11 years has demonstrated the long-term safety of MB-FFP in comparison to untreated quarantine FFP. In addition to lowering the adverse event rate, implementing the system on a national scale in at-risk countries would presumably reduce the transmission of severe viral infections including emerging infectious diseases by transfusion.
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Affiliation(s)
- C Politis
- Coordinating Haemovigilance Centre, Athens, Greece
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Lozano M, Cid J, Müller TH. Plasma Treated with Methylene Blue and Light: Clinical Efficacy and Safety Profile. Transfus Med Rev 2013; 27:235-40. [DOI: 10.1016/j.tmrv.2013.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 12/29/2022]
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Affiliation(s)
- B. Custer
- Blood Systems Research Institute; Masonic Ave; San Francisco; CA; USA
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21
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Seltsam A, Müller TH. Update on the use of pathogen-reduced human plasma and platelet concentrates. Br J Haematol 2013; 162:442-54. [PMID: 23710899 DOI: 10.1111/bjh.12403] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The use of pathogen reduction technologies (PRTs) for labile blood components is slowly but steadily increasing. While pathogen-reduced plasma is already used routinely, efficacy and safety concerns impede the widespread use of pathogen-reduced platelets. The supportive and often prophylactic nature of blood component therapy in a variety of clinical situations complicates the clinical evaluation of these novel blood products. However, an increasing body of evidence on the clinical efficacy, safety, cost-benefit ratio and development of novel technologies suggests that pathogen reduction has entered a stage of maturity that could further increase the safety margin in haemotherapy. This review summarizes the clinical evidence on PRTs for plasma and platelet products that are currently licensed or under development.
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Affiliation(s)
- Axel Seltsam
- Institute Springe, German Red Cross Blood Service NSTOB, Springe, Germany.
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Seltsam A, Mueller TH. Updated hemovigilance data do not show an increased risk of allergic reactions to methylene blue–treated plasma. J Allergy Clin Immunol 2013; 131:1253-4. [DOI: 10.1016/j.jaci.2012.11.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 11/08/2012] [Indexed: 11/25/2022]
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Mertes PM, Demoly P, Alperovitch A, Bazin A, Bienvenu J, Caldani C, Lamy B, Laroche D, Leconte des Floris MF, Py JY, Drouet C, Carlier M, Lienhart A. Reply. J Allergy Clin Immunol 2013; 131:1254-5. [DOI: 10.1016/j.jaci.2012.11.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 11/08/2012] [Indexed: 11/16/2022]
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Peden DB, Bush RK. Advances in environmental and occupational disorders in 2012. J Allergy Clin Immunol 2013; 131:668-74. [PMID: 23384680 DOI: 10.1016/j.jaci.2012.12.1572] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
Abstract
The year 2012 produced a number of advances in our understanding of the effect of environmental factors on allergic diseases, identification of new allergens, immune mechanisms in host defense, factors involved in asthma severity, and therapeutic approaches. This review focuses on the articles published in the Journal in 2012 that enhance our knowledge base of environmental and occupational disorders. Identification of novel allergens can improve diagnostics, risk factor analysis can aid preventative approaches, and studies of genetic-environmental interactions and immune mechanisms will lead to better therapeutics.
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Affiliation(s)
- David B Peden
- Department of Pediatrics, Division of Allergy, Immunology, Rheumatology, and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC 27599-7310, USA.
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Mariotte D, Bazin A, Da Silva Costa-Aze V, Pottier V, Samba D, Vergnaud MC, Comby E, Le Mauff B, Laroche D. Immediate hypersensitivity to platelet concentrate: allergic or not? Transfus Med 2013; 23:136-7. [PMID: 23356776 DOI: 10.1111/tme.12007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 11/19/2012] [Accepted: 12/20/2012] [Indexed: 12/01/2022]
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