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Ollé L, García-García L, Ruano M, Bartra J, González-Navarro EA, Pérez M, Roca-Ferrer J, Pasca MI, Martín M, Muñoz-Cano R. Mast Cell Activation Profile and TFH13 Detection Discriminate Food Anaphylaxis Versus Sensitization. J Investig Allergol Clin Immunol 2024; 35:0. [PMID: 38381397 DOI: 10.18176/jiaci.0995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The prevalence of food allergy (FA) has increased significantly, and the risk of developing anaphylaxis is unpredictable. Thus, discriminating between sensitized patients and those at risk of having a severe reaction is of utmost interest. To explore mast cell activation pattern and T follicular helper (TFH) 13 presence in sensitized and food anaphylaxis patients. METHODS Patients sensitized to Lipid transfer protein (LTP) were classified as anaphylaxis or sensitized depending on the symptoms elicited by LTP-containing food. CD34+-derived MCs from patients and controls were obtained, sensitized with pooled sera, and challenged with Pru p 3 (peach LTP). Degranulation, PGD2, and cytokine/chemokine release were measured. The TFH13 population was examined by flow cytometry in the peripheral blood of all groups. In parallel, LAD2 cells were activated similarly to patients' MCs. RESULTS A distinguishable pattern of mast cell activation was found in anaphylaxis compared to sensitized patients. Robust degranulation, PGD2, and IL-8 and GM-CSF secretion were higher in anaphylaxis, whereas TFG- and CCL2 secretion increased in sensitized patients. Concomitantly, anaphylaxis patients had a larger TFH13 population. MC activation profile was dependent on the sera rather than the MC source. In agreement with that, LAD2 cells reproduce the same pattern as MCs from anaphylactic and sensitized patients. CONCLUSION The distinct profile of mast cell activation allows to discriminate between anaphylaxis and sensitized patients. Pooled sera may determine mast cell activation independently of mast cell origin. Besides, the presence of TFH13 cells in anaphylaxis patients points to an essential role of IgE affinity.
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Affiliation(s)
- L Ollé
- Biochemistry and Molecular Biology Unit, Biomedicine Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - L García-García
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Ruano
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
- ARADyAL, REI - RICOR, Instituto de Salud Carlos III, Madrid, Spain
| | - J Bartra
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
- ARADyAL, REI - RICOR, Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - E A González-Navarro
- Immunology Department, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic, Barcelona, Spain
| | - M Pérez
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J Roca-Ferrer
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M I Pasca
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- ARADyAL, REI - RICOR, Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Immunology Department, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic, Barcelona, Spain
| | - M Martín
- Biochemistry and Molecular Biology Unit, Biomedicine Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- ARADyAL, REI - RICOR, Instituto de Salud Carlos III, Madrid, Spain
| | - R Muñoz-Cano
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
- ARADyAL, REI - RICOR, Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain
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Tubita V, Fuentes M, Callejas B, Bantulà M, Marin C, Alobid I, Bartra J, Valero A, Roca-Ferrer J, Mullol J. Low levels of miR-143-3p are associated with severe chronic rhinosinusitis with nasal polyps. Rhinology 2024; 0:3157. [PMID: 38299637 DOI: 10.4193/rhin23.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
microRNAs (miRNAs) are small, single-stranded, non-coding RNA molecules that regulate post-transcriptional gene expression. Accumulating evidence suggests their involvement in regulating various biological and pathological processes, including inflammation. Studies have revealed distinct expression patterns of miRNAs in Chronic Rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps (1). Specifically, miR-155 and miR-21 have been observed to be upregulated in CRSwNP, increasing and attenuating the expression of pro-inflammatory cytokines, respectively (2,3). Conversely, the downregulation of miR-34, miR-449, and members of the miR-200 family has been associated with impaired ciliogenesis and the regulation of epithelial-mesenchymal transition, respectively (4,5). Nonetheless, the direct role of miRNAs in CRSwNP is still being investigated.
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Affiliation(s)
- V Tubita
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Universitat de Barcelona. Barcelona, Catalonia, Spain
| | - M Fuentes
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - B Callejas
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
| | - M Bantulà
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - C Marin
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
| | - I Alobid
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
- Universitat de Barcelona. Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelo
| | - J Bartra
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Universitat de Barcelona. Barcelona, Catalonia, Spain
- Allergy Department, Hospital Clinic Barcelona, Barcelona, Catalonia, Spain
| | - A Valero
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
- Allergy Department, Hospital Clinic Barcelona, Barcelona, Catalonia, Spain
| | - J Roca-Ferrer
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
| | - J Mullol
- INGENIO, Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut d\'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
- Universitat de Barcelona. Barcelona, Catalonia, Spain
- CIBER of Respiratory Diseases (CIBERES), Carlos III Health Institute, Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic Barcelona, Universitat de Barcelona, Barcel
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Calzada D, Bartra J, Serrano CD, Riggioni S, Moran E, Maselli JP, Silva DL, Ramirez LF, Pascal M, Carnés J, Valero A. Differences in molecular sensitization profiles between a Spanish and Latin American mite allergic patients. J Investig Allergol Clin Immunol 2024; 35:0. [PMID: 38174976 DOI: 10.18176/jiaci.0968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE To analyze the sensitization pattern to Dermatophagoides pteronyssinus and to associate the diagnostic findings and clinical severity in 218 allergic patients from two different continents. METHODS Mite allergic patients were recruited by the Allergology departments from Latin America (n=88: Colombia, Costa Rica and Guatemala) and Spain (N=130). All patients had allergic rhinitis with or without asthma and positive skin prick test results to D. pteronyssinus. Specific IgE levels to D. pteronyssinus, D. farinae, Der p 1, Der p 2, and Der p 23 were quantified by ImmunoCAP system (ThermoFisher Scientific). Allergenic profile was also determined by western blot. Comparative Statistical analysis was performed by GraphPad software. RESULTS Patients recognized most frequently Der p 2 (79%) followed by Der p 1 (73%), and Der p 23 (69%) allergens. The percentage of asthmatic patients increases with the number of sensitizations however none statistically significant differences were found. Interestingly, asthmatic patients presented the highest median levels of total IgE and specific IgE levels of D. pteronyssinus and molecular allergens, mainly Der p 2. Analysing the two different populations, Spanish patients were predominantly sensitized to Der p 2 (88.46%) and Der p 1 (83.84%), whereas Latin American population were more sensitized to Der p 23. CONCLUSION Our data support the relevance of Der p 2 in mite allergy as the major allergen, with the high number of patients sensitized to it and its importance in the development of asthma. Sensitization to Der p 23 was more important in Latin America.
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Affiliation(s)
- D Calzada
- Unidad I+D. LETI Pharma. S.L.u. Madrid, España
| | - J Bartra
- Servicio de Alergología, Hospital Clínic, IDIBAPS Barcelona, RICORS, España
| | - C D Serrano
- Unidad de Alergia, Fundación Valle del Lili. Cali, Colombia
| | - S Riggioni
- Centro Diagnóstico y Tratamiento de Alergia. San José, Costa Rica
| | - E Moran
- Universidad Rafael Landivar, Facultad de Medicina, Catedra de Inmunología, Guatemala City, Guatemala
| | - J P Maselli
- Universidad Rafael Landivar, Facultad de Medicina, Catedra de Inmunología, Guatemala City, Guatemala
| | - D L Silva
- Unidad de Alergia, Fundación Valle del Lili. Cali, Colombia
| | - L F Ramirez
- Unidad de Alergia, Fundación Valle del Lili. Cali, Colombia
| | - M Pascal
- Servicio de Inmunología, CDB, Hospital Clínic, IDIBAPS Barcelona, RICORS, España
| | - J Carnés
- Unidad I+D. LETI Pharma. S.L.u. Madrid, España
| | - A Valero
- Servicio de Alergología, Hospital Clínic, IDIBAPS Barcelona, CIBERES, España
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Ruano-Zaragoza M, Torrent-Rodríguez A, Araujo-Sanchez G, Ribó P, Loli-Ausejo D, Solis K, Sánchez-Fernández MC, Bolaños J, Bolós U, López C, Ruiz S, Pascal M, Bartra J, Muñoz-Cano R. Successful Oral Dasatinib Desensitization in Immediate Hypersensitivity. J Investig Allergol Clin Immunol 2023; 34:0. [PMID: 38131221 DOI: 10.18176/jiaci.0985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- M Ruano-Zaragoza
- Allergy Department, Hospital Clinic, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- RETIC Asma, Reacciones Adversas y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Madrid, Spain
| | | | - G Araujo-Sanchez
- Allergy Department, Hospital Clinic, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- RETIC Asma, Reacciones Adversas y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Madrid, Spain
| | - P Ribó
- Allergy Department, Hospital Clinic, Barcelona, Spain
| | - D Loli-Ausejo
- Allergy Department, Hospital Clinic, Barcelona, Spain
| | - K Solis
- Allergy Department, Hospital Clinic, Barcelona, Spain
| | | | - J Bolaños
- Immunology Department, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - U Bolós
- Immunology Department, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | - M Pascal
- RETIC Asma, Reacciones Adversas y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Madrid, Spain
- Immunology Department, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J Bartra
- Allergy Department, Hospital Clinic, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- RETIC Asma, Reacciones Adversas y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Madrid, Spain
| | - R Muñoz-Cano
- Allergy Department, Hospital Clinic, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- RETIC Asma, Reacciones Adversas y Alergia (ARADyAL) and RICORS Red de Enfermedades Inflamatorias (REI), Madrid, Spain
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Salas-Casinello M, Sáenz-de Santa María R, López-Sánchez JD, Cornejo-Garcia JA, Pérez-Sánchez N, Casas R, Bartra J, Laguna JJ, Cortés-Collado JJ, Doña I, Torres MJ. Different Patterns of Response in Hypersensitivity Reactions to Arylpropionic Acid Derivatives. J Allergy Clin Immunol Pract 2023; 11:3715-3723. [PMID: 37586474 DOI: 10.1016/j.jaip.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Ibuprofen and other arylpropionic acid derivatives (APs) are among the most consumed nonsteroidal anti-inflammatory drugs worldwide at all age ranges; however, little is known about drug hypersensitivity reactions (DHRs) they induce. OBJECTIVE To characterize in detail patients reporting DHRs to APs. METHODS We prospectively evaluated patients with symptoms suggestive of AP-DHRs and analyzed their clinical characteristics, reported reactions, and diagnostic approaches. RESULTS Six hundred sixty-two patients confirmed as hypersensitive to APs were included: 489 with cross-reactive reactions (CRs) (73.86%) and 173 with selective reactions (SRs) (26.13%). The percentage of subjects reporting reactions to ibuprofen and dexketoprofen was higher in CRs (P = .005 and P = .01, respectively), whereas naproxen and ketoprofen were more frequently involved in SRs (P = .0002 and P = .00001, respectively). The most frequent symptoms induced by ibuprofen, dexketoprofen, and naproxen were isolated angioedema and urticaria, combined or not with angioedema in both CRs and SRs. The result of nasal provocation test with lysine acetylsalicylate was positive in 156 cases (77.14% in patients showing exclusively respiratory symptoms, and in 68.18% of those with both cutaneous and respiratory involvement). To confirm diagnosis, drug provocation test with acetylsalicylic acid was required in 246 CR patients (50.3%), whereas in 28 SR patients (16.18%) drug provocation test with the culprit AP was required. CONCLUSIONS Skin is the organ most commonly involved in AP-DHRs, with ibuprofen and dexketoprofen inducing most frequently CRs, and naproxen and ketoprofen SRs. More studies are necessary to clarify the underlying mechanism in DHRs induced by APs.
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Affiliation(s)
- María Salas-Casinello
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain; Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Malaga, Spain
| | - Rocío Sáenz-de Santa María
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain; Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Malaga, Spain
| | | | - José Antonio Cornejo-Garcia
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain; Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Malaga, Spain; Spanish Network for Allergy-RETICS de Asma, Reacciones adversas y Alérgicas, (ARADyAL), Madrid, Spain
| | - Natalia Pérez-Sánchez
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain; Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Malaga, Spain
| | - Rocío Casas
- Spanish Network for Allergy-RETICS de Asma, Reacciones adversas y Alérgicas, (ARADyAL), Madrid, Spain; Allergy Section, Pneumology Department, IDIBAPS, Universitat de Barcelona, Hospital Clinic, Barcelona, Spain
| | - Joan Bartra
- Spanish Network for Allergy-RETICS de Asma, Reacciones adversas y Alérgicas, (ARADyAL), Madrid, Spain; Allergy Section, Pneumology Department, IDIBAPS, Universitat de Barcelona, Hospital Clinic, Barcelona, Spain
| | - José Julio Laguna
- Spanish Network for Allergy-RETICS de Asma, Reacciones adversas y Alérgicas, (ARADyAL), Madrid, Spain; Allergy Unit, Hospital Central de la Cruz Roja, Madrid, Spain
| | | | - Inmaculada Doña
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain; Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Malaga, Spain; Spanish Network for Allergy-RETICS de Asma, Reacciones adversas y Alérgicas, (ARADyAL), Madrid, Spain.
| | - María José Torres
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain; Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Malaga, Spain; Spanish Network for Allergy-RETICS de Asma, Reacciones adversas y Alérgicas, (ARADyAL), Madrid, Spain; Medicine Department, Universidad de Málaga, Malaga, Spain
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González-de Paz L, Valdesoiro-Navarrete L, Roma J, Blat-Guimerà E, Benavent-Areu J, Bartra J, Sisó-Almirall A. Prevalence and Impact of Asthma and Allergy on Daily Life, Health Outcomes and Use of Healthcare Services in Children: A Population-Based Study. Arch Bronconeumol 2023:S0300-2896(23)00163-1. [PMID: 37277255 DOI: 10.1016/j.arbres.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Studies on the prevalence of asthma and allergies often lack representation of the pediatric population, and their impact has not been examined using children without these diseases as a reference group. This study aimed to determine the prevalence of asthma and allergies in children under 14 years old in Spain and their impact on health-related quality of life, activities, healthcare utilization, and environmental and household exposure risk factors. METHODS Data came from a Spanish population-based representative survey of children aged <14 years (N=6297). A sample of controls (1:4) from the same survey was matched using propensity score matching. Logistic regression models and population-attributable fractions were calculated to determine the impact of asthma and allergy. RESULTS The population prevalence of asthma was 5.7% (95% CI: 5.0%, 6.4%), and of allergy was 11.4% (95% CI: 10.5%, 12.4. In children with lower percentiles of health-related quality of life (≤20th), 32.3% (95% CI, 13.6%, 47.0%) was attributed to asthma and 27.7% (95% CI: 13.0%, 40.0%) to allergy. Forty-four percent of restrictions in usual activity were attributed to asthma (OR: 2.0, p-value: <0.001), and 47.9% to allergy (OR: 2.1, p-value: <0.001). 62.3% of all hospital admissions were attributed to asthma (OR: 2.8, p-value: <0.001), and 36.8% (OR: 2.5, p-value: <0.001) of all specialist consults to allergy. CONCLUSIONS The high prevalence of atopic disease and its impact on daily life and healthcare utilization call for an integrated healthcare system focused on children and caregivers' needs with continuity of care across education and healthcare settings.
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Affiliation(s)
- Luis González-de Paz
- Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain; Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Valdesoiro-Navarrete
- Department of Pediatric Allergy, Parc Taulí University Hospital, Sabadell, Spain; Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell Spain.
| | - Josep Roma
- Department of Medicine, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain; Barcelona School of Management, Pompeu Fabra University, Barcelona Spain
| | - Esther Blat-Guimerà
- Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Jaume Benavent-Areu
- Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Joan Bartra
- Department of Allergy, Hospital Clinic, Barcelona, Spain; Clinical and Experimental Respiratory Immunoallergy Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Antoni Sisó-Almirall
- Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain; Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
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7
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Bartra J, Turner PJ, Muñoz-Cano RM. Cofactors in Food Anaphylaxis in Adults. Ann Allergy Asthma Immunol 2023:S1081-1206(23)00183-7. [PMID: 36958469 DOI: 10.1016/j.anai.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/25/2023]
Abstract
Around 25%-50% of food-induced allergic reactions in adults causes anaphylaxis, and epidemiological evidence suggests that food is the most common cause of anaphylaxis. Reaction severity is unpredictable, and patients will often experience reactions of variable severity, even to an identical exposure (both dose and allergen). A common explanation for this phenomenon has been the impact of "cofactors" - factors which might contribute to reaction severity independent of the allergen exposure. Cofactors can influence reaction severity in two ways: either by reducing the reaction threshold (i.e. the dose needed to trigger any symptoms) so that patients have no symptoms in the absence of the cofactor and only react with the cofactor present, or by increasing reaction severity - such that individuals have only mild symptoms in the absence of the cofactor, but a more severe reaction when the cofactor is present. Indeed, the same patient may have reactions with different cofactors or even need more than one cofactor to develop a severe reaction. Cofactors reportedly play a role in approximately 30% of anaphylaxis reactions in adults. Exercise, NSAIDs, alcohol and sleep deprivation are the most frequent cofactors reported. Routine evaluation of the possible involvement of cofactors is essential in managing patients with food anaphylaxis: in patients with a suggestive history but a negative oral food challenge, cofactors should be taken into account in order to provide appropriate advice to reduce risk of future anaphylaxis. Key Messages.
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Affiliation(s)
- Joan Bartra
- Department of Allergy, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), RETIC ARADyAL, RICORs REI, Barcelona, Spain
| | - Paul J Turner
- National Heart & Lung Institute, Imperial College London, London, UK.
| | - Rosa M Muñoz-Cano
- Department of Allergy, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), RETIC ARADyAL, RICORs REI, Barcelona, Spain
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8
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Giménez-Arnau AM, Jáuregui I, Silvestre-Salvador JF, Valero A, Ferrer M, Sastre J, Ortiz de Frutos FJ, Labrador-Horrillo M, Bartra J, Miquel Miquel J. Consensus on the Definition of Control and Remission in Chronic Urticaria. J Investig Allergol Clin Immunol 2022; 32:261-269. [PMID: 35503509 DOI: 10.18176/jiaci.0820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
The terms control and remission and other key terms used in chronic urticaria (CU) such as flare-up, relapse, exacerbation, and recurrence have not been fully defined in the literature. Disease monitoring and treatment goals in clinical practice are not well established. After a qualitative appraisal of available evidence, we aimed to find a consensus definition of control and remission, clarify key terminology, provide guidance on how to monitor the disease, and establish treatment goals in clinical practice. A modified Delphi consensus approach was used. Based on a literature review, a scientific committee provided 137 statements addressing controversial definitions and terms, available patient-reported outcomes (PROs), and recommendations on how to measure therapeutic objectives in CU. The questionnaire was evaluated by 138 expert allergists and dermatologists. A consensus was reached on 105 out of the 137 proposed items (76.6%). The experts agreed that complete control and remission of CU could be defined as the absence of signs or symptoms while on treatment and in the absence of treatment, respectively. Consensus was not reached on the definition of other key terms such as flare-up, exacerbation, and recurrence. The panel agreed that the objective of therapy in CU should be to achieve complete control. PROs that define the degree of control (complete, good, partial, or absence) were established. An algorithm for disease assessment is provided. In conclusion, this work offers consensus definitions and tools that may be useful in the management of patients with CU.
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Affiliation(s)
- A M Giménez-Arnau
- Dermatology Department, Hospital del Mar, Institut Mar d'investigacions Mèdiques, Universitat Pompeu Fabra, Barcelona, Spain
| | - I Jáuregui
- Allergology Service, Hospital Universitario Cruces, Baracaldo, Vizcaya, Spain
| | | | - A Valero
- Allergy Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M Ferrer
- Department of Allergy, Clínica Universidad de Navarra, Navarra, Spain
| | - J Sastre
- Allergology Service, Hospital Universitario Fundación Jiménez Díaz and Instituto de Investigación Sanitaria (IIS), Madrid, Spain
| | | | - M Labrador-Horrillo
- Allergology Department, Hospital Universitario Vall d´Hebron, Universidad Autónoma de Barcelona, Spain
| | - J Bartra
- Allergy Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - J Miquel Miquel
- Dermatology Department, Hospital Arnau de Vilanova, Valencia, Spain
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Loli-Ausejo D, Gómez-Armayones S, Sáez-Peñataro J, González-Matamala MF, Mascaró B, Muñoz-Cano R, Bartra J. Covid-19 vaccine tolerabilty in a patient with a delayed allergic reaction to polyethylene glycol: a case report. J Investig Allergol Clin Immunol 2022:0. [PMID: 35833860 DOI: 10.18176/jiaci.0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D Loli-Ausejo
- Department of Allergy, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain
| | - S Gómez-Armayones
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Spain.,Technical Committee for Pharmacovigilance, Hospital Clínic de Barcelona. Barcelona, Spain
| | - J Sáez-Peñataro
- Technical Committee for Pharmacovigilance, Hospital Clínic de Barcelona. Barcelona, Spain.,Department of Clinical Pharmacology, Medicines Division, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Spain.5Department of Clinical Pharmacology, Medicines Division, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Sp
| | - M F González-Matamala
- Department of Allergy, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Spain
| | | | - R Muñoz-Cano
- Department of Allergy, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain.,Technical Committee for Pharmacovigilance, Hospital Clínic de Barcelona. Barcelona, Spain.,Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS), Red de Enfermedades Inflamatorias. Instituto de Salud Carlos III. Madrid, Spain
| | - J Bartra
- Department of Allergy, Hospital Clínic de Barcelona, University of Barcelona. Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain.,Technical Committee for Pharmacovigilance, Hospital Clínic de Barcelona. Barcelona, Spain.,Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS), Red de Enfermedades Inflamatorias. Instituto de Salud Carlos III. Madrid, Spain
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10
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Gimenez-Arnau A, Bartra J, Ferrer M, Jauregui I, Borbujo J, Figueras I, Muñoz-Bellido FJ, Pedraz J, Serra-Baldrich E, Tejedor-Alonso MA, Velasco M, Terradas P, Labrador M. A Specialized Therapeutic Approach to Chronic Urticaria Refractory to H1-Antihistamines Improves Disease Burden: The Spanish AWARE Experience. J Investig Allergol Clin Immunol 2022; 32:191-199. [PMID: 33349612 DOI: 10.18176/jiaci.0661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE During its first year, the AWARE study assessed disease activity, patient quality of life (QOL), and treatment patterns in chronic urticaria (CU) refractory to H1-antihistamines (H1-AH) in clinical practice. METHODS We performed an observational, prospective (24 months), international, multicenter study. The inclusion criteria were age ≥18 years and H1-AH-refractory CU (>2 months). At each visit, patients completed questionnaires to assess disease burden (Urticaria Control Test [UCT]), disease activity (7 day-Urticaria Activity Score [UAS7]), and QOL (Dermatology Life Quality index [DLQI], Chronic Urticaria Quality of Life Questionnaire [CU-Q2oL], and Angioedema Quality of Life Questionnaire [AE-QoL]). We present data for Spain. RESULTS The study population comprised 270 evaluable patients (73.3% female, mean [SD] age, 48.9 [14.7] years). At baseline, 89.3% were prescribed a CU treatment. After 1 year, first- and second-line treatments became less frequent and third-line treatments became more frequent. At baseline, 47.0% of patients experienced angioedema; at 1 year, this percentage had fallen to 11.8%. The mean (SD) AE-QoL score decreased from 45.2 (28.7) to 24.0 (25.8). The mean (SD) UCT score decreased from 7.0 (4.5) to 12.1 (4.1). According to UAS7, 38.2% of patients reported absence of wheals and itch in the previous 7 days at 1 year compared with 8.3% at baseline. The mean (SD) DLQI score decreased from 8.0 (7.4) to 2.8 (4.6). At the 1-year visit, the percentage of patients reporting a high or very high impact on QOL fell from 29.9% to 9.6%. CONCLUSION H1-AH-refractory CU in Spain is characterized by absence of control of symptoms and a considerable impact on QOL. Continuous follow-up of CU patients and third-line therapies reduce disease burden and improve patients' QOL.
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Affiliation(s)
| | - J Bartra
- Allergy Section, Pulmonology Department, Hospital Clínic, IDIBAPS, ARADyAL, Universitat de Barcelona, Barcelona, Spain
| | - M Ferrer
- Clínica Universidad de Navarra, ARADyAL, Pamplona, Spain
| | - I Jauregui
- Hospital Universitario Cruces, Vizcaya, Spain
| | - J Borbujo
- Hospital de Fuenlabrada, Madrid, Spain
| | - I Figueras
- Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - J Pedraz
- Hospital Quirón, Pozuelo de Alarcón, Madrid, Spain
| | | | | | - M Velasco
- Hospital Arnau de Vilanova, Valencia, Spain
| | | | - M Labrador
- Hospital Vall d'Hebron, ARADyAL, Barcelona, Spain
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11
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Ruano‐Zaragoza M, Casas‐Saucedo R, De la Cruz Martinez CA, Araujo‐Sanchez G, Gelis S, González MF, San Bartolomé C, Pascal M, Jiménez‐Rodriguez TW, Gonzalez‐Delgado P, Fernandez‐Sanchez J, Muñoz‐Cano R, Bartra J. Advances in the understanding of the cofactor effect in lipid transfer protein food allergy: From phenotype description to clinical management. Allergy 2022; 77:1924-1926. [PMID: 35322440 DOI: 10.1111/all.15291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/08/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Maria Ruano‐Zaragoza
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
| | - Rocío Casas‐Saucedo
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
| | | | - Giovanna Araujo‐Sanchez
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
| | - Sonia Gelis
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
| | - Maria Fernanda González
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
| | - Clara San Bartolomé
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
- Immunology Department Centre de Diagnòstic Biomèdic (CDB) Hospital Clínic de Barcelona Barcelona Spain
| | - Mariona Pascal
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
- Immunology Department Centre de Diagnòstic Biomèdic (CDB) Hospital Clínic de Barcelona Barcelona Spain
| | - Teodorikez Wilfox Jiménez‐Rodriguez
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
- Allergy Section Alicante University Hospital Alicante Spain
- UMH‐ISABIAL Alicante University Hospital Alicante Spain
| | - Purificación Gonzalez‐Delgado
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
- Allergy Section Alicante University Hospital Alicante Spain
- UMH‐ISABIAL Alicante University Hospital Alicante Spain
| | - Javier Fernandez‐Sanchez
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
- Allergy Section Alicante University Hospital Alicante Spain
- UMH‐ISABIAL Alicante University Hospital Alicante Spain
| | - Rosa Muñoz‐Cano
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
| | - Joan Bartra
- Allergy Department Hospital Clinic Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy Institut Investigacions Biomediques August Pi I Sunyer (IDIBAPS) Barcelona Spain
- Asma Reacciones Adversas y Alergia (ARADyAL) Instituto de Salud Carlos III Madrid Spain
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12
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Zuberbier T, Dörr T, Aberer W, Alvaro M, Angier E, Arasi S, Arshad H, Ballmer‐Weber B, Bartra J, Beck L, Bégin P, Bindslev‐Jensen C, Bislimovska J, Bousquet J, Brockow K, Bush A, Cianferoni A, Cork MJ, Custovic A, Darsow U, Jong N, Deleanu D, Del Giacco S, Deschildre A, Dunn Galvin A, Ebisawa M, Fernández‐Rivas M, Ferrer M, Fiocchi A, Gerth van Wijk R, Gotua M, Grimshaw K, Grünhagen J, Heffler E, Hide M, Hoffmann‐Sommergruber K, Incorvaia C, Janson C, Malte John S, Jones C, Jutel M, Katoh N, Kendziora B, Kinaciyan T, Knol E, Kurbacheva O, Lau S, Loh R, Lombardi C, Mäkelä M, Marchisotto MJ, Makris M, Maurer M, Meyer R, Mijakoski D, Minov J, Mullol J, Nilsson C, Nowak–Wegrzyn A, Nwaru BI, Odemyr M, Pajno GB, Paudel S, Papadopoulos NG, Renz H, Ricci G, Ring J, Rogala B, Sampson H, Senna G, Sitkauskiene B, Smith PK, Stevanovic K, Stoleski S, Szajewska H, Tanaka A, Todo‐Bom A, Topal FA, Valovirta E, Van Ree R, Venter C, Wöhrl S, Wong GW, Zhao Z, Worm M. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper. Allergy 2022; 77:1736-1750. [PMID: 34741557 DOI: 10.1111/all.15167] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/15/2021] [Accepted: 11/01/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. METHODS MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. RESULTS In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. CONCLUSION Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
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13
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Balsells-Vives S, San Bartolomé C, Casas-Saucedo R, Ruano-Zaragoza M, Rius J, Torradeflot M, Bartra J, Munoz-Cano R, Pascal M. Low Levels Matter: Clinical Relevance of Low Pru p 3 sIgE in Patients With Peach Allergy. Front Allergy 2022; 3:868267. [PMID: 35769570 PMCID: PMC9234939 DOI: 10.3389/falgy.2022.868267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Many clinical lab settings still use 0.35 KUA/L as the cut-off for serum specific-IgE (sIgE) immunoassays, while the detection limit is 0.1 KUA/L. The clinical relevance of -low-level sIgE (0.1–0.35 KUA/L) remains controversial. Pru p 3 sIgE is considered to be the main routine tool for assessing lipid transfer protein (LTP) sensitization. We aimed to evaluate the clinical relevance of Pru p 3 sIgE low levels in a population diagnosed with LTP allergy. Adults diagnosed with LTP allergy and Pru p 3 sIgE ≥ 0.1 KUA/L between 2012 and 2019 were included. Clinical data were reviewed. nPru p 3 basophil activation test (BAT) was performed and basophil reactivity (BR) and sensitivity (BS) correlated with the peach allergy symptoms. Pru p 3 sIgE from 496 subjects was recorded, 114 (23.0%) between 0.1 and 0.34 KUA/L (grLOW), the rest ≥ 0.35 KUA/L (grB). A total of 44.7% in grLOW and 59.9% in grB were allergic. Urticaria was more frequent in grLOW. In grLOW, Pru p 3 sIgE was higher in patients with local compared with systemic symptoms. In grB, Pru p 3 sIgE was higher in allergic patients. Pru p 3/Total IgE ratios were higher in allergic vs. tolerant in both groups. In BAT, BR was similar in both groups. In grLOW, it was higher on allergic compared with tolerant (p = 0.0286), and on those having systemic vs. local symptoms (p = 0.0286). BS showed no significant difference between groups. Patients with low levels represent a non-negligible fraction and around 45% are peach allergic. BAT showed functional sIgE in them. Pru p 3 sensitizations should be carefully evaluated even when sIgE levels are low.
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Affiliation(s)
- Sara Balsells-Vives
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Clara San Bartolomé
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Centre de Diagnòstic Biomedic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Rocío Casas-Saucedo
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Section, Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
- Spanish Research Network on Allergy (ARADyAL, Red Nacional de Alergia–Asma, Reacciones Adversas y Alérgicas-), Instituto de Salud Carlos III, Madrid, Spain
| | - María Ruano-Zaragoza
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Section, Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
- Spanish Research Network on Allergy (ARADyAL, Red Nacional de Alergia–Asma, Reacciones Adversas y Alérgicas-), Instituto de Salud Carlos III, Madrid, Spain
| | - Josefina Rius
- Department of Immunology, Centre de Diagnòstic Biomedic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Torradeflot
- Department of Immunology, Centre de Diagnòstic Biomedic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joan Bartra
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Section, Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
- Spanish Research Network on Allergy (ARADyAL, Red Nacional de Alergia–Asma, Reacciones Adversas y Alérgicas-), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Joan Bartra
| | - Rosa Munoz-Cano
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Allergy Section, Department of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
- Spanish Research Network on Allergy (ARADyAL, Red Nacional de Alergia–Asma, Reacciones Adversas y Alérgicas-), Instituto de Salud Carlos III, Madrid, Spain
| | - Mariona Pascal
- Clinical and Experimental Respiratory Immunoallergy (IRCE), Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Centre de Diagnòstic Biomedic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
- Spanish Research Network on Allergy (ARADyAL, Red Nacional de Alergia–Asma, Reacciones Adversas y Alérgicas-), Instituto de Salud Carlos III, Madrid, Spain
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Picado C, Mascaró JMJ, Vlagea A, Pascal M, Muñoz-Cano R, Bartra J. Selective IgE deficiency predicts poor or no response of chronic spontaneous urticaria to omalizumab. J Investig Allergol Clin Immunol 2022; 32:504-506. [DOI: 10.18176/jiaci.0796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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15
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Jurado-Escobar R, Dona I, Montes AT, Bartra J, Sanchez NP, Laguna J, Cruz-Amaya A, Saenz de Santamaria R, Nuñez R, Salas M, Labella M, Torres M, Cornejo-Garcia J. FCERIA Single Nucleotide Polymorphisms Associated with Nonsteroidal Anti-inflammatory Drug-induced Acute Urticaria/Angioedema. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Álvarez García O, Bartra J, Ruiz‐Garcia M, Skypala IJ, Durham SR, Boyle RJ, Mills EC, Turner PJ. No apparent impact of incremental dosing on eliciting dose at double-blind, placebo-controlled peanut challenge. Allergy 2022; 77:667-670. [PMID: 34614236 DOI: 10.1111/all.15130] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/11/2021] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Olaya Álvarez García
- National Heart & Lung Institute Imperial College London London UK
- Complexo Hospitalario Universitario de Ferrol, A Coruña Spain
| | - Joan Bartra
- National Heart & Lung Institute Imperial College London London UK
- Hospital Clínic de Barcelona Barcelona Spain
| | | | - Isabel J. Skypala
- National Heart & Lung Institute Imperial College London London UK
- Royal Brompton and Harefield Hospitals NHS Foundation Trust London UK
| | - Stephen R. Durham
- National Heart & Lung Institute Imperial College London London UK
- Royal Brompton and Harefield Hospitals NHS Foundation Trust London UK
| | - Robert J. Boyle
- National Heart & Lung Institute Imperial College London London UK
| | - E.N. Clare Mills
- Division of Infection, Immunity & Respiratory Medicine Manchester Institute of Biotechnology University of Mancheste Manchester UK
| | - Paul J. Turner
- National Heart & Lung Institute Imperial College London London UK
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17
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Quan PL, Sabaté-Brescó M, D'Amelio CM, Pascal M, García BE, Gastaminza G, Blanca-López N, Alvarado MI, Fernández J, Moya C, Bartra J, Ferrer M, Goikoetxea MJ. Validation of a commercial allergen microarray platform for specific immunoglobulin E detection of respiratory and plant food allergens. Ann Allergy Asthma Immunol 2021; 128:283-290.e4. [PMID: 34863952 DOI: 10.1016/j.anai.2021.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/11/2021] [Accepted: 11/28/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND As the use of multiplex-specific immunoglobulin E (sIgE) detection methods becomes increasingly widespread, proper comparative validation assessments of emerging new platforms are vital. OBJECTIVE To evaluate the clinical and technical performance of a newly introduced microarray platform, Allergy Explorer (ALEX) (MacroArray Diagnostics), in the diagnosis of pollen (cypress, grass, olive), dust mite (Dermatophagoides pteronyssinus), mold (Alternaria alternata), fruit (apple, peach), and nut (walnut, hazelnut and peanut) allergies and to compare it with those of the ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC) 112 microarray and the ImmunoCAP singleplex method (ThermoFisher Scientific). METHODS We enrolled 153 patients with allergy and 16 controls without atopy. The sIgE assays were conducted using ISAC112, ALEX version 2 (ALEX2), and ImmunoCAP for whole extracts and major components. Technical validation of ALEX2 was performed by measuring repeatability and interassay, interbatch, and interlaboratory reproducibility. RESULTS When measured globally (detection by 1 or more allergen components), ALEX2 had adequate sensitivity and specificity for most of the allergens studied, comparable in general with that of ISAC112 (except for olive pollen and walnut) and similar to that of ImmunoCAP whole extract measurements. Component-by-component analysis revealed comparable results for all techniques, except for Ole e 1 and Jug r 3, in both ISAC112 and ImmunoCAP comparisons, and Alt a 1, when compared with ISAC112. Continuous sIgE levels correlate with sIgE by ImmunoCAP. Good reproducibility and repeatability were observed for ALEX2. CONCLUSION ALEX2 has sound technical performance and adequate diagnostic capacity, comparable in general with that of ISAC112 and ImmunoCAP.
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Affiliation(s)
- Paola Leonor Quan
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Marina Sabaté-Brescó
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain; Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Navarra Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.
| | - Carmen Mariana D'Amelio
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain; Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Navarra Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
| | - Mariona Pascal
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Department of Immunology, CDB, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Blanca Esther García
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Navarra Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain; Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Gabriel Gastaminza
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain; Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Navarra Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
| | - Natalia Blanca-López
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Allergy Service, Infanta Leonor Hospital, Madrid, Spain
| | - Maria Isabel Alvarado
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Allergy Department, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain
| | - Javier Fernández
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Allergy Section, Hospital General de Alicante, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernandez, Alicante, Spain
| | - Carmen Moya
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Allergy Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - Joan Bartra
- Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Allergy Department, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Marta Ferrer
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain; Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Navarra Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
| | - Maria Jose Goikoetxea
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain; Research Network on Asthma, Drug Adverse Reactions and Allergy (ARADyAL, Red de Investigación en Asma, Reacciones Adversas a Fármacos y Alergia), Spain; Navarra Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
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González-García R, Albanell-Fernández M, Aranda L, Gelis S, Bartra J, Soy Muner D, López-Cabezas C. Evaluation of desensitization protocols to betalactam antibiotics. J Clin Pharm Ther 2021; 47:592-599. [PMID: 34820864 DOI: 10.1111/jcpt.13578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/03/2021] [Accepted: 11/11/2021] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Betalactam antibiotics are the most frequent cause of hypersensitivity reactions. Rapid drug desensitization (RDD) is a technique that induces temporary tolerance to a drug allowing a patient to receive the optimal agent. The increased use of RDD and the lack of standardization among available protocols in terms of formulation, starting dose, number of steps and dosing frequency make it essential to determine the safety and appropriate management of these protocols, especially regarding reconstitution, diluents, stability and drug administration in order to guarantee reproducibility. We reviewed betalactam desensitization protocols in a tertiary hospital, in accordance with currently published practices and evaluated its use on patients over a period of three years. METHODS (a) We performed a literature search in PubMed, MEDLINE and Google Scholar databases for case reports and/or systematic reviews describing desensitization protocols for betalactam antibiotics. Pharmacokinetic parameters and physicochemical stability were checked for each antibiotic. (b) We retrospectively reviewed inpatients undergoing our antibiotic desensitization protocols from February 2018 to January 2021. Data and outcomes of desensitization procedures were analysed. RESULTS We developed nine RDD protocols: meropenem, ceftriaxone, ceftazidime, ampicillin, ceftolozane/tazobactam, cloxacillin, piperacillin/tazobactam, amoxicillin/clavulanate and penicillin G sodium. Five antibiotics have RDD protocols for two different doses, adjusted to patients with impaired renal function. Detailed data (diluent, total dose, volume, concentrations, duration and stability) of the protocol of each antibiotic used are provided. 28 desensitizations were performed in 17 patients, three of them with confirmed allergies by skin test. 26 out of 28 (92.9%) of them were successfully completed, including those three with positive skin results. The pathogens most frequently involved were E. faecalis and P. aeruginosa; both frequently associated with bacterial resistance. Meropenem, ceftriaxone and ceftazidime were the antibiotics most desensitized. 25 out of 26 (96.1%) procedures were successful in resolving the infection. WHAT IS NEW AND CONCLUSIONS Detailed information about compounding, dilution and stability is crucial to ensure safe and successful desensitization processes, as well as good coordination between the Allergy and Pharmacy departments. The increase in bacterial resistance to many of the commercially available antibiotics limits the therapeutic options for treating multidrug-resistant infections; in those situations, antibiotic desensitization may be a key therapeutic option. Although there is a broad consensus in limiting the use of RDD to patients with confirmed allergy, in usual clinical practice its application in those strongly suspected of having type I hypersensitivity is still observed. Our betalactam desensitization protocols have shown themselves to be safe and effective, as evidenced by data from the 17 patients on whom they have been tested.
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Affiliation(s)
- Rubén González-García
- Pharmacy Service, Division of Medicines, Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Marta Albanell-Fernández
- Pharmacy Service, Division of Medicines, Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Laura Aranda
- Pharmacy Service, Division of Medicines, Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Sonia Gelis
- Allergology Section, Pneumology Service, ICR. ARADYAL, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Joan Bartra
- Allergology Section, Pneumology Service, ICR. ARADYAL, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Dolors Soy Muner
- Pharmacy Service, Division of Medicines, Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Carmen López-Cabezas
- Pharmacy Service, Division of Medicines, Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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19
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Patel N, Chong KW, Yip AYG, Ierodiakonou D, Bartra J, Boyle RJ, Turner PJ. Use of multiple epinephrine doses in anaphylaxis: A systematic review and meta-analysis. J Allergy Clin Immunol 2021; 148:1307-1315. [PMID: 33862009 PMCID: PMC8588837 DOI: 10.1016/j.jaci.2021.03.042] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/25/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Regulatory bodies recommend that all patients at risk of anaphylaxis be prescribed 2 epinephrine autoinjectors, which they should carry at all times. This is in contrast to some guidelines. The proportion of anaphylaxis reactions that are treated with multiple doses of epinephrine has not been systematically evaluated. OBJECTIVE Our aim was to undertake a systematic review and meta-analysis of published studies reporting epinephrine treatment for anaphylaxis in which data relating to the number of doses administered were available. METHODS We searched the Medline, Embase, and Cochrane databases for relevant studies reporting at least 10 anaphylaxis events (due to food or venom) from 1946 until January 2020. Data were extracted in duplicate for the meta-analysis, and the risk of bias was assessed. The study was registered under the PROSPERO identifier CRD42017069109. RESULTS A total of 86 studies (36,557 anaphylaxis events) met the inclusion criteria (20 of the studies [23%] were prospective studies; 64 [74%] reported reactions in the community, and 22 [26%] included food challenge data). Risk of bias was assessed as low in 50 studies. Overall, 7.7% of anaphylaxis events from any cause (95% CI = 6.4-9.1) were treated with multiple doses of epinephrine. When only epinephrine-treated reactions for which subsequent doses were administered by a health care professional were considered, 11.1% of food-induced reactions (95% CI = 9.4-13.2) and 17.1% of venom-induced reactions (95% CI = 11.3-25.0) were treated with more than 1 epinephrine dose. Heterogeneity was moderate to high in the meta-analyses, but at sensitivity analysis this estimate was not affected by study design or anaphylaxis definition. CONCLUSION Around 1 in 10 anaphylaxis reactions are treated with more than 1 dose of epinephrine.
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Affiliation(s)
- Nandinee Patel
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Kok Wee Chong
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | | | - Despo Ierodiakonou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Joan Bartra
- Hospital Clínic de Barcelona, Barcelona, Spain
| | - Robert J Boyle
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Paul J Turner
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.
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20
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Macías Y, García-Menaya JM, Martí M, Cordobés C, Jurado-Escobar R, Cornejo-García JA, Torres MJ, Blanca-López N, Canto G, Blanca M, Laguna JJ, Bartra J, Rosado A, Fernández J, García-Martín E, Agúndez JAG. Lack of Major Involvement of Common CYP2C Gene Polymorphisms in the Risk of Developing Cross-Hypersensitivity to NSAIDs. Front Pharmacol 2021; 12:648262. [PMID: 34621165 PMCID: PMC8490926 DOI: 10.3389/fphar.2021.648262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Cross-hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) is a relatively common, non-allergic, adverse drug event triggered by two or more chemically unrelated NSAIDs. Current evidence point to COX-1 inhibition as one of the main factors in its etiopathogenesis. Evidence also suggests that the risk is dose-dependent. Therefore it could be speculated that individuals with impaired NSAID biodisposition might be at increased risk of developing cross-hypersensitivity to NSAIDs. We analyzed common functional gene variants for CYP2C8, CYP2C9, and CYP2C19 in a large cohort composed of 499 patients with cross-hypersensitivity to NSAIDs and 624 healthy individuals who tolerated NSAIDs. Patients were analyzed as a whole group and subdivided in three groups according to the main enzymes involved in the metabolism of the culprit drugs as follows: CYP2C9, aceclofenac, indomethacin, naproxen, piroxicam, meloxicam, lornoxicam, and celecoxib; CYP2C8 plus CYP2C9, ibuprofen and diclofenac; CYP2C19 plus CYP2C9, metamizole. Genotype calls ranged from 94 to 99%. No statistically significant differences between patients and controls were identified in this study, either for allele frequencies, diplotypes, or inferred phenotypes. After patient stratification according to the enzymes involved in the metabolism of the culprit drugs, or according to the clinical presentation of the hypersensitivity reaction, we identified weak significant associations of a lower frequency (as compared to that of control subjects) of CYP2C8*3/*3 genotypes in patients receiving NSAIDs that are predominantly CYP2C9 substrates, and in patients with NSAIDs-exacerbated cutaneous disease. However, these associations lost significance after False Discovery Rate correction for multiple comparisons. Taking together these findings and the statistical power of this cohort, we conclude that there is no evidence of a major implication of the major functional CYP2C polymorphisms analyzed in this study and the risk of developing cross-hypersensitivity to NSAIDs. This argues against the hypothesis of a dose-dependent COX-1 inhibition as the main underlying mechanism for this adverse drug event and suggests that pre-emptive genotyping aiming at drug selection should have a low practical utility for cross-hypersensitivity to NSAIDs.
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Affiliation(s)
- Yolanda Macías
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Jesús M García-Menaya
- Allergy Service, Badajoz University Hospital, Badajoz, Spain.,ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - Manuel Martí
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Concepción Cordobés
- Allergy Service, Badajoz University Hospital, Badajoz, Spain.,ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - Raquel Jurado-Escobar
- Research Laboratory, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain.,ARADyAL Instituto de Salud Carlos III, Málaga, Spain
| | - José A Cornejo-García
- Research Laboratory, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain.,ARADyAL Instituto de Salud Carlos III, Málaga, Spain
| | - María J Torres
- ARADyAL Instituto de Salud Carlos III, Málaga, Spain.,Allergy Unit, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Natalia Blanca-López
- Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.,ARADyAL Instituto de Salud Carlos III, Madrid, Spain
| | - Gabriela Canto
- Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.,ARADyAL Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Blanca
- Allergy Service, Infanta Leonor University Hospital, Madrid, Spain.,ARADyAL Instituto de Salud Carlos III, Madrid, Spain
| | - José J Laguna
- ARADyAL Instituto de Salud Carlos III, Madrid, Spain.,Allergy Unit and Allergy-Anaesthesia Unit, Hospital Central Cruz Roja, Faculty of Medicine, Alfonso X El Sabio University, Madrid, Spain
| | - Joan Bartra
- Allergy Section, Pneumology Department, Hospital Clinic, ARADyAL, Universitat de Barcelona, Barcelona, Spain.,ARADyAL Instituto de Salud Carlos III, Barcelona, Spain
| | - Ana Rosado
- Allergy Service, Alcorcón Hospital, Madrid, Spain
| | - Javier Fernández
- Allergy Unit, Regional University Hospital, Alicante, Spain.,ARADyAL Instituto de Salud Carlos III, Alicante, Spain
| | - Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain.,ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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Pascal M, Moreno C, Dávila I, Tabar AI, Bartra J, Labrador M, Luengo O. Integration of in vitro allergy test results and ratio analysis for the diagnosis and treatment of allergic patients (INTEGRA). Clin Transl Allergy 2021; 11:e12052. [PMID: 34582103 PMCID: PMC9082998 DOI: 10.1002/clt2.12052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/05/2021] [Accepted: 07/30/2021] [Indexed: 01/09/2023] Open
Abstract
The introduction of molecular diagnosis into routine clinical practice has substantially improved the diagnosis and management of allergic patients by allowing clinicians to precisely identify the allergenic molecule responsible for immunoglobulin E (IgE)‐mediated allergies. However, it can be challenging to accurately interpret the results of molecular assays, partly due to the limited evidence base. In this context, a panel of experts with extensive experience in interpreting in vitro measures of total and serum specific IgE reviewed the available scientific evidence. After this review, the panel selected a series of representative case studies to demonstrate how determination of specific and total IgE values and the relationship between them (ratio analysis) can add value to the diagnostic process by more precisely defining the patient’s sensitization profile. Finally, the experts developed a series of recommendations on the clinical application of ratio analysis to optimize and complement the classical approach to allergy diagnosis.
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Affiliation(s)
- Mariona Pascal
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,ARADyAL Network, Health Institute Carlos III, Madrid, Spain
| | - Carmen Moreno
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Hospital Universitario Reina Sofía, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
| | - Ignacio Dávila
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Department of Biomedical and Diagnostic Sciences and Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Ana I Tabar
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Hospital Complex of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Cooperative Health Research Thematic Networks (RETICs) for Asthma, Madrid, Spain
| | - Joan Bartra
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Pneumology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Moisés Labrador
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Olga Luengo
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona. Barcelona, Spain
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22
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Picado C, de Landazuri IO, Vlagea A, Bobolea I, Arismendi E, Amaro R, Sellarés J, Bartra J, Sanmarti R, Hernandez-Rodriguez J, Mascaró JM, Colmenero J, Vaquero EC, Pascal M. Spectrum of Disease Manifestations in Patients with Selective Immunoglobulin E Deficiency. J Clin Med 2021; 10:jcm10184160. [PMID: 34575269 PMCID: PMC8466644 DOI: 10.3390/jcm10184160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Selective IgE deficiency (SIgED) has been previously evaluated in selected patients from allergy units. This study investigates the effects of SIgED on the entire population in a hospital setting and sought to delineate in detail the clinical aspects of SIgED. METHODS A retrospective study of the data obtained from electronic medical records of 52 adult patients (56% female) with a mean age of 43 years and IgE levels of <2.0 kU/L with normal immunoglobulin (Ig) IgG, IgA, and IgM levels, seen at our hospital, without selection bias, from 2010 to 2019. RESULTS Recurrent upper respiratory infections were recorded in 18 (34.6%) patients, pneumonia was recorded in 16 (30.7%) patients, bronchiectasis was recorded in 16 (30.7%) patients, and asthma was recorded in 10 (19.2%) patients. Eighteen patients (34.6%) suffered autoimmune clinical manifestations either isolated (19%) or combining two or more diseases (15%), Hashimoto's thyroiditis being the most frequent (19%), which was followed by arthritis (10%) and thrombocytopenia and/or neutropenia (5.7%). Other less frequent associations were Graves' disease, primary sclerosing cholangitis, Sjögren's syndrome, and autoimmune hepatitis. Eczematous dermatitis (15.3%), chronic spontaneous urticaria (17.3%), and symptoms of enteropathy (21%) were also highly prevalent. Thirty percent of patients developed malignancies, with non-Hodgkin lymphomas (13.4%) being the most prevalent. CONCLUSIONS The clinical manifestations of SIgED encompass a variety of infectious, non-infectious complications, and malignancy. Since it cannot be ruled out that some type of selection bias occurred in the routine assessment of IgE serum Ievels, prospective studies are required to better characterize SIgED and to determine whether it should be added to the list of antibody deficiencies.
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Affiliation(s)
- César Picado
- Institut Clinic Respiratory, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.B.); (E.A.); (R.A.); (J.S.); (J.B.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Correspondence:
| | - Iñaki Ortiz de Landazuri
- Immunology Department, CDB. Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.O.d.L.); (A.V.)
| | - Alexandru Vlagea
- Immunology Department, CDB. Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.O.d.L.); (A.V.)
| | - Irina Bobolea
- Institut Clinic Respiratory, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.B.); (E.A.); (R.A.); (J.S.); (J.B.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Ebymar Arismendi
- Institut Clinic Respiratory, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.B.); (E.A.); (R.A.); (J.S.); (J.B.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Rosanel Amaro
- Institut Clinic Respiratory, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.B.); (E.A.); (R.A.); (J.S.); (J.B.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Jacobo Sellarés
- Institut Clinic Respiratory, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.B.); (E.A.); (R.A.); (J.S.); (J.B.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
| | - Joan Bartra
- Institut Clinic Respiratory, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.B.); (E.A.); (R.A.); (J.S.); (J.B.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
| | - Raimon Sanmarti
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Department of Rheumatology, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
| | - José Hernandez-Rodriguez
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Department of Autoimmune Diseases, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
| | - José-Manuel Mascaró
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Department of Dermatology, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Jordi Colmenero
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Liver Unit, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigaciones en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
| | - Eva C. Vaquero
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Centro de Investigaciones en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
- Department of Gastroenterology, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Mariona Pascal
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (R.S.); (J.H.-R.); (J.-M.M.); (J.C.); (E.C.V.); (M.P.)
- Immunology Department, CDB. Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain; (I.O.d.L.); (A.V.)
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Gelis S, Rueda M, Pascal M, Fernández-Caldas E, Abel Fernández E, Araujo-Sánchez G, Bartra J, Valero A. Usefulness of the Allergen Specific Nasal Provocation Test in the Diagnosis of Shellfish Allergy. J Investig Allergol Clin Immunol 2021; 32:460-470. [PMID: 34489219 DOI: 10.18176/jiaci.0736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Shellfish allergy is an important cause of food allergy and anaphylaxis worldwide. Several allergenic proteins have been described in the last few years, but the only diagnostic tool that allows discrimination between allergic and non-allergic sensitized subjects is still the oral food challenge (OFC). Objective: The aim of this study was to evaluate the usefulness of nasal allergen provocation test (NAPT) as a diagnostic tool in the diagnosis of shellfish allergy. MATERIAL AND METHODS Forty-five subjects with confirmed sensitization to shrimp by a positive skin prick test (SPT) to a commercial shrimp extract were recruited and classified as Sensitized-Allergic or non-Allergic based on current tolerance to shrimp intake, the result of an OFC with a freeze-dried cooked shrimp mixture extract, or recent history of anaphylaxis from shrimp ingestion. These subjects and ten controls without shrimp sensitization were subjected to a NAPT with a freeze-dried cooked shrimp mixture extract. The response was evaluated by means of acoustic rhinometry (AcRh) and visual analogue scale scores (VAS). RESULTS Significant differences (p=.001) were found between the Sensitized-Allergic group (18/20 positive NAPT, 90%) compared to both Sensitized-non-Allergic (2/18 positive NAPT, 11.1%) and Control (0/10 positive NAPT) groups. NAPT allows differentiation between allergic and non-allergic subjects with a S: 90%, E: 89%, PPV: 90% and NPV: 89%. CONCLUSIONS According to the study results NAPT may be a useful diagnostic tool that allows differentiating sensitized symptomatic subjects from sensitized tolerant. It could be a valuable test to consider when conducting a shrimp allergy study.
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Affiliation(s)
- S Gelis
- Department of Pneumology and Allergy, Hospital Clínic. Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS). Universitat de Barcelona. Barcelona, Spain
| | - M Rueda
- Allergology Department, Hospital Quirónsalud, Barcelona, Spain
| | - M Pascal
- Immunology Department, Hospital Clínic. Institut d'Investigacions Biomèrdiques Agustí Pi I Sunyer (IDIBAPS). Universitat de Barcelona. Barcelona, Spain.,RETICS ARADyAL Network, Instituto de Salud Carlos III, Spain
| | - E Fernández-Caldas
- Immunotek SL, Madrid, Spain.,University of South Florida College of Medicine, Tampa, Florida, USA
| | | | - G Araujo-Sánchez
- Department of Pneumology and Allergy, Hospital Clínic. Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS). Universitat de Barcelona. Barcelona, Spain
| | - J Bartra
- Department of Pneumology and Allergy, Hospital Clínic. Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS). Universitat de Barcelona. Barcelona, Spain.,RETICS ARADyAL Network, Instituto de Salud Carlos III, Spain
| | - A Valero
- Department of Pneumology and Allergy, Hospital Clínic. Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS). Universitat de Barcelona. Barcelona, Spain
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24
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San Bartolomé C, Muñoz-Cano R, Rius J, Casas-Saucedo R, Balsells S, Egri N, Ruano-Zaragoza M, de la Cruz C, Bartra J, Pascal M. Detection of Wheat Lipid Transfer Protein (Tri a 14) Sensitization: Comparison between Currently Available Diagnostic Tools. Int Arch Allergy Immunol 2021; 183:75-79. [PMID: 34515140 DOI: 10.1159/000517963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Wheat lipid transfer protein (LTP; Tri a 14) and ω5-gliadin have been described as major allergens in wheat allergy (WA) and relevant in wheat-induced anaphylaxis, frequently associated with cofactors. OBJECTIVE The objective of this study was to compare tools currently available in routine diagnosis to detect Tri a 14 sensitization, its clinical relevance, and cosensitization to ω5-gliadin and other LTPs. METHODS One hundred eighteen adults sensitized to rTri a 14 by ImmunoCAP® (cutoff ≥0.1 kUA/L) identified among 210 LTP allergic patients were included. We evaluated (1) wheat skin prick test (SPT), (2) specific IgE (sIgE) to wheat, rTri a 14, rTri a 19, peach, apple, walnut, hazelnut, and peanut LTPs using ImmunoCAP® and microarray ImmunoCAP®ISAC (cutoff ≥0.3I SU), and (3) wheat-related symptoms. RESULTS Wheat SPT and sIgE were positive in 31% and 85% of subjects, respectively. rTri a 14 by microarray was detected in 25%. Eight percent showed cosensitization to ω5-gliadin. Thirty percent referred symptoms (gastrointestinal [13%], urticaria [11%], and anaphylaxis [8%]). Cofactors (45%) were significantly associated with systemic reactions. CONCLUSION WA due to Tri a 14 is frequently related with systemic reactions and because are frequently related to cofactors, the culprit may not be suspected. Together with the poor performance to identify Tri a 14 sensitization of the current routine diagnostic tools based on the analysis of whole wheat extract, such as wheat SPT or sIgE, there is a high risk that WA may be overlooked. Thus, when WA is suspected, sIgE Tri a 14 assessment is recommended, together with wheat and ω5-gliadin, preferably in the singleplex format, and carefully evaluated considering ≥0.1 kUA/L as a cutoff.
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Affiliation(s)
- Clara San Bartolomé
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain, .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain, .,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain,
| | - Rosa Muñoz-Cano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain.,Department of Pneumology, Allergy Section, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josefina Rius
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Rocío Casas-Saucedo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain.,Department of Pneumology, Allergy Section, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sara Balsells
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Natalia Egri
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Ruano-Zaragoza
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain.,Department of Pneumology, Allergy Section, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Cinthia de la Cruz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain.,Department of Pneumology, Allergy Section, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joan Bartra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain.,Department of Pneumology, Allergy Section, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mariona Pascal
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain
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25
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Ibáñez-Sandín MD, Escudero C, Candón Morillo R, Lasa EM, Marchán-Martín E, Sánchez-García S, Terrados S, González Díaz C, Juste S, Martorell A, Gázquez García V, Ramírez Jiménez A, Abellán Á, Martos Calahorro MD, Tabar AI, Bartra J, García Rodríguez R, Gómez Galán C, Martín-Muñoz MF, Meseguer Arce J, Miralles JC, Montoro de Francisco AM, Poza Guedes P, Rodríguez Del Río P. Oral immunotherapy in severe cow's milk allergic patients treated with omalizumab: Real life survey from a Spanish registry. Pediatr Allergy Immunol 2021; 32:1287-1295. [PMID: 33835593 DOI: 10.1111/pai.13517] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/29/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral immunotherapy is a frequent treatment for the management of food allergies, but adverse events (AE) are common. This study assessed the outcome of cow's milk oral immunotherapy (MOIT) in severe cow`s milk-allergic patients treated with omalizumab in a real-life setting. METHODS OmaBASE was a national, multicenter, open, and observational registry that collected clinical, immunologic, and treatment from patients with food allergy receiving omalizumab. RESULTS Data derived from 58 patients aged 10.3 years (IQR 6.3-13.2) and median milk-specific IgE 100 kUA /L at the start of omalizumab treatment. Most had experienced anaphylaxis by accidental exposures (70.7%) and had asthma (81.0%). Omalizumab in monotherapy induced tolerance to ≥6000 mg of cow's milk protein (CMP) to 34.8% of patients tested by oral food challenge. Omalizumab combined with MOIT conferred desensitization to ≥6000 mg of CMP to 83.0% of patients. Omalizumab withdrawal triggered more AE (P = .013) and anaphylaxis (P = .001) than no discontinuation. Anaphylaxis was observed in 36.4% of patients who discontinued omalizumab, and more in those with sudden (50.0%) rather than progressive (12.5%) discontinuation. At database closure, 40.5% of patients who had completed follow-up tolerated CMP without omalizumab (7.2% 1500-4500 mg; 33.3% ≥6000 mg). CONCLUSION Milk oral immunotherapy initiated under omalizumab allows the desensitization of subjects with severe cow's milk allergy even after omalizumab discontinuation. However, discontinuation of omalizumab can lead to severe AE and should be carefully monitored.
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Affiliation(s)
- María Dolores Ibáñez-Sandín
- Department of Allergy, Hospital Infantil Universitario Niño Jesús and ARADyAL- RETICs network RD16/0006/0026, Instituto de Salud Carlos III, IIS-P, FibHNJ, Madrid, Spain
| | - Carmelo Escudero
- Department of Allergy, Hospital Infantil Universitario Niño Jesús and ARADyAL- RETICs network RD16/0006/0026, Instituto de Salud Carlos III, IIS-P, FibHNJ, Madrid, Spain
| | - Rocío Candón Morillo
- Department of Allergy, Hospital General La Mancha Centro, Alcázar de San Juan, Spain
| | - Eva M Lasa
- Pediatric Allergy Unit, Hospital Universitario Donostia, San Sebastián, Spain
| | - Eva Marchán-Martín
- Department of Allergy, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Silvia Sánchez-García
- Department of Allergy, Hospital Infantil Universitario Niño Jesús and ARADyAL- RETICs network RD16/0006/0026, Instituto de Salud Carlos III, IIS-P, FibHNJ, Madrid, Spain
| | - Soledad Terrados
- Department of Allergy, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Carlos González Díaz
- Pediatric Allergy Unit, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, Bilbao, Spain
| | - Sonsoles Juste
- Department of Allergy, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Vanessa Gázquez García
- Department of Allergy, Hospital Universitari Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | - Antonio Ramírez Jiménez
- Food Safety Unit, Department of Allergy, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Ángel Abellán
- Department of Allergy, Hospital Universitario Los Arcos del Mar Menor, Murcia, Spain
| | | | - Ana I Tabar
- Department of Allergy, Hospital Complex of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Cooperative Health Research Thematic Networks (RETICs) for Asthma, Adverse Reactions to drugs and Allergy (ARADYAL) Research Network, Pamplona, Spain
| | - Joan Bartra
- Department of Allergy, Hospital Clinic, IDIBAPS, Universitat de Barcelona and ARAdyAL, Barcelona, Spain
| | - Rosa García Rodríguez
- Department of Allergy, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Catalina Gómez Galán
- Department of Allergy, Althaia, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | | | - José Meseguer Arce
- Department of Allergy, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Juan C Miralles
- Department of Allergy, Hospital General Universitario Reina Sofía, Murcia, Spain
| | | | - Paloma Poza Guedes
- Department of Allergy, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Pablo Rodríguez Del Río
- Department of Allergy, Hospital Infantil Universitario Niño Jesús and ARADyAL- RETICs network RD16/0006/0026, Instituto de Salud Carlos III, IIS-P, FibHNJ, Madrid, Spain
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26
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Skypala IJ, Bartra J, Ebo DG, Antje Faber M, Fernández‐Rivas M, Gomez F, Luengo O, Till SJ, Asero R, Barber D, Cecchi L, Diaz Perales A, Hoffmann‐Sommergruber K, Anna Pastorello E, Swoboda I, Konstantinopoulos AP, Ree R, Scala E. The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins. Allergy 2021; 76:2433-2446. [PMID: 33655502 DOI: 10.1111/all.14797] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/29/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
Sensitization to one or more non-specific lipid transfer proteins (nsLTPs), initially thought to exist mainly in southern Europe, is becoming accepted as a cause of allergic reactions to plant foods across Europe and beyond. The peach nsLTP allergen Pru p 3 is a dominant sensitizing allergen and peaches a common food trigger, although multiple foods can be involved. A frequent feature of reactions is the requirement for a cofactor (exercise, alcohol, non-steroidal anti-inflammatory drugs, Cannabis sativa) to be present for a food to elicit a reaction. The variability in the food and cofactor triggers makes it essential to include an allergy-focused diet and clinical history in the diagnostic workup. Testing on suspected food triggers should also establish whether sensitization to nsLTP is present, using purified or recombinant nsLTP allergens such as Pru p 3. The avoidance of known trigger foods and advice on cofactors is currently the main management for this condition. Studies on immunotherapy are promising, but it is unknown whether such treatments will be useful in populations where Pru p 3 is not the primary sensitizing allergen. Future research should focus on the mechanisms of cofactors, improving diagnostic accuracy and establishing the efficacy of immunotherapy.
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Affiliation(s)
- Isabel J. Skypala
- Royal Brompton & Harefield NHS Foundation Trust London UK
- Department of Allergy and Clinical Immunology Imperial College London UK
| | - Joan Bartra
- Hospital Clinic Barcelona Spain
- IDIBAPS Universitat de Barcelona ARADyAL, Barcelona Spain
| | - Didier G. Ebo
- Department of Immunology, Allergology, Rheumatology Faculty of Medicine and Health Sciences Infla‐Med Centre of Excellence Antwerp University Hospital University of Antwerp Antwerp Belgium
- Jan Palfijn Ziekenhuis Ghent Ghent Belgium
| | - Margaretha Antje Faber
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology Infla‐Med Centre of Excellence Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Montserrat Fernández‐Rivas
- Department of Allergy Hospital Clínico San Carlos Universidad Complutense de Madrid IdISSC ARADyAL Madrid Spain
| | - Francisca Gomez
- Allergy Unit IBIMA—Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reaccionesadversas y Alérgicas (ARADyAL Madrid Spain
| | - Olga Luengo
- Allergy Unit Internal Medicine Department Vall d'Hebron University Hospital Universitat Autònoma de Barcelona ARADyAL Barcelona Spain
| | - Stephen J. Till
- Peter Gorer Department of Immunobiology King’s College London London UK
- Department of Allergy Guy’s & St Thomas’ NHS Foundation Trust London UK
| | - Riccardo Asero
- Ambulatorio di Allergologia Clinica San Carlo Paderno Dugnano Italy
| | - Domingo Barber
- IMMA School of Medicine Universidad San Pablo CEU, Universities Madrid Spain
- RETIC ARADYAL RD16/0006/0015 Instituto de Salud Carlos III Madrid Spain
| | - Lorenzo Cecchi
- SOS Allergy and Clinical Immunology USL Toscana Centro Prato Italy
| | - Araceli Diaz Perales
- Centro de Biotecnología y Genómica de Plantas Universidad Politecnica Madrid Spain
| | | | - Elide Anna Pastorello
- Unit of Allergology and Immunology ASST Grande Ospedale Metropolitano Niguarda University of Milan Milan Italy
| | - Ines Swoboda
- Biotechnology Section Campus Vienna Biocenter FH Campus Wien, University of Applied Sciences Vienna Austria
| | | | - Ronald Ree
- Department of Experimental Immunology Amsterdam University Medical Centers, location AMC Amsterdam The Netherlands
- Department of Otorhinolaryngology Amsterdam University Medical Centers, location AMC Amsterdam The Netherlands
| | - Enrico Scala
- Experimental Allergy Unit Istituto Dermopatico dell’Immacolata – IRCCS FLMM Rome Italy
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27
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Jimenez‐Rodriguez T, Berges‐Gimeno MP, Barranco R, Bartra J, Diéguez MDC, Doña I, Fernández‐Rivas M, Gandolfo‐Cano MDM, Gastaminza‐Lasarte G, González‐Mancebo E, Hoz Caballer B, Sánchez‐Morillas L, Torres MJ, Vega A, Muñoz‐Cano R. Management of hypersensitivity reactions to chemotherapy and biologic agents: A survey of ARADyAL (Asthma, Adverse Drug Reactions and Allergy Network) Spanish allergy services. Allergy 2021; 76:2249-2253. [PMID: 33476405 DOI: 10.1111/all.14743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/17/2020] [Accepted: 01/08/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Teodorikez‐Wilfox Jimenez‐Rodriguez
- Allergy Section Alicante General University Hospital‐ISABIAL Alicante Spain
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
| | - María Pilar Berges‐Gimeno
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Division Ramon y Cajal University Hospital IRYCIS Madrid Spain
| | - Ruth Barranco
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Department Hospital Universitario 12 de Octubrei+12. PIELenRed Consortium Madrid Spain
| | - Joan Bartra
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Section Pneumology Department Hospital Clinic IRCE‐ Institutd'InvestigacionsBiomèdiques August Pi iSunyer (IDIBAPS Universitat de Barcelona Barcelona Spain
| | - María del Carmen Diéguez
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Department Hospital Universitario 12 de Octubrei+12. PIELenRed Consortium Madrid Spain
| | - Inmaculada Doña
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Research Group Hospital Civil Instituto de Investigación Biomédica de Málaga‐IBIMA Malaga Spain
- Allergy Unit Hospital Civil Hospital Regional Universitario de Málaga Málaga Spain
| | - Montserrat Fernández‐Rivas
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Servicio de Alergia Hospital Clínico San Carlos IdISSCUCM Madrid Spain
| | - Maria Del Mar Gandolfo‐Cano
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Department Hospital Universitario de Fuenlabrada IdiPAZ Madrid Spain
| | - Gabriel Gastaminza‐Lasarte
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Department Clínica Universidad de Navarra Pamplona España
| | - Eloína González‐Mancebo
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Department Hospital Universitario de Fuenlabrada IdiPAZ Madrid Spain
| | - Belén Hoz Caballer
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Division Ramon y Cajal University Hospital IRYCIS Madrid Spain
- Universidad de Alcalá Madrid Spain
| | - Leticia Sánchez‐Morillas
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Servicio de Alergia Hospital Clínico San Carlos IdISSCUCM Madrid Spain
| | - María José Torres
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Research Group Hospital Civil Instituto de Investigación Biomédica de Málaga‐IBIMA Malaga Spain
- Allergy Unit Hospital Civil Hospital Regional Universitario de Málaga Málaga Spain
| | - Arantza Vega
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Service Hospital Universitario de Guadalajara Guadalajara Spain
- Facultad de Medicina Universidad Internacional de Cataluña Barcelona Spain
| | - Rosa Muñoz‐Cano
- ARADyAL Spanish Network (RD16/0006) Instituto de Salud Carlos III (ISCIII) Fundación Española para la Ciencia y la Tecnología (FECyT Madrid Spain
- Allergy Section Pneumology Department Hospital Clinic IRCE‐ Institutd'InvestigacionsBiomèdiques August Pi iSunyer (IDIBAPS Universitat de Barcelona Barcelona Spain
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28
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Vega A, Jimenez-Rodriguez TW, Barranco R, Bartra J, Diéguez MC, Doña I, Fernández-Rivas M, Gandolfo-Cano M, Gastaminza-Lasarte G, González-Mancebo E, de la Hoz Caballer B, Sánchez-Morillas L, Torres MJ, Berges-Gimeno MP, Muñoz-Cano R. Hypersensitivity Reactions to Cancer Chemotherapy: Practical Recommendations of ARADyAL for Diagnosis and Desensitization. J Investig Allergol Clin Immunol 2021; 31:364-384. [PMID: 34045179 DOI: 10.18176/jiaci.0712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Vega
- Allergy Department. Hospital Universitario de Guadalajara, Spain.,ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Facultad de Medicina, Universidad Internacional de Cataluña
| | - T W Jimenez-Rodriguez
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Section, Alicante General University Hospital-ISABIAL. Alicante, Spain
| | - R Barranco
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Department. Hospital Universitario 12 de Octubre. Madrid,Spain. i+12
| | - J Bartra
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Section, Pneumology Department, Hospital Clinic, Universitat de Barcelona. IRCE- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M C Diéguez
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Department. Hospital Universitario 12 de Octubre. Madrid,Spain. i+12
| | - I Doña
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA. Hospital Civil, Málaga, Spain.,Allergy Unit, Hospital Regional Universitario de Málaga. Hospital Civil, 29009 Málaga, Spain
| | - M Fernández-Rivas
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Servicio de Alergia. Hospital Clínico San Carlos. IdISSC. UCM. Madrid, Spain
| | - M Gandolfo-Cano
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Department. Hospital Universitario de Fuenlabrada. Madrid, Spain. IdiPAZ
| | - G Gastaminza-Lasarte
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Department. Clínica Universidad de Navarra. Pamplona, España
| | - E González-Mancebo
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Department. Hospital Universitario de Fuenlabrada. Madrid, Spain. IdiPAZ
| | - B de la Hoz Caballer
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain. IRYCIS.,Universidad de Alcalá. Madrid, Spain
| | - L Sánchez-Morillas
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Servicio de Alergia. Hospital Clínico San Carlos. IdISSC. UCM. Madrid, Spain
| | - M J Torres
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA. Hospital Civil, Málaga, Spain.,Allergy Unit, Hospital Regional Universitario de Málaga. Hospital Civil, 29009 Málaga, Spain
| | - M P Berges-Gimeno
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain. IRYCIS
| | - R Muñoz-Cano
- ARADyAL Spanish network (RD16/0006). Instituto de Salud Carlos III (ISCIII). Fundación Española para la Ciencia y la Tecnología (FECyT), Madrid. Spain.,Allergy Section, Pneumology Department, Hospital Clinic, Universitat de Barcelona. IRCE- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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29
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Skypala IJ, Asero R, Barber D, Cecchi L, Diaz Perales A, Hoffmann-Sommergruber K, Pastorello EA, Swoboda I, Bartra J, Ebo DG, Faber MA, Fernández-Rivas M, Gomez F, Konstantinopoulos AP, Luengo O, van Ree R, Scala E, Till SJ. Non-specific lipid-transfer proteins: Allergen structure and function, cross-reactivity, sensitization, and epidemiology. Clin Transl Allergy 2021; 11:e12010. [PMID: 34025983 PMCID: PMC8129635 DOI: 10.1002/clt2.12010] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/08/2021] [Indexed: 12/27/2022] Open
Abstract
Background Discovered and described 40 years ago, non‐specific lipid transfer proteins (nsLTP) are present in many plant species and play an important role protecting plants from stressors such as heat or drought. In the last 20 years, sensitization to nsLTP and consequent reactions to plant foods has become an increasing concern. Aim The aim of this paper is to review the evidence for the structure and function of nsLTP allergens, and cross‐reactivity, sensitization, and epidemiology of nsLTP allergy. Materials and Methods A Task Force, supported by the European Academy of Allergy & Clinical Immunology (EAACI), reviewed current evidence and provide a signpost for future research. The search terms for this paper were “Non‐specific Lipid Transfer Proteins”, “LTP syndrome”, “Pru p 3”, “plant food allergy”, “pollen‐food syndrome”. Results Most nsLTP allergens have a highly conserved structure stabilised by 4‐disulphide bridges. Studies on the peach nsLTP, Pru p 3, demonstrate that nsLTPs are very cross‐reactive, with the four major IgE epitopes of Pru p 3 being shared by nsLTP from other botanically related fruits. These nsLTP allergens are to varying degrees resistant to heat and digestion, and sensitization may occur through the oral, inhaled or cutaneous routes. In some populations, Pru p 3 is the primary and sole sensitizing allergen, but many are poly‐sensitised both to botanically un‐related nsLTP in foods, and non‐food sources of nsLTP such as Cannabis sativa, Platanus acerifolia, (plane tree), Ambrosia artemisiifolia (ragweed) and Artemisia vulgaris (mugwort). Initially, nsLTP sensitization appeared to be limited to Mediterranean countries, however more recent studies suggest clinically relevant sensitization occurs in North Atlantic regions and also countries in Northern Europe, with nsLTP sensitisation profiles being broadly similar. Discussion These robust allergens have the potential to sensitize and provoke symptoms to a large number of plant foods, including those which are raw, cooked or processed. It is unknown why some sensitized individuals develop clinical symptoms to foods whereas others do not, or indeed what other allergens besides Pru p 3 may be primary sensitising allergens. It is clear that these allergens are also relevant in non‐Mediterranean populations and there needs to be more recognition of this. Conclusion Non‐specific LTP allergens, present in a wide variety of plant foods and pollens, are structurally robust and so may be present in both raw and cooked foods. More studies are needed to understand routes of sensitization and the world‐wide prevalence of clinical symptoms associated with sensitization to these complex allergens.
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Affiliation(s)
- Isabel J Skypala
- Department of Allergy & Clinical Immunology Royal Brompton & Harefield NHS Foundation Trust Imperial College London UK
| | - Ricardo Asero
- Ambulatorio di Allergologia Clinica San Carlo Milan Italy
| | - Domingo Barber
- IMMA School of Medicine Universidad San Pablo CEU CEU Universities Madrid Spain.,RETIC ARADYAL RD16/0006/0015 Instituto de Salud Carlos III Madrid Spain
| | - Lorenzo Cecchi
- SOS Allergy and Clinical Immunology USL Toscana Centro Prato Italy
| | - Arazeli Diaz Perales
- Departamento de Biotecnología-Biología Vegetal Centro de Biotecnología y Genómica de Plantas (CBGP, UPM-INIA) Universidad Politécnica de Madrid Madrid Spain
| | | | - Elide A Pastorello
- Unit of Allergology and Immunology ASST Grande Ospedale Metropolitano Niguarda University of Milan Milan Italy
| | - Ines Swoboda
- Biotechnology Section FH Campus Wien University of Applied Sciences Vienna Austria
| | - Joan Bartra
- Hospital Clinic de Barcelona IDIBAPS Universitat de Barcelona ARADyAL Barcelona Spain
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence Faculty of Medicine and Health Sciences University of Antwerp and Antwerp University Hospital Ghent Belgium
| | - Margaretha A Faber
- Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence Faculty of Medicine and Health Sciences University of Antwerp and Antwerp University Hospital Ghent Belgium
| | - Montserrat Fernández-Rivas
- Department of Allergy Hospital Clínico San Carlos Universidad Complutense de Madrid IdISSC, ARADyAL Madrid Spain
| | - Francesca Gomez
- Allergy Unit IBIMA- Hospital Regional Universitario de Malaga Malaga and Spanish Network for Allergy - RETICS de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | | | - Olga Luengo
- Allergy Unit, Internal Medicine Department Vall d'Hebron University Hospital Universitat Autònoma de Barcelona ARADyAL Barcelona Spain
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology Amsterdam University Medical Centers location AMC Amsterdam The Netherlands
| | - Enrico Scala
- Experimental Allergy Unit Istituto Dermopatico Dell'immacolata IRCCS FLMM Rome Italy
| | - Stephen J Till
- Peter Gorer Department of Immunobiology King's College London London UK.,Department of Allergy Guy's & St Thomas' NHS Foundation Trust London UK
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30
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Muñoz‐Cano RM, Casas R, Araujo G, de la Cruz C, Martin M, Roca‐Ferrer J, Perez M, Torradeflot M, San Bartolome C, Picado C, Bartra J, Pascal M. Prostaglandin E2 decreases basophil activation in patients with food-induced anaphylaxis. Allergy 2021; 76:1556-1559. [PMID: 33029821 DOI: 10.1111/all.14615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/24/2020] [Accepted: 09/30/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Rosa M. Muñoz‐Cano
- Pneumology Department Allergy Section, Hospital Clinic Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Rocio Casas
- Pneumology Department Allergy Section, Hospital Clinic Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Giovanna Araujo
- Pneumology Department Allergy Section, Hospital Clinic Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
| | - Cinthia de la Cruz
- Pneumology Department Allergy Section, Hospital Clinic Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
| | - Margarita Martin
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- ARADyAL Instituto de Salud Carlos III Madrid Spain
- Faculty of Medicine, Biochemistry Unit University of Barcelona Barcelona Spain
| | - Jordi Roca‐Ferrer
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Centro de Investigaciones Biomedicas en Red de Enfermedades Respiratorias (CIBERES) Madrid Spain
| | - Maria Perez
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
| | - Maria Torradeflot
- Immunology Department Centre de Diagnostic Biomedic (CDB) Hospital Clínic Universitat de Barcelona Barcelona Spain
| | - Clara San Bartolome
- Immunology Department Centre de Diagnostic Biomedic (CDB) Hospital Clínic Universitat de Barcelona Barcelona Spain
| | - Cesar Picado
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
| | - Joan Bartra
- Pneumology Department Allergy Section, Hospital Clinic Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- ARADyAL Instituto de Salud Carlos III Madrid Spain
| | - Mariona Pascal
- Clinical and Experimental Respiratory Immunoallergy (IRCE) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Immunology Department Centre de Diagnostic Biomedic (CDB) Hospital Clínic Universitat de Barcelona Barcelona Spain
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31
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Sánchez‐López J, Araujo G, Cardona V, García‐Moral A, Casas‐Saucedo R, Guilarte M, Torres MJ, Doña I, Picado C, Pascal M, Muñoz‐Cano R, Bartra J. Food-dependent NSAID-induced hypersensitivity (FDNIH) reactions: Unraveling the clinical features and risk factors. Allergy 2021; 76:1480-1492. [PMID: 33289951 DOI: 10.1111/all.14689] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 10/10/2020] [Accepted: 10/19/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND In up to 70%-80% of patients with a suspected non-steroidal anti-inflammatory drug hypersensitivity (NSAIDH), challenge tests with the culprit drug yield negative results. On the other hand, there could be a NSAIDH overdiagnosis when anaphylaxis is the clinical manifestation. We hypothesize that some negative NSAID challenge tests and an overdiagnosis of NSAIDH occur in patients with food-dependent NSAID-induced hypersensitivity (FDNIH). METHODS We studied 328 patients with a suspected acute NSAIDH. FDNIH was diagnosed in patients meeting all the following: (1) tolerance to the food ingested more temporally closed before the reaction, later the episode, (2) respiratory or cutaneous symptoms or anaphylaxis related to NSAID, (3) positive skin prick test to foods and/or specific IgE to food allergens (Pru p 3, Tri a 19, Pen a 1) involved in the reaction, and (4) negative oral provocation test to the culprit NSAID. RESULTS 199 patients (60%) were diagnosed with NSAIDH and 52 (16%) with FDNIH. Pru p 3 was involved in 44 cases (84.6%) and Tri a 19 in 6 cases (11%). FDNIH subjects were younger (p < .001), with a higher prevalence of rhinitis (p < .001) and previous food allergy (p < .001), together with a higher proportion of subjects sensitized to pollens (p < .001) and foods (p < .001). Using just four variables (Pru p 3 sensitization, Tri a 19 sensitization, anaphylaxis, and any NSAID different from pyrazolones), 95.3% of cases were correctly classified, with a sensitivity of 92% and specificity of 96%. CONCLUSION Evaluation of FDNIH should be included in the diagnostic workup of NSAIDH.
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Affiliation(s)
- Jaime Sánchez‐López
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Giovanna Araujo
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Victoria Cardona
- Department of Internal medicine, Allergy Section Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Barcelona Spain
- Vall d'Hebron Research Institute Allergy Research Unit Barcelona Spain
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Alba García‐Moral
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Rocío Casas‐Saucedo
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Mar Guilarte
- Department of Internal medicine, Allergy Section Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Barcelona Spain
- Vall d'Hebron Research Institute Allergy Research Unit Barcelona Spain
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - María José Torres
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Allergy Unit Hospital Regional Universitario de Málaga Malaga Spain
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA Malaga Spain
| | - Inmaculada Doña
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Allergy Unit Hospital Regional Universitario de Málaga Malaga Spain
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA Malaga Spain
| | - Cesar Picado
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- CIBERES CIBER of Respiratory Diseases Madrid Spain
| | - Mariona Pascal
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Immunology Department Centre de Diagnòstic Biomèdic (CDB) Hospital Clínic de Barcelona Barcelona Spain
| | - Rosa Muñoz‐Cano
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Joan Bartra
- Department of Pulmonology and Respiratory Allergy Allergy Section Hospital Clinic Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy—RETIC de Asma, Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
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32
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Jurado-Escobar R, Doña I, Triano-Cornejo J, Perkins JR, Pérez-Sánchez N, Testera-Montes A, Labella M, Bartra J, Laguna JJ, Estravís M, Agúndez JAG, Torres MJ, Cornejo-García JA. Genetic Variants in Cytosolic Phospholipase A2 Associated With Nonsteroidal Anti-Inflammatory Drug-Induced Acute Urticaria/Angioedema. Front Pharmacol 2021; 12:667824. [PMID: 33995098 PMCID: PMC8120030 DOI: 10.3389/fphar.2021.667824] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022] Open
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the main triggers of drug hypersensitivity reactions, probably due to their high consumption worldwide. The most frequent type of NSAID hypersensitivity is NSAID cross-hypersensitivity, in which patients react to NSAIDs from different chemical groups in the absence of a specific immunological response. The underlying mechanism of NSAID cross-hypersensitivity has been linked to cyclooxygenase (COX)-1 inhibition causing an imbalance in the arachidonic acid pathway. Despite NSAID-induced acute urticaria/angioedema (NIUA) being the most frequent clinical phenotype, most studies have focused on NSAID-exacerbated respiratory disease. As NSAID cross-hypersensitivity reactions are idiosyncratic, only appearing in some subjects, it is believed that individual susceptibility is under the influence of genetic factors. Although associations with polymorphisms in genes from the AA pathway have been described, no previous study has evaluated the potential role of cytosolic phospholipase A2 (cPLA2) variants. This enzyme catalyzes the initial hydrolysis of membrane phospholipids to release AA, which can be subsequently metabolized into eicosanoids. Here, we analyzed for the first time the overall genetic variation in the cPLA2 gene (PLA2G4A) in NIUA patients. For this purpose, a set of tagging single nucleotide polymorphisms (tagSNPs) in PLA2G4A were selected using data from Europeans subjects in the 1,000 Genomes Project, and genotyped with the iPlex Sequenom MassArray technology. Two independent populations, each comprising NIUA patients and NSAID-tolerant controls, were recruited in Spain, for the purposes of discovery and replication, comprising a total of 1,128 individuals. Fifty-eight tagSNPs were successfully genotyped in the discovery cohort, of which four were significantly associated with NIUA after Bonferroni correction (rs2049963, rs2064471, rs12088010, and rs12746200). These polymorphisms were then genotyped in the replication cohort: rs2049963 was associated with increased risk for NIUA after Bonferroni correction under the dominant and additive models, whereas rs12088010 and rs12746200 were protective under these two inheritance models. Our results suggest a role for PLA2G4A polymorphisms in NIUA. However, further studies are required to replicate our findings, elucidate the mechanistic role, and evaluate the participation of PLA2G4A variants in other phenotypes induced by NSAID cross-hypersensitivity.
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Affiliation(s)
- Raquel Jurado-Escobar
- Allergy Research Group, Instituto De Investigación Biomédica De Málaga-IBIMA, Malaga, Spain.,Departamento De Medicina, Universidad De Málaga, Malaga, Spain
| | - Inmaculada Doña
- Allergy Research Group, Instituto De Investigación Biomédica De Málaga-IBIMA, Malaga, Spain.,Allergy Unit, Hospital Regional Universitario De Málaga, Malaga, Spain.,ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain
| | - José Triano-Cornejo
- Allergy Research Group, Instituto De Investigación Biomédica De Málaga-IBIMA, Malaga, Spain
| | - James R Perkins
- Department of Molecular Biology and Biochemistry, University of Malaga, Malaga, Spain.,CIBER De Enfermedades Raras (CIBERER), ISCIII, Madrid, Spain.,The Biomedical Research Institute of Malaga (IBIMA), Malaga, Spain
| | | | | | - Marina Labella
- Allergy Unit, Hospital Regional Universitario De Málaga, Malaga, Spain
| | - Joan Bartra
- ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain.,Allergy Section, Pneumology Department, Hospital Clinic, Universitat De Barcelona, Barcelona, Spain
| | - José J Laguna
- ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain.,Allergy Unit, Allergo-Anaesthesia Unit, Hospital Central De La Cruz Roja, Faculty of Medicine, Alfonso X El Sabio University, Madrid, Spain
| | - Miguel Estravís
- ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain.,Instituto De Investigación Biomédica De Salamanca (IBSAL), Salamanca, Spain
| | - José A G Agúndez
- ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain.,Institute of Molecular Pathology Biomarkers, UEx, Cáceres, Spain
| | - María J Torres
- Allergy Research Group, Instituto De Investigación Biomédica De Málaga-IBIMA, Malaga, Spain.,Departamento De Medicina, Universidad De Málaga, Malaga, Spain.,Allergy Unit, Hospital Regional Universitario De Málaga, Malaga, Spain.,ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain.,Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Malaga, Spain
| | - José A Cornejo-García
- Allergy Research Group, Instituto De Investigación Biomédica De Málaga-IBIMA, Malaga, Spain.,ARADyAL Network, Instituto De Salud Carlos III, Madrid, Spain
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33
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Bousquet J, Anto JM, Czarlewski W, Haahtela T, Fonseca SC, Iaccarino G, Blain H, Vidal A, Sheikh A, Akdis CA, Zuberbier T, Hamzah Abdul Latiff A, 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 IJ, Anto J, Ara Bardajo P, Arasi S, Arshad H, Cristina Artesani M, Asayag E, Avolio F, Azhari K, Bachert C, Bagnasco D, Baiardini I, Bajrović N, Bakakos P, Bakeyala Mongono S, Balotro‐Torres C, Barba S, Barbara C, Barbosa E, Barreto B, Bartra J, Bateman ED, Battur L, Bedbrook A, Bedolla Barajas M, Beghé B, Bekere A, Bel E, Ben Kheder A, Benson M, Berghea EC, Bergmann K, Bernardini R, Bernstein D, Bewick M, Bialek S, Białoszewski A, Bieber T, Billo NE, Bilo MB, 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, Bourret R, Bousquet P, Braido F, Briggs A, Brightling CE, Brozek J, Brussino L, Buhl R, Bumbacea R, Buquicchio R, Burguete Cabañas M, Bush A, Busse WW, Buters J, Caballero‐Fonseca F, Calderon MA, Calvo M, Camargos P, Camuzat T, Canevari F, Cano A, Canonica GW, Capriles‐Hulett A, Caraballo L, Cardona V, Carlsen K, Carmon Pirez J, Caro J, Carr W, Carreiro‐Martins P, Carreon‐Asuncion F, Carriazo A, Casale T, Castor M, Castro E, Caviglia A, Cecchi L, Cepeda Sarabia A, Chandrasekharan R, Chang Y, Chato‐Andeza V, Chatzi L, Chatzidaki C, Chavannes NH, Chaves Loureiro C, Chelninska M, Chen Y, Cheng L, Chinthrajah S, Chivato T, Chkhartishvili E, Christoff G, Chrystyn H, Chu DK, Chua A, Chuchalin A, Chung KF, Cicerán A, Cingi C, Ciprandi G, Cirule I, Coelho AC, Compalati E, Constantinidis J, Correia de Sousa J, Costa EM, Costa D, Costa Domínguez MDC, Coste A, Cottini M, Cox L, Crisci C, Crivellaro MA, Cruz AA, Cullen J, Custovic A, Cvetkovski B, Czarlewski W, D'Amato G, Silva J, Dahl R, Dahlen S, Daniilidis V, DarjaziniNahhas L, Darsow U, Davies J, Blay F, De Feo G, De Guia E, 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 AT, Djukanovic R, Do Ceu Texeira M, Dokic D, Dominguez Silva MG, 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 ZA, El‐Sayed SS, El‐Seify M, Emuzyte R, Enecilla L, Erhola M, Espinoza H, Espinoza Contreras JG, Farrell J, Fernandez L, Fink Wagner A, Fiocchi A, Fokkens WJ, Lenia F, Fonseca JA, Fontaine J, Forastiere F, Fuentes Pèrez JM, Gaerlan–Resureccion E, Gaga M, Gálvez Romero JL, Gamkrelidze A, Garcia A, García Cobas CY, García Cruz MDLLH, Gayraud J, Gelardi M, Gemicioglu B, Gennimata D, Genova S, Gereda J, Gerth van Wijk R, Giuliano A, Gomez M, González Diaz S, Gotua M, Grigoreas C, Grisle I, Gualteiro L, Guidacci M, Guldemond N, Gutter Z, Guzmán A, Halloum R, Halpin D, Hamelmann E, Hammadi S, Harvey R, Heffler E, Heinrich J, Hejjaoui A, Hellquist‐Dahl B, Hernández Velázquez L, Hew M, Hossny E, Howarth P, Hrubiško M, Huerta Villalobos YR, Humbert M, Salina H, Hyland M, Ibrahim M, Ilina N, Illario M, Incorvaia C, Infantino A, Irani C, Ispayeva Z, Ivancevich J, E.J. Jares E, Jarvis D, Jassem E, Jenko K, Jiméneracruz Uscanga RD, Johnston SL, Joos G, Jošt M, Julge K, Jung K, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu F, Kapsali J, Kardas P, Karjalainen J, Kasala CA, Katotomichelakis M, Kavaliukaite L, Kazi BS, Keil T, Keith P, Khaitov M, Khaltaev N, Kim Y, Kirenga B, Kleine‐Tebbe J, Klimek L, Koffi N’Goran B, Kompoti E, Kopač P, Koppelman G, KorenJeverica A, Koskinen S, Košnik M, Kostov KV, Kowalski ML, Kralimarkova T, Kramer Vrščaj 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, Lau S, Laune D, Lavrut J, Le L, Lenzenhuber M, Lessa M, Levin M, Li J, Lieberman P, Liotta G, Lipworth B, Liu X, Lobo R, Lodrup Carlsen KC, Lombardi C, Louis R, Loukidis S, Lourenço O, Luna Pech JA, Madjar B, Maggi E, Magnan A, Mahboub B, Mair A, Mais Y, Maitland van der Zee A, Makela M, Makris M, Malling H, Mandajieva M, Manning P, Manousakis M, Maragoudakis P, Marseglia G, Marshall G, Reza Masjedi M, Máspero JF, Matta Campos JJ, Maurer M, Mavale‐Manuel S, Meço C, Melén E, Melioli G, Melo‐Gomes E, Meltzer EO, Menditto E, Menzies‐Gow A, Merk H, Michel J, Micheli Y, Miculinic N, Midão L, Mihaltan F, Mikos N, Milanese M, Milenkovic B, Mitsias D, Moalla B, Moda G, Mogica Martínez MD, Mohammad Y, Moin M, Molimard M, Momas I, Mommers M, Monaco A, Montefort S, Mora D, Morais‐Almeida M, Mösges R, Mostafa B, Mullol J, Münter L, Muraro A, Murray R, Musarra A, Mustakov T, Naclerio R, Nadeau KC, 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, Odjakova C, Ohta K, Okamoto Y, Okubo K, Oliver B, Onorato GL, Pia Orru M, Ouédraogo S, Ouoba K, Paggiaro PL, Pagkalos A, Pajno G, Pala G, Palaniappan S, Pali‐Schöll I, Palkonen S, Palmer S, Panaitescu Bunu C, Panzner P, Papadopoulos NG, Papanikolaou V, Papi A, Paralchev B, Paraskevopoulos G, Park H, Passalacqua G, Patella V, Pavord I, Pawankar R, Pedersen S, Peleve S, Pellegino S, Pereira A, Pérez 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 TA, Portejoie F, Potter P, Poulsen L, Prados‐Torres A, Prarros F, Price D, Prokopakis E, Puggioni F, Puig‐Domenech E, Puy R, Rabe K, Raciborski F, Ramos J, Recto MT, Reda SM, Regateiro FS, Reider N, Reitsma S, Repka‐Ramirez S, Ridolo E, Rimmer J, Rivero Yeverino D, Angelo Rizzo J, Robalo‐Cordeiro C, Roberts G, Roche N, Rodríguez González M, Rodríguez 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, Rovina N, Rozman Sinur I, Ruiz M, Ruiz Segura LT, Ryan D, Sagara H, Sakai D, Sakurai D, Saleh W, Salimaki J, Samitas K, Samolinski B, Sánchez Coronel MG, Sanchez‐Borges M, Sanchez‐Lopez J, Sarafoleanu C, Sarquis Serpa F, Sastre‐Dominguez J, Savi E, Sawaf B, Scadding GK, Scheire S, Schmid‐Grendelmeier P, Schuhl JF, Schunemann H, Schvalbová M, Schwarze J, Scichilone N, Senna G, Sepúlveda C, Serrano E, Shields M, Shishkov V, Siafakas N, Simeonov A, FER Simons E, Carlos Sisul J, Sitkauskiene B, Skrindo I, SokličKošak T, Solé D, Sooronbaev T, Soto‐Martinez M, Soto‐Quiros M, Sousa Pinto B, Sova M, Soyka M, Specjalski K, 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, Ping Tang I, Taniguchi M, Tannert L, Tantilipikorn P, Tattersall J, Tesi F, Thijs C, Thomas M, To T, Todo‐Bom A, Togias A, Tomazic P, Tomic‐Spiric V, Toppila‐Salmi S, Toskala E, Triggiani M, Triller N, Triller K, Tsiligianni I, Uberti M, Ulmeanu R, Urbancic J, Urrutia Pereira M, Vachova M, Valdés F, Valenta R, Valentin Rostan M, Valero A, Valiulis A, Vallianatou M, Valovirta E, Van Eerd M, Van Ganse E, Hage M, Vandenplas O, Vasankari T, Vassileva D, Velasco Munoz C, Ventura MT, Vera‐Munoz C, 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, Wang DY, Waserman S, Wickman M, Williams S, Williams D, Wilson N, Wong G, Woo K, Wright J, Wroczynski P, Xepapadaki P, Yakovliev P, Yamaguchi M, Yan K, Yeow Yap Y, Yawn B, Yiallouros P, Yorgancioglu A, Yoshihara S, Young I, Yusuf OB, Zaidi A, Zaitoun F, Zar H, Zedda M, Zernotti ME, Zhang L, Zhong N, Zidarn M, Zubrinich C. Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19. Allergy 2021; 76:735-750. [PMID: 32762135 PMCID: PMC7436771 DOI: 10.1111/all.14549] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022]
Abstract
Large differences in COVID‐19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS‐CoV‐2 binds to its receptor, the angiotensin‐converting enzyme 2 (ACE2). As a result of SARS‐CoV‐2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT1R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID‐19. The nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT1R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof‐of‐concept of dietary manipulations that may enhance Nrf2‐associated antioxidant effects, helpful in mitigating COVID‐19 severity.
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Affiliation(s)
- Jean Bousquet
- Charité Universitätsmedizin BerlinHumboldt‐Universität zu Berlin Berlin Germany
- Department of Dermatology and Allergy Berlin Institute of HealthComprehensive Allergy Center Berlin Germany
- MACVIA‐France and CHU Montpellier France
| | - Josep M. Anto
- Centre for Research in Environmental Epidemiology (CREAL) ISGlobAL Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | | | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Finland
| | - Susana C. Fonseca
- Faculty of Sciences GreenUPorto ‐ Sustainable Agrifood Production Research Centre DGAOTUniversity of Porto Porto Portugal
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences Federico II University Napoli Italy
| | - Hubert Blain
- Department of Geriatrics Montpellier University hospital and MUSE Montpellier France
| | - Alain Vidal
- World Business Council for Sustainable Development (WBCSD) Geneva Switzerland
- AgroParisTech ‐ Paris Institute of Technology for Life, Food and Environmental Sciences Paris France
| | - Aziz Sheikh
- Usher Institute University of Edinburgh Scotland, UK
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Torsten Zuberbier
- Charité Universitätsmedizin BerlinHumboldt‐Universität zu Berlin Berlin Germany
- Department of Dermatology and Allergy Berlin Institute of HealthComprehensive Allergy Center Berlin Germany
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Muñoz-Cano R, San Bartolome C, Casas-Saucedo R, Araujo G, Gelis S, Ruano-Zaragoza M, Roca-Ferrer J, Palomares F, Martin M, Bartra J, Pascal M. Immune-Mediated Mechanisms in Cofactor-Dependent Food Allergy and Anaphylaxis: Effect of Cofactors in Basophils and Mast Cells. Front Immunol 2021; 11:623071. [PMID: 33679712 PMCID: PMC7925840 DOI: 10.3389/fimmu.2020.623071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/31/2020] [Indexed: 12/19/2022] Open
Abstract
Cofactors may explain why in some cases food ingestion leads to anaphylaxis while in others elicits a milder reaction or tolerance. With cofactors, reactions become more severe and/or have a lower allergen threshold. Cofactors are present in up to 58% of food anaphylaxis (FAn). Exercise, NSAIDs, and alcohol are the most frequently described, although the underlying mechanisms are poorly known. Several hypotheses have suggested the influence of these cofactors on basophils and mast cells (MCs). Exercise has been suggested to enhance MC activation by increasing plasma osmolarity, redistributing blood flow, and activating adenosine and eicosanoid metabolism. NSAIDs’ cofactor effect has been related with cyclooxygenase inhibition and therefore, prostaglandin E2 (PGE2) production. Indeed, overexpression of adenosine receptor 3 (A3) gene has been described in NSAID-dependent FAn; A3 activation potentiates FcϵRI-induced MC degranulation. Finally, alcohol has been related with an increase of histamine levels by inhibition of diamino oxidase (DAO) and also with and increase of extracellular adenosine by inhibition of its uptake. However, most of these mechanisms have limited evidence, and further studies are urgently needed. In conclusion, the study of the immune-related mechanisms involved in food allergic reactions enhanced by cofactors is of the utmost interest. This knowledge will help to design both tailored treatments and prophylactic strategies that, nowadays, are non-existent.
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Affiliation(s)
- Rosa Muñoz-Cano
- Allergy Section, Pneumology Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Barcelona, Spain.,Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Clara San Bartolome
- Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain.,Immunology Department, Centre de Diagnostic Biomedic (CDB), Hospital Clínic, Barcelona, Spain
| | - Rocío Casas-Saucedo
- Allergy Section, Pneumology Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Barcelona, Spain.,Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain
| | - Giovanna Araujo
- Allergy Section, Pneumology Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Barcelona, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain
| | - Sonia Gelis
- Allergy Section, Pneumology Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Barcelona, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain
| | - Maria Ruano-Zaragoza
- Allergy Section, Pneumology Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Barcelona, Spain.,Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain
| | - Jordi Roca-Ferrer
- Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Francis Palomares
- Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Margarita Martin
- Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain.,Biochemistry Unit, University of Barcelona Faculty of Medicine and Health Sciences, Barcelona, Spain
| | - Joan Bartra
- Allergy Section, Pneumology Department, Institut Clinic Respiratori (ICR), Hospital Clinic, Barcelona, Spain.,Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Mariona Pascal
- Asma, Reacciones Adversas y Alergia (ARADyAL), Instituto de Salud Carlos III, Madrid, Spain.,Immunoalergia Respiratoria y Experimental - Institut d'Investigacions Biomediques August Pi i Sunyer (IRCE-IDIBAPS), Barcelona, Spain.,Immunology Department, Centre de Diagnostic Biomedic (CDB), Hospital Clínic, Barcelona, Spain
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García-Martín E, García-Menaya JM, Esguevillas G, Cornejo-García JA, Doña I, Jurado-Escobar R, Torres MJ, Blanca-López N, Canto G, Blanca M, Laguna JJ, Bartra J, Rosado A, Fernández J, Cordobés C, Agúndez JAG. Deep sequencing of prostaglandin-endoperoxide synthase (PTGE) genes reveals genetic susceptibility for cross-reactive hypersensitivity to NSAID. Br J Pharmacol 2021; 178:1218-1233. [PMID: 33450044 DOI: 10.1111/bph.15366] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Cross-reactive hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) is a relatively common adverse drug event caused by two or more chemically unrelated drugs and that is attributed to inhibition of the COX activity, particularly COX-1. Several studies investigated variations in the genes coding for COX enzymes as potential risk factors. However, these studies only interrogated a few single nucleotide variations (SNVs), leaving untested most of the gene sequence. EXPERIMENTAL APPROACH In this study, we analysed the whole sequence of the prostaglandin-endoperoxide synthase genes, PTGS1 and PTGS2, including all exons, exon-intron boundaries and both the 5' and 3' flanking regions in patients with cross-reactive hypersensitivity to NSAIDs and healthy controls. After sequencing analysis in 100 case-control pairs, we replicated the findings in 540 case-control pairs. Also, we analysed copy number variations for both PTGS genes. KEY RESULTS The most salient finding was the presence of two PTGS1 single nucleotide variations, which are significantly more frequent in patients than in control subjects. Patients carrying these single nucleotide variations displayed a significantly and markedly lower COX-1 activity as compared to non-carriers for both heterozygous and homozygous patients. CONCLUSION AND IMPLICATIONS Although the risk single nucleotide variations are present in a small proportion of patients, the strong association observed and the functional effect of these single nucleotide variations raise the hypothesis of genetic susceptibility to develop cross-reactive NSAID hypersensitivity in individuals with an impairment in COX-1 enzyme activity.
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Affiliation(s)
- Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, University of Extremadura. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - Jesús M García-Menaya
- Allergy Service, Badajoz University Hospital. ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - Gara Esguevillas
- University Institute of Molecular Pathology Biomarkers, University of Extremadura. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A Cornejo-García
- Research Laboratory, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Inmaculada Doña
- Allergy Unit, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Raquel Jurado-Escobar
- Research Laboratory, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - María J Torres
- Allergy Unit, IBIMA, ARADyAL Instituto de Salud Carlos III, Regional University Hospital of Málaga, UMA, Málaga, Spain
| | - Natalia Blanca-López
- Allergy Service, ARADyAL Instituto de Salud Carlos III, Infanta Leonor University Hospital, Madrid, Spain
| | - Gabriela Canto
- Allergy Service, ARADyAL Instituto de Salud Carlos III, Infanta Leonor University Hospital, Madrid, Spain
| | - Miguel Blanca
- Allergy Service, ARADyAL Instituto de Salud Carlos III, Infanta Leonor University Hospital, Madrid, Spain
| | - José J Laguna
- Allergy Unit and Allergy-Anaesthesia Unit, ARADyAL Instituto de Salud Carlos III, Hospital Central Cruz Roja, Madrid, Spain
| | - Joan Bartra
- Allergy Section, Pneumology Department, Hospital Clinic, ARADyAL Instituto de Salud Carlos III, Universitat de Barcelona, Barcelona, Spain
| | - Ana Rosado
- Allergy Service, Alcorcón Hospital, Madrid, Spain
| | - Javier Fernández
- Allergy Unit, ARADyAL Instituto de Salud Carlos III, Regional University Hospital, Alicante, Spain
| | - Concepción Cordobés
- Allergy Service, Badajoz University Hospital. ARADyAL Instituto de Salud Carlos III, Badajoz, Spain
| | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, University of Extremadura. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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Ruiz-Garcia M, Bartra J, Alvarez O, Lakhani A, Patel S, Tang A, Sim M, Shamji MH, Skypala I, Mills ENC, Lyon AR, Hayward C, Durham SR, Turner PJ, Boyle RJ. Cardiovascular changes during peanut-induced allergic reactions in human subjects. J Allergy Clin Immunol 2021; 147:633-642. [PMID: 32707226 PMCID: PMC7858218 DOI: 10.1016/j.jaci.2020.06.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/30/2020] [Accepted: 06/11/2020] [Indexed: 10/26/2022]
Abstract
BACKGROUND Food allergy is the most common cause of anaphylaxis. Changes in posture during acute reactions can trigger fatal outcomes, but the impact of allergic reactions on the cardiovascular system in nonfatal reactions remains poorly understood. OBJECTIVE Our aim was to systematically evaluate changes in cardiovascular function during acute allergic reactions to peanut. METHODS Participants underwent double-blind placebo-controlled food challenge to peanut as part of a clinical trial. Changes in hemodynamic parameters (heart rate, stroke volume, blood pressure, and peripheral blood flow) and electrocardiogram findings during food challenges were assessed using noninvasive continuous monitoring. RESULTS A total of 57 adults (median age 24 years [interquartile range = 20-29]), 53% of whom were female, participated; 22 (39%) had anaphylaxis. Acute reactions were associated with significant changes in stroke volume (mean decrease of 4.2% [95% CI = 0.8-7.6; P = .03]), heart rate (mean increase 11.6% [95% CI = 8.4-14.8; P < .0001]), and peripheral blood flow (mean increase 19.7% [95% CI = 10.8-28.6; P < .0001]), irrespective of reaction severity. These changes were reproduced at a subsequent repeat peanut challenge in 26 participants, and could be reversed with administration of intravenous fluids which resulted in faster resolution of abdominal symptoms. CONCLUSIONS In this first detailed human study of cardiovascular changes during food-induced allergic reactions, we found evidence for significant fluid redistribution, independent of reaction severity. This provides a sound rationale for optimizing venous return during significant allergic reactions to food. Finally, these data provide a new paradigm for understanding severity in anaphylaxis, in which poor outcomes may occur as a result of a failure in compensatory mechanisms.
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Affiliation(s)
- Monica Ruiz-Garcia
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Joan Bartra
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom; Hospital Clínic Barcelona, Barcelona, Spain
| | - Olaya Alvarez
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Ashna Lakhani
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Shalinee Patel
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Alistair Tang
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Marcus Sim
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Mohamed H Shamji
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Isabel Skypala
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, United Kingdom
| | - E N Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Alexander R Lyon
- Myocardial Function, National Heart & Lung Institute, Imperial College London, London, United Kingdom; Cardiology Department, Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, United Kingdom
| | - Carl Hayward
- Myocardial Function, National Heart & Lung Institute, Imperial College London, London, United Kingdom; Cardiology Department, Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, United Kingdom; Barts Health NHS Trust, London, United Kingdom
| | - Stephen R Durham
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom; Royal Brompton and Harefield Hospitals NHS Foundation Trust, London, United Kingdom
| | - Paul J Turner
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom.
| | - Robert J Boyle
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom
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Doña I, Jurado-Escobar R, Pérez-Sánchez N, Laguna JJ, Bartra J, Testera-Montes A, de Santa María RS, Torres MJ, Cornejo-García JA. Genetic Variants Associated With Drug-Induced Hypersensitivity Reactions: towards Precision Medicine? Curr Treat Options Allergy 2021. [DOI: 10.1007/s40521-020-00278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Eguiluz‐Gracia I, Testera‐Montes A, Salas M, Perez‐Sanchez N, Ariza A, Bogas G, Bartra J, Torres MJ, Rondon C. Comparison of diagnostic accuracy of acoustic rhinometry and symptoms score for nasal allergen challenge monitoring. Allergy 2021; 76:371-375. [PMID: 32687610 DOI: 10.1111/all.14499] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/18/2020] [Accepted: 07/11/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Ibon Eguiluz‐Gracia
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
| | - Almudena Testera‐Montes
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Universidad de Malaga (UMA) Malaga Spain
| | - Maria Salas
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
| | - Natalia Perez‐Sanchez
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
| | - Adriana Ariza
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
| | - Gador Bogas
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
| | - Joan Bartra
- Allergy Section, Pulmonology Unit Hospital ClinicUniversitat de Barcelona Barcelona Spain
- Clinical & Experimental Respiratory Immunoallergy (IRCE) Instituto de Investigaciones Biomedicas August Pi i Sunyer (IDIBAPS)‐ARADyAL Barcelona Spain
| | - Maria Jose Torres
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
- Universidad de Malaga (UMA) Malaga Spain
- Laboratory for Nanostructures for the Diagnosis and Treatment of Allergic Diseases Andalusian Center for Nanomedicine and Biotechnology (BIONAND) Malaga Spain
| | - Carmen Rondon
- Allergy Unit Hospital Regional Universitario de Malaga Malaga Spain
- Allergy Research Group Instituto de Investigacion Biomedica de Malaga‐IBIMA and ARADyAL Malaga Spain
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Bogas G, Muñoz‐Cano R, Mayorga C, Casas R, Bartra J, Pérez N, Pascal M, Palomares F, Torres MJ, Gómez F. Phenotyping peach-allergic patients sensitized to lipid transfer protein and analysing severity biomarkers. Allergy 2020; 75:3228-3236. [PMID: 32535938 DOI: 10.1111/all.14447] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/10/2020] [Accepted: 05/18/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Patients with peach allergy due to nsLTP sensitization constitute a heterogeneous group in terms of sensitization profile and severity. This could be due to the presence of additional allergies to pollens. The aim of this study was to analyse the clinical characteristics, sensitization profile and severity of reactions in peach-allergic patients sensitized to nsLTP from two Mediterranean areas with different pollen exposure. METHODS Patients with diagnosis of LTP allergy from the Allergy Unit of Hospital Regional Universitario de Malaga (HRUM) and Hospital Clinic de Barcelona (HCB) were prospectively included and classified into two groups; (a) LTP-monoallergic: those that presented reaction only with peach and (b) LTP-Allergy: those that presented reaction with peach and at least another plant-food containing LTP. RESULTS A total of 252 patients were included, 235 (93.2%) had LTP-syndrome and 17 (6.8%) were LTP-monoallergic. We found a higher percentage of anaphylaxis and delayed onset of symptoms in the LTP-monoallergic group (P = .02 and P = .04, respectively). Moreover, anaphylaxis was less frequent in patients with profilin sensitization (P = .03). The comparison of patients' data from HRUM with data from HCB showed differences in sensitization to olive tree pollen and profilin (P = .01 and P = .001, respectively). CONCLUSION This study was undertaken to characterize two large group of subjects from to two regions with differing exposures to pollen. We found that more than 90% of peach-allergic patients in both populations evolved to LTP-Allergy and showed an early onset. Profilin sensitization could be more useful as a severity biomarker than the number of nsLTP, aeroallergen sensitizations or sIgE levels. This could provide clues regarding sensitization and severity patterns that might be relevant in other geographical areas.
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Affiliation(s)
- Gador Bogas
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Rosa Muñoz‐Cano
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Cristobalina Mayorga
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Research Laboratory IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Rocio Casas
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
| | - Joan Bartra
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Natalia Pérez
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Mariona Pascal
- Allergy Section Pneumology Department IDIBAPS Universitat de Barcelona, Hospital Clínic Barcelona Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
| | - Francisca Palomares
- Research Laboratory IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - María José Torres
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
- Research Laboratory IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
| | - Francisca Gómez
- Allergy Unit IBIMA‐ Hospital Regional Universitario de Malaga Malaga Spain
- Spanish Network for Allergy ‐ RETICS de Asma Reacciones adversas y Alérgicas (ARADyAL) Madrid Spain
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Wangorsch A, Kulkarni A, Jamin A, Spiric J, Bräcker J, Brockmeyer J, Mahler V, Blanca‐López N, Ferrer M, Blanca M, Torres M, Gomez P, Bartra J, García‐Moral A, Goikoetxea MJ, Vieths S, Toda M, Zoccatelli G, Scheurer S. Identification and Characterization of IgE‐Reactive Proteins and a New Allergen (Cic a 1.01) from Chickpea (
Cicer arietinum
). Mol Nutr Food Res 2020; 64:e2000560. [DOI: 10.1002/mnfr.202000560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/04/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Andrea Wangorsch
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
| | - Anuja Kulkarni
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
- Amity University Mumbai India
| | - Annette Jamin
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
| | - Jelena Spiric
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
| | - Julia Bräcker
- Analytical Food Chemistry University of Stuttgart Allmandring 5B 70569 Stuttgart Germany
| | - Jens Brockmeyer
- Analytical Food Chemistry University of Stuttgart Allmandring 5B 70569 Stuttgart Germany
| | - Vera Mahler
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
| | | | - Marta Ferrer
- Department of Allergy, IdiSNA (Instituto de Investigación Sanitaria de Navarra) Clinica Universidad de Navarra Pio XII Pamplona 3631008 Spain
| | - Miguel Blanca
- Allergy Service Hospital Infanta Leonor Gran Via del Este 80 Madrid 28031 Spain
- Jefe de Servicio de Alergología Hospital Civil Plaza del Hospital Civil s/n, Pabellon 5, sotano Málaga 29009 Spain
| | - Maria Torres
- Jefe de Servicio de Alergología Hospital Civil Plaza del Hospital Civil s/n, Pabellon 5, sotano Málaga 29009 Spain
| | - Paqui Gomez
- Jefe de Servicio de Alergología Hospital Civil Plaza del Hospital Civil s/n, Pabellon 5, sotano Málaga 29009 Spain
| | - Joan Bartra
- Allergy Unit, Pneumology Department Clinic Hospital Sant Antoni Maria Claret, 167 Barcelona Catalunya 08025 Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) University of Barcelona Carrer del Rosselló, 149 Barcelona 08036 Spain
| | - Alba García‐Moral
- Allergy Unit, Pneumology Department Clinic Hospital Sant Antoni Maria Claret, 167 Barcelona Catalunya 08025 Spain
| | - María J. Goikoetxea
- Department of Allergy, IdiSNA (Instituto de Investigación Sanitaria de Navarra) Clinica Universidad de Navarra Pio XII Pamplona 3631008 Spain
| | - Stefan Vieths
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
| | - Masako Toda
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
- Laboratory of Food and Biomolecular Science, Graduate School of Agricultural Science Tohoku University Aramaki 468‐1, Aoba‐ku Sendai‐city 980‐8572 Japan
| | - Gianni Zoccatelli
- Department of Biotechnology University of Verona Strada le Grazie 15 Verona 37134 Italy
| | - Stephan Scheurer
- Division Allergology and Section Molecular Allergology Paul‐Ehrlich‐Institut Paul‐Ehrlich‐Str. 2 63225 Langen Germany
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Ivancevich JC, Cardona V, Larenas-Linnemann D, Mullol J, Neffen H, Zernotti M, Asayag E, Blua AE, Gómez RM, Jares E, Máspero J, Anto JM, Dedeu T, Rodríguez-González M, Huerta-Villalobos YR, Fuentes-Pérez JM, Rodríguez-Zagal E, Valero A, Bartra J, Alobid I, Castillo-Vizuete JA, Dordal T, Hijano R, Picado C, Sastre J, Bedolla-Barajas M, Burguete-Cabañas MT, Costa-Domínguez MDC, Domínguez-Silva M, Espinoza-Contreras JG, Gálvez-Romero JL, García-Cobas CY, García-Cruz MDLLH, Hernández-Velázquez L, Luna-Pech JA, Matta JJ, Mogica-Martínez MD, Rivero-Yeverino D, Ruiz LT, Del Río-Navarro BE, Gómez-Vera J, Macías-Weinmann A, Agache I, Ansotegui I, Bachert C, Bedbrook A, Canonica GW, Casale TB, Cruz Á, Fokkens W, Hellings P, Samolinski B, Bousquet J. [Executive Summary of ARIA 2019: Integrated care pathways for allergic rhinitis in Argentina, Spain and Mexico]. ACTA ACUST UNITED AC 2020; 66:409-425. [PMID: 32105425 DOI: 10.29262/ram.v66i4.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The health and economic impact of allergic diseases are increasing rapidly, and changes in management strategies are required. Its influence reduces the capacity of work and school performance by at least a third. The ICPs of the airways (integrated care pathways for respiratory diseases) are structured multidisciplinary healthcare plans, promoting the recommendations of the guidelines in local protocols and their application to clinical practice. This document presents an executive summary for Argentina, Mexico, and Spain. Next-generation ARIA guidelines are being developed for the pharmacological treatment of allergic rhinitis (AR), using the GRADE-based guidelines for AR, tested with real-life evidence provided by mobile technology with visual analogue scales. It is concluded that in the AR treatment, H1-antihistamines are less effective than intranasal corticosteroids (INCS), in severe AR the INCS represent the first line of treatment, and intranasal combination INCS + anti-H1 is more effective than monotherapy. However, according to the MASK real-life observational study, patients have poor adherence to treatment and often self-medicate, according to their needs.
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Garriga-Baraut T, Labrador-Horrillo M, Araujo G, Baltasar-Dragó MA, Basagaña-Torrento M, Campa-Falcon N, Cortés N, De Linares C, Esteso-Hontoria O, Ferré-Ybarz L, Gázquez-Garcia V, Miquel S, Padró-Casas C, Pedemonte C, Viñas M, Asensio O, Bartra J, Belmonte J, Bobolea I, Farrarons L, Muñoz-Cano R, Raga E, Moncín MDMSM. ImmunoCAT study: study of the impact of molecular diagnosis by ImmunoCAP ISAC® 112 on allergen Immunotherapy prescription in CATalonia. World Allergy Organ J 2020. [DOI: 10.1016/j.waojou.2020.100143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Torres MJ, Agundez J, Barber D, Bartra J, Davila I, Escribese MM, Fernandez-Rivas M, Ferrer M, Perez-Inestrosa E, Villalba M, Mayorga C. ARADyAL: The Spanish Multidisciplinary Research Network for Allergic Diseases. J Investig Allergol Clin Immunol 2020; 31:108-119. [PMID: 32694094 DOI: 10.18176/jiaci.0629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Thematic cooperative health research networks (RETICS) are organizational structures promoted by the Instituto de Salud Carlos III of the Spanish Ministry of Science with the objective of carrying out cooperative research projects addressing challenges of general interest for society as a whole in the field of health care. The RETICS of Asthma, Adverse Drug Reactions, and Allergy (ARADyAL) received funding in 2016 for a 5-year program (2017-2021). ARADyAL integrates basic and clinical research in the areas of allergy, immunology, genetics, nanomedicine, pharmacology, and chemistry, with special interest in research on new biomarkers and the design and evaluation of new interventions for allergic patients with severe phenotypes. The consortium comprises 28 groups across Spain, including 171 clinical and basic researchers, 17 clinical groups that cover more than 10 000 000 patients of all ages from urban and rural areas and 11 basic groups active mostly at universities and research institutes. ARADyAL has proposed a research program organized into 3 different areas focusing on precision medicine, as follows: Program 1, Mechanisms and prediction of adverse drug reactions and allergic diseases; Program 2, Toward a precise diagnosis of allergic diseases; and Program 3, Predicting interventions in allergic diseases. There is also 1 common program dedicated to training. The network has a Steering Committee and an External Advisory Scientific Committee, which advise the global network coordinator, who has recognized expertise in the field. ARADyAL is a unique meeting point for clinicians and basic scientists who are already working in allergy.
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Affiliation(s)
- M J Torres
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, ARADyAL, Málaga, Spain.,Allergy Clinical Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.,Centro Andaluz de Nanomedicina y Biotecnología-BIONAND, Málaga, Spain.,Medicine Department, Universidad de Málaga-UMA, Málaga, Spain
| | - J Agundez
- University Institute of Molecular Pathology Biomarkers, UEx, Cáceres; ARADyAL Instituto de Salud Carlos III, Spain
| | - D Barber
- School of Medicine, Institute for Applied Molecular Medicine, Universidad CEU San Pablo, Madrid, Spain
| | - J Bartra
- Allergy Section, Pneumology Department, Institut Clínic Respiratori (ICR), Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - I Davila
- Allergy Service, University Hospital of Salamanca, Department of Biomedical and Diagnostics Sciences, School of Medicine, University of Salamanca, Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - M M Escribese
- School of Medicine, Department of Basic Medical Sciences, Universidad CEU San Pablo, Madrid, Spain
| | - M Fernandez-Rivas
- Allergy Department, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
| | - M Ferrer
- Department of Allergy and Clinical Immunology, Clinica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - E Perez-Inestrosa
- Centro Andaluz de Nanomedicina y Biotecnología-BIONAND, Málaga, Spain.,Departamento de Química Orgánica, Universidad de Málaga-IBIMA, Málaga, Spain
| | - M Villalba
- Biochemistry and Molecular Biology Department, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, Madrid, Spain
| | - C Mayorga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, ARADyAL, Málaga, Spain.,Allergy Clinical Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.,Centro Andaluz de Nanomedicina y Biotecnología-BIONAND, Málaga, Spain
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Lloret J, Abós-Herràndiz R, Alemany S, Allué R, Bartra J, Basagaña M, Berdalet E, Campàs M, Carreño A, Demestre M, Diogène J, Fontdecaba E, Gascon M, Gómez S, Izquierdo A, Mas L, Marquès M, Pedro-Botet J, Pery M, Peters F, Pintó X, Planas M, Sabatés A, San J, Sanchez-Vidal A, Trepat M, Vendrell C, Fleming LE. The Roses Ocean and Human Health Chair: A New Way to Engage the Public in Oceans and Human Health Challenges. Int J Environ Res Public Health 2020; 17:ijerph17145078. [PMID: 32674437 PMCID: PMC7400534 DOI: 10.3390/ijerph17145078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023]
Abstract
Involving and engaging stakeholders is crucial for studying and managing the complex interactions between marine ecosystems and human health and wellbeing. The Oceans and Human Health Chair was founded in the town of Roses (Catalonia, Spain, NW Mediterranean) in 2018, the fruit of a regional partnership between various stakeholders, and for the purpose of leading the way to better health and wellbeing through ocean research and conservation. The Chair is located in an area of the Mediterranean with a notable fishing, tourist, and seafaring tradition and is close to a marine reserve, providing the opportunity to observe diverse environmental conditions and coastal and maritime activities. The Chair is a case study demonstrating that local, collaborative, transdisciplinary, trans-sector, and bottom-up approaches offer tremendous opportunities for engaging coastal communities to help support long-lasting solutions that benefit everyone, and especially those living by the sea or making their living from the goods and services provided by the sea. Furthermore, the Chair has successfully integrated most of its experts in oceans and human health from the most prestigious institutions in Catalonia. The Chair focuses on three main topics identified by local stakeholders: Fish and Health; Leisure, Health, and Wellbeing; and Medicines from the Sea. Led by stakeholder engagement, the Chair can serve as a novel approach within the oceans and human health field of study to tackle a variety of environmental and public health challenges related to both communicable and non-communicable diseases, within the context of sociocultural issues. Drawing on the example provided by the Chair, four principles are established to encourage improved participatory processes in the oceans and human health field: bottom-up, “think local”, transdisciplinary and trans-sectorial, and “balance the many voices”.
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Affiliation(s)
- Josep Lloret
- SeaHealth Research Group-Institute of Aquatic Ecology & LIPPSO-Dept. of Chemistry, University of Girona, 17003 Girona, Spain; (A.C.); (M.P.); (J.S.)
- Correspondence:
| | - Rafael Abós-Herràndiz
- Department of Primary Health Care, Institut Català de la Salut, Government of Catalonia, 08013 Barcelona and 17480 Roses, Spain; (R.A.-H.); (E.F.); (C.V.)
| | - Sílvia Alemany
- History Museum of Sant Feliu de Guíxols, Sant Feliu de Guíxols, 17220 Catalonia, Spain;
| | - Rosario Allué
- D.G. Fisheries and Maritime Affairs, Government of Catalonia, 08017 Barcelona, Spain;
| | - Joan Bartra
- Allergy Section, Pneumology Department, Institut Clínic Respiratori (ICR), Hospital Clínic, 08036 Barcelona, Spain;
| | - Maria Basagaña
- Allergology Unit, Hospital Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Elisa Berdalet
- Institut de Ciències del Mar, CSIC, 08003 Barcelona, Spain; (E.B.); (M.D.); (F.P.); (A.S.)
| | - Mònica Campàs
- Marine and Continental Waters Programme, IRTA, Sant Carles de la Ràpita, 43540 Catalonia, Spain; (M.C.); (J.D.)
| | - Arnau Carreño
- SeaHealth Research Group-Institute of Aquatic Ecology & LIPPSO-Dept. of Chemistry, University of Girona, 17003 Girona, Spain; (A.C.); (M.P.); (J.S.)
| | - Montserrat Demestre
- Institut de Ciències del Mar, CSIC, 08003 Barcelona, Spain; (E.B.); (M.D.); (F.P.); (A.S.)
| | - Jorge Diogène
- Marine and Continental Waters Programme, IRTA, Sant Carles de la Ràpita, 43540 Catalonia, Spain; (M.C.); (J.D.)
| | - Eva Fontdecaba
- Department of Primary Health Care, Institut Català de la Salut, Government of Catalonia, 08013 Barcelona and 17480 Roses, Spain; (R.A.-H.); (E.F.); (C.V.)
| | - Mireia Gascon
- ISGlobal (Global Health Institute Barcelona), Barcelona, Spain;
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sílvia Gómez
- Departament of Social and Cultural Anthropology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Catalonia, Spain;
| | - Angel Izquierdo
- Medical Oncology Service, Catalan Institute of Oncology, Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain;
| | - Lluïsa Mas
- Sub-direcció Regional a Girona, Catalan Public Health Agency, Government of Catalonia, 17002 Girona, Spain; (L.M.); (M.T.)
| | - Montse Marquès
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, 43201 Reus, Spain;
| | - Juan Pedro-Botet
- Department of Medicine, Hospital del Mar & Universitat Autònoma de Barcelona, 08003 Barcelona, Spain;
| | - Maria Pery
- Servei d’Espais Naturals Protegits, D.G. Environmental Policies and Environment, Government of Catalonia, 08036 Barcelona, Spain;
| | - Francesc Peters
- Institut de Ciències del Mar, CSIC, 08003 Barcelona, Spain; (E.B.); (M.D.); (F.P.); (A.S.)
| | - Xavier Pintó
- Unitat de Lípids i Risc Vascular, Servei de Medicina Interna, Hospital Universitari de Bellvitge, Idibell, University of Barcelona, CiberObn, 08907 L’Hospitalet de Llobregat, Spain;
| | - Marta Planas
- SeaHealth Research Group-Institute of Aquatic Ecology & LIPPSO-Dept. of Chemistry, University of Girona, 17003 Girona, Spain; (A.C.); (M.P.); (J.S.)
| | - Ana Sabatés
- Institut de Ciències del Mar, CSIC, 08003 Barcelona, Spain; (E.B.); (M.D.); (F.P.); (A.S.)
| | - Joan San
- SeaHealth Research Group-Institute of Aquatic Ecology & LIPPSO-Dept. of Chemistry, University of Girona, 17003 Girona, Spain; (A.C.); (M.P.); (J.S.)
| | - Anna Sanchez-Vidal
- Department of Earth and Ocean Dynamics, University of Barcelona, 08028 Barcelona, Spain;
| | - Martí Trepat
- Sub-direcció Regional a Girona, Catalan Public Health Agency, Government of Catalonia, 17002 Girona, Spain; (L.M.); (M.T.)
| | - Cristina Vendrell
- Department of Primary Health Care, Institut Català de la Salut, Government of Catalonia, 08013 Barcelona and 17480 Roses, Spain; (R.A.-H.); (E.F.); (C.V.)
| | - Lora E. Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Cornwall TR1 3HD, UK;
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D'Amelio CM, García-Moral A, Bartra J, Azofra J, García Blanca E, Quiñones MD, Goikoetxea MJ, Martínez-Aranguren R, Gastaminza G. Diagnostic Capacity of Commercial Extracts vs Prick-by-Prick in the Study of Sensitization to Peanut: Which Technique Should We Use? J Investig Allergol Clin Immunol 2020; 30:373-375. [PMID: 32376516 DOI: 10.18176/jiaci.0555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C M D'Amelio
- Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | | | - J Bartra
- Hospital Clínic, Barcelona, Spain.,Hospital Clínic, Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - J Azofra
- Hospital Universitario Central de Oviedo, Oviedo, Spain
| | - E García Blanca
- Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | | | - M J Goikoetxea
- Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - R Martínez-Aranguren
- Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - G Gastaminza
- Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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Decuyper II, Pascal M, Van Gasse AL, Mertens C, Díaz‐Perales A, Araujo G, Torradeflot M, Rius J, Balsells S, Muñoz‐Cano RM, Bartra J, Li L, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Ebo DG, Faber MA. Performance of basophil activation test and specific IgG4 as diagnostic tools in nonspecific lipid transfer protein allergy: Antwerp-Barcelona comparison. Allergy 2020; 75:616-624. [PMID: 31512256 DOI: 10.1111/all.14040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 07/23/2019] [Accepted: 08/07/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Recent studies show that nsLTP sensitization is not limited to the Mediterranean basin and can present diverse clinical phenotypes. It remains challenging to predict clinical outcome when specific IgE antibodies (sIgE) to nsLTPs are present. This study compares both clinical and in vitro allergy characteristics but also diagnostic performance of a basophil activation test (BAT) and sIgG4 in nsLTP-sensitized patients from Antwerp (ANT, Belgium) and Barcelona (BCN, Spain). METHODS Adult subjects with positive sIgE rPru p 3 and/or rMal d 3 ≥ 0.10 kUA /L (n = 182) and healthy controls (n = 37) were included. NsLTP-sensitized individuals were stratified according to clinical symptoms with peach/apple, respectively. BAT rPru p 3 and rMal d 3 were performed and sIgG4 antibodies to both components quantified. RESULTS In BCN, only ratios of sIgG4/sIgE rMal d 3 and BAT rMal d 3 (0.001 µg/mL) can identify clinically relevant Mal d 3 sensitization (sensitivity of 60%-63% and a specificity of 75%-67%, respectively). In ANT, only the sIgE/total IgE rPru p 3 ratio shows added value (sensitivity 60% and specificity 83%). Finally, it appears that symptomatic patients in BCN are more sensitive to lower allergen concentrations compared to ANT. In addition, it was shown that ANT patients were more often sensitized to pollen and that specific pollen sources differed between regions. CONCLUSIONS NsLTP-related allergy profiles and diagnostic performance differ significantly between regions and are component-specific, which makes extrapolation of data difficult to do. In addition, it seems that basophil sensitivity might show geographical differences. Additional research is needed to confirm these findings.
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Affiliation(s)
- Ine I. Decuyper
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Mariona Pascal
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
| | - Athina L. Van Gasse
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Christel Mertens
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Araceli Díaz‐Perales
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Plant Biotechnology Institute (UPM‐INIA) Madrid Spain
| | - Giovanna Araujo
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Maria Torradeflot
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Josefina Rius
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Sara Balsells
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Rosa M. Muñoz‐Cano
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Joan Bartra
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Lynne Li
- Department of Medicine University of British Columbia Vancouver BC Canada
| | - Vito Sabato
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margo M. Hagendorens
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Chris H. Bridts
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Luc S. De Clerck
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Didier G. Ebo
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margaretha A. Faber
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
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47
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Doña I, Pérez‐Sánchez N, Eguiluz‐Gracia I, Muñoz-Cano R, Bartra J, Torres MJ, Cornejo‐García JA. Progress in understanding hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. Allergy 2020; 75:561-575. [PMID: 31469167 DOI: 10.1111/all.14032] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross-hypersensitivity reactions (CRs), associated with COX-1 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs-exacerbated respiratory disease, NSAIDs-exacerbated cutaneous disease and NSAIDs-induced urticaria/angioedema. Two phenotypes fill into the second one: single-NSAID-induced urticaria/angioedema/anaphylaxis and single-NSAID-induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re-evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food-dependent NSAID-induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.
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Affiliation(s)
- Inmaculada Doña
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA ARADyAL Malaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga Malaga Spain
| | - Natalia Pérez‐Sánchez
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA ARADyAL Malaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga Malaga Spain
- Departamento de Medicina Universidad de Málaga Malaga Spain
| | - Ibon Eguiluz‐Gracia
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA ARADyAL Malaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga Malaga Spain
| | - Rosa Muñoz-Cano
- Allergy Section Pneumology Department Hospital Clinic ARADyAL Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) August Pi i Sunyer Biomedical Research Institute (IDIBAPS) ARADyAL Barcelona Spain
| | - Joan Bartra
- Allergy Section Pneumology Department Hospital Clinic ARADyAL Universitat de Barcelona Barcelona Spain
- Clinical and Experimental Respiratory Immunoallergy (IRCE) August Pi i Sunyer Biomedical Research Institute (IDIBAPS) ARADyAL Barcelona Spain
| | - María José Torres
- Allergy Research Group Instituto de Investigación Biomédica de Málaga‐IBIMA ARADyAL Malaga Spain
- Allergy Unit Hospital Regional Universitario de Málaga Malaga Spain
- Departamento de Medicina Universidad de Málaga Malaga Spain
- Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory Andalusian Center for Nanomedicine and Biotechnology‐BIONAND Malaga Spain
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48
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Perez FG, MuNoz Cano R, Bartra J, Herrera GB, Palomares F, Testera-Montes A, Rodriguez MJ, Casas R, Escobar RJ, Núñez R, Jaen MT, Mayorga C. “LTP syndrome patients: Sensitization profile and severity of reactions. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Larenas-Linnemann D, Mullol J, Ivancevich JC, Anto JM, Cardona V, Dedeu T, Rodríguez-González M, Huerta-Villalobos YR, Neffen H, Fuentes-Pérez JM, Rodríguez-Zagal E, Valero A, Zernotti M, Bartra J, Alobid I, Castillo-Vizuete JA, Dordal T, Hijano R, Picado C, Sastre J, Blua AE, Jares E, Lavrut AJ, Máspero J, Bedolla-Barajas M, Burguete-Cabañas MT, Costa-Domínguez MC, Domínguez-Silva M, Espinoza-Contreras JG, Gálvez-Romero JL, García-Cobas CY, García-Cruz MDLLH, Hernández-Velázquez L, Luna-Pech JA, Matta JJ, Mogica-Martínez MD, Rivero-Yeverino D, Ruiz LT, Del Río-Navarro BE, Gómez-Vera J, Macías-Weinmann A, Murray R, Onorato G, Laune D, Bedbrook A, Bousquet J. [MASK (Mobile Airways Sentinel Network), a mobile App with ARIA's comprehensive solution in Spanish-speaking countries]. ACTA ACUST UNITED AC 2020; 66:263-268. [PMID: 31200425 DOI: 10.29262/ram.v66i2.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Although there are high quality clinical guidelines about allergic rhinitis, many patients receive deficient treatment, partly due to the high level of self-medication. MASK (Mobile Airways Sentinel Network) is an integral part of a project against chronic diseases which it is focused on active and healthy aging and is supported by the European Union. It forms the third phase of ARIA (Allergic Rhinitis and its Impact on Asthma) in which, through a mobile app on a smart device, the purpose is to guide patients in the control of their multimorbidity, allergic rhinitis or conjunctivitis, or asthma. The "Allergy Diary" app by MACVIA-ARIA is free and it is available for Android and iOS; on it, patients indicate how unpleasant the symptoms are on a daily basis through five screens with an analogous visual scale; two more screens were recently added (sleep affectation). With the app, it is also possible to download the information of the "Allergy Diary" on the physician's computer through a QR code at the moment of the medical consultation. In this article, we review the first year of experience in Spain, Mexico and Argentina, where the Spanish version is used.
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50
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Larenas-Linnemann D, Mullol J, Ivancevich JC, Antó JM, Cardona V, Dedeu T, Rodríguez-González M, Huerta Y, Neffen H, Fuentes-Pérez JM, Rodríguez-Zagal E, Valero A, Zernotti M, Bartra J, Alobid I, Castillo-Vizuete JA, Dordal T, Hijano R, Picado C, Sastre J, Blua AE, Jares E, Lavrut AJ, Máspero J, Bedolla-Barajas M, Burguete M, Costa MC, Domínguez-Silva M, Espinoza-Contreras JG, Gálvez-Romero JL, García-Cobas CY, García-Cruz MDLLH, Hernández-Velázquez L, Luna-Pech J, Matta JJ, Mogica-Martínez MD, Rivero-Yeverino D, Ruiz-Segura LT, Del Río-Navarro B, Gómez J, Macías-Weinmann A, Murray R, Onorato G, Laune D, Bedbrook A, Bousquet J. [MASK (Mobile Airways Sentinel Network). ARIA's comprehensive solution for mobile app for the multimorbidity of allergic rhinitis and asthma]. ACTA ACUST UNITED AC 2019; 66:140-146. [PMID: 31013416 DOI: 10.29262/ram.v66i1.578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The vast majority of patients with allergic rhinitis (AR) do not receive the proper management which is recommended by the guidelines, but they frequently self-medicate. MASK (Mobile Airways Sentinel Network) is an integral part of a project that is supported by the European Union against chronic diseases and focused on active and healthy aging. MASK represents the third phase of ARIA (Allergic Rhinitis and its Impact on Asthma), in which, by using a mobile application in a smart device, the objective is to guide the patient in the control of his/her multi-morbidity, AR and/or allergic conjunctivitis (AC) and/or asthma. The mobile app Allergy Diary by MACVIA-ARIA is free and it is available for both Android and iOS platforms. After it is downloaded to the patient's cell phone, it first requests some information about the patient's profile, allergic pathologies and medication; afterwards, through a visual analog scale, the patient is invited to determine the degree of affectation in the nose, eyes, and bronchi, and its influence on their productivity at work / school. After analyzing the data generated by filling the Allergy Diary, it became clear there is a new clinical entity: allergic rhinitis+ allergic conjunctivitis +asthma, with greater effect; in addition to a high level of self-medication: in general, the patient takes medication on days when symptoms are present. The app has already been deployed in 23 countries, including several Spanish-speaking countries.
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