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Román‐Carrasco P, Klug C, Hemmer W, Focke‐Tejkl M, Raith M, Grosinger I, Stoll P, Quirce S, Sanchez‐Jareño M, Martínez‐Blanco M, Molina E, Somoza V, Lieder B, Marin Z, Nöbauer K, Hummel K, Razzazi‐Fazeli E, Swoboda I. Bos d 13, A Novel Heat-Stable Beef Allergen. Mol Nutr Food Res 2023; 67:e2200601. [PMID: 37173826 PMCID: PMC10909433 DOI: 10.1002/mnfr.202200601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/24/2023] [Indexed: 05/15/2023]
Abstract
SCOPE Red meat, a staple food of Western diets, can also induce IgE-mediated allergic reactions. Yet, apart from the heat-labile protein serum albumin and the carbohydrate α-Gal, the molecules causing allergic reactions to red meat remain unknown. METHODS AND RESULTS IgE reactivity profiles of beef-sensitized individuals are analyzed by IgE-immunoblotting with protein extracts from raw and cooked beef. Two IgE-reactive proteins are identified by peptide mass fingerprinting as myosinlight chain 1 (MYL1) and myosin light chain 3 (MYL3) in cooked beef extract and are designated Bos d 13 isoallergens. MYL1 and MYL3 are produced recombinantly in Escherichia coli. ELISAs proved their IgE reactivity and circular dichroism analysis showed that they represent folded molecules with remarkable thermal stability. In vitro gastrointestinal digestion experiments showed the higher stability of rMYL1 as compared to rMYL3. Exposure of a monolayer of Caco-2 cells to rMYL1 indicated that the molecule is able to cross intestinal epithelial cells without disturbing the integrity of the tight junctions, suggesting the sensitizing capacity of MYL1. CONCLUSION MYLs are identified as novel heat-stable bovine meat allergens.
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Affiliation(s)
- Patricia Román‐Carrasco
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Christoph Klug
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
- Present address: MacroArray Diagnostics GmbHVienna1230Austria
| | | | - Margarete Focke‐Tejkl
- Division of ImmunopathologyDepartment of Pathophysiology and Allergy ResearchCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaVienna1090Austria
| | - Marianne Raith
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Isabella Grosinger
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Peter Stoll
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Santiago Quirce
- Department of AllergyLa Paz University Hospital, IdiPAZMadrid28046Spain
| | | | - Mónica Martínez‐Blanco
- Instituto de Investigación en Ciencias de la Alimentación (CIAL, CSIC‐UAM)Madrid28049Spain
| | - Elena Molina
- Instituto de Investigación en Ciencias de la Alimentación (CIAL, CSIC‐UAM)Madrid28049Spain
| | - Veronika Somoza
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaVienna1090Austria
- Leibniz Institute for Food Systems BiologyTechnical University Munich85354MunichGermany
| | - Barbara Lieder
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaVienna1090Austria
| | - Zana Marin
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Katharina Nöbauer
- VetCore Facility for ResearchUniversity of Veterinary MedicineVienna1210Austria
| | - Karin Hummel
- VetCore Facility for ResearchUniversity of Veterinary MedicineVienna1210Austria
| | | | - Ines Swoboda
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
- Division of ImmunopathologyDepartment of Pathophysiology and Allergy ResearchCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaVienna1090Austria
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Sturm GJ, Boni E, Antolín-Amérigo D, Bilò MB, Breynaert C, Fassio F, Spriggs K, Vega A, Ricciardi L, Arzt-Gradwohl L, Hemmer W. Allergy to stings and bites from rare or locally important arthropods: worldwide distribution, available diagnostics, and treatment. Allergy 2023. [PMID: 37191880 DOI: 10.1111/all.15769] [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: 04/19/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
Insect venom allergy is the most frequent cause of anaphylaxis in Europe and possibly worldwide. The majority of systemic allergic reactions after insect stings are caused by Hymenoptera and among these, vespid genera induce most of the systemic sting reactions (SSR). Honey bees are the second leading cause of SSR. Depending on the global region, other Hymenoptera such as different ant genera are responsible for SSR. Widely distributed hornets and bumblebees or local vespid or bee genera rarely induce SSR. Hematophagous insects such as mosquitoes and horse flies usually cause (large) local reactions while SSR occasionally occur. This position paper aims to identify either rare or locally important insects causing SSR as well as rarely occurring SSR after stings or bites of widely distributed insects. We summarized relevant venom or saliva allergens and intended to identify possible cross-reactivities between the insect allergens. Moreover, we aimed to locate diagnostic tests for research and routine diagnosis, which are sometimes only regionally available. Finally, we gathered information on available immunotherapies. Major allergens of most insects were identified, and cross-reactivity between insects was frequently observed. While some diagnostics and immunotherapies are locally available, standardized skin tests and immunotherapies are generally lacking in rare insect allergy.
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Affiliation(s)
- Gunter Johannes Sturm
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
- Allergy Outpatient Clinic Reumannplatz, Vienna, Austria
| | - Elisa Boni
- Allergy and Immunology Department, Metropolitan Laboratory AUSL Bologna, Maggiore Hospital, Bologna, Italy
| | - Darío Antolín-Amérigo
- Allergy Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Maria Beatrice Bilò
- Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
- Allergy Unit, Department of Internal Medicine, Ospedali Riuniti Ancona University Hospital, Ancona, Italy
| | - Christine Breynaert
- Department of General Internal Medicine - Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Filippo Fassio
- Allergy and Clinical Immunology Unit, Ospedale San Giovanni di Dio, Azienda USL Toscana Centro, Florence, Italy
| | - Kymble Spriggs
- Department of Allergy & Immunology, Monash Medical Centre, Clayton, Australia
- Department of Allergy & Immunology, The Royal Melbourne Hospital, Parkville, Australia
- Department of Medicine, Melbourne Medical School, The University of Melbourne, Parkville, Australia
| | - Arantza Vega
- Allergy Department, University Hospital of Guadalajara, Spain
- ARADyAL Spanish Thematic Network and Co-operative Research Centre RD16/0006/0023
| | - Luisa Ricciardi
- Allergy and Clinical Immunology Unit, AOU Policlinico G.Martino, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Lisa Arzt-Gradwohl
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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Koch L, Laipold K, Arzt‐Gradwohl L, Sturm EM, Aberer W, Aumayr M, Hemmer W, Čerpes U, Sturm GJ. Molecular allergy diagnosis is sensitive and avoids misdiagnosis in patients sensitized to seasonal allergens. Clin Transl Allergy 2023; 13:e12231. [PMID: 36973961 PMCID: PMC10011670 DOI: 10.1002/clt2.12231] [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: 07/13/2022] [Revised: 10/31/2022] [Accepted: 02/14/2023] [Indexed: 03/15/2023] Open
Abstract
Background The specificity of extract‐based pollen allergy diagnosis is decreased due to cross‐reactivity via cross‐reactive carbohydrate determinants (CCDs) or panallergens such as profilins or polcalcins. This study aimed to explore the prevalence of sensitization to seasonal extracts, CCDs, profilin and polcalcin and investigate the sensitivity and specificity of seasonal molecular allergy diagnosis (MAD) using commercially available test methods. Methods 2948 patients were screened for specific immunoglobulin E to ash, birch, mugwort, ragweed and timothy grass pollen extracts and grouped according to the number of positive tests (1–5). 100 patients from each group and a control group were randomly selected to calculate the prevalence of CCD and panallergen sensitization. With 742 patients, sensitivity and specificity of MAD (Alt a 1, Fra/Ole e 1, Bet v 1, Phl p 1, Art v 1, and Amb a 1) was determined. Results 1627 patients (55.2%) were positive to at least one, and 1002 patients (34.0%) were positive to multiple of the five pollen allergens investigated; 18.5% of the pollen‐sensitized patients had sensitization to CCDs or panallergens. Specifically, sensitization to CCDs, profilins, and polcalcins was observed in 8.7%, 10.9%, and 2.9% of these patients, respectively. The sensitivity of MAD was high, with sensitivities between 96.2% and 100% using ImmunoCAP and 91.5% and 100% using ALEX2. Specificity was 100% for both assays. Conclusions Due to cross‐reactivity, about one‐fifth of pollen‐sensitized patients is at risk of misdiagnosis. However, MAD is sensitive, specific and helps to avoid misdiagnosis and select primary allergen sources for immunotherapy.
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Affiliation(s)
- Lukas Koch
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Karin Laipold
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Lisa Arzt‐Gradwohl
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Eva Maria Sturm
- Otto‐Loewi Research Center for Vascular Biology, Immunology and InflammationDivision of PharmacologyMedical University of GrazGrazAustria
| | - Werner Aberer
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | | | | | - Urban Čerpes
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria
| | - Gunter J. Sturm
- Department of Dermatology and VenereologyMedical University of GrazGrazAustria,Allergy Outpatient Clinic ReumannplatzViennaAustria
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Palladino C, Ellinger I, Kalic T, Humeniuk P, Ret D, Mayr V, Hafner C, Hemmer W, Hoffmann-Sommergruber K, Untersmayr E, Bublin M, Radauer C, Breiteneder H. Peanut lipids influence the response of bronchial epithelial cells to the peanut allergens Ara h 1 and Ara h 2 by decreasing barrier permeability. Front Mol Biosci 2023; 10:1126008. [PMID: 36845549 PMCID: PMC9945344 DOI: 10.3389/fmolb.2023.1126008] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Peanut-allergic individuals react upon their first known ingestion of peanuts, suggesting sensitization occurs through non-oral exposure. Increasing evidence suggests that the respiratory tract is a probable site for sensitization to environmental peanuts. However, the response of the bronchial epithelium to peanut allergens has never been explored. Furthermore, food matrix-derived lipids play an important role in allergic sensitization. Objective: To contribute to a better understanding of the mechanisms of allergic sensitization to peanuts via inhalation, by exploring the direct effect of the major peanut allergens Ara h 1 and Ara h 2 and peanut lipids on bronchial epithelial cells. Methods: Polarized monolayers of the bronchial epithelial cell line 16HBE14o- were stimulated apically with peanut allergens and/or peanut lipids (PNL). Barrier integrity, transport of allergens across the monolayers, and release of mediators were monitored. Results: Ara h 1 and Ara h 2 impacted the barrier integrity of the 16HBE14o- bronchial epithelial cells and crossed the epithelial barrier. Ara h 1 also induced the release of pro-inflammatory mediators. PNL improved the barrier function of the cell monolayers, decreased paracellular permeability and reduced the amount of allergens crossing the epithelial layer. Conclusion: Our study provides evidence of the transport of Ara h 1 and Ara h 2 across the airway epithelium, of the induction of a pro-inflammatory milieu, and identifies an important role for PNL in controlling the amount of allergens that can cross the epithelial barrier. These, all together, contribute to a better understanding of the effects of peanuts exposure on the respiratory tract.
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Affiliation(s)
- Chiara Palladino
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Isabella Ellinger
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Tanja Kalic
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria,Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Piotr Humeniuk
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Davide Ret
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria,Division of Macromolecular Chemistry, Institute of Applied Synthetic Chemistry, Vienna University of Technology, Vienna, Austria
| | - Vanessa Mayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria,Karl Landsteiner Institute for Dermatological Research, St. Pölten, Austria
| | | | - Karin Hoffmann-Sommergruber
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Merima Bublin
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Christian Radauer
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria,*Correspondence: Heimo Breiteneder,
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Gureczny T, Heindl B, Klug L, Wantke F, Hemmer W, Wöhrl S. Allergy screening with extract-based skin prick tests demonstrates higher sensitivity over in vitro molecular allergy testing. Clin Transl Allergy 2023; 13:e12220. [PMID: 36825518 PMCID: PMC9899493 DOI: 10.1002/clt2.12220] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/20/2022] [Accepted: 12/10/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND As extract-based skin testing as well as in vitro tests for major allergens have their own advantages, both procedures are usually performed in routine settings. In times of shortages in medical staff and supplies, we asked ourselves, how many patients would be underdiagnosed, if only one test could be used. METHODS In a retrospective analysis, we investigated a cohort of 2646 patients seen by a single physician in a large Austrian outpatient allergy clinic in 2018. Only patients with an allergen source-specific history and pairs of extract-based skin prick (SPT) and in vitro molecular allergy tests to major allergens were included. RESULTS For all tested allergen sources, sensitivity was higher for SPT than for sIgE-based molecular allergy testing. Concerning 1006 birch pollen-allergic patients, 791 (78.6%) had positive results with both tests, while 153 (15.2%) only with the SPT and 62 (6.2%) only with the sIgE to Bet v1. The other allergen sources showed similar results: For house dust mite 816/1120 (72.9%), grass pollen 1077/1416 (76.1%) and cat 433/622 (69.6%) remained test-positive with both procedures, whereas in 276 (24.6%), 224 (15.8%) and 173 (27.8%) times only the SPT and 28 (2.5%), 115 (8.1%) and 16 (2.6%) times only the sIgE to Der p1/2/23, Phl p1/5 and Fel d1 showed a positive result. Each comparison was statistically significant (each p < 0.0001, Chi-squared test). CONCLUSIONS Screening for allergy with major molecular allergens has lower sensitivity when compared with extract-based skin tests. A combination of both is required for an optimal sensitivity.
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Affiliation(s)
- Tobias Gureczny
- Floridsdorf Allergy Center (FAZ)ViennaWienAustria,Medical University of ViennaViennaWienAustria
| | - Benjamin Heindl
- Floridsdorf Allergy Center (FAZ)ViennaWienAustria,Medical University of ViennaViennaWienAustria
| | - Livia Klug
- Floridsdorf Allergy Center (FAZ)ViennaWienAustria,Medical University of ViennaViennaWienAustria
| | - Felix Wantke
- Floridsdorf Allergy Center (FAZ)ViennaWienAustria
| | | | - Stefan Wöhrl
- Floridsdorf Allergy Center (FAZ)ViennaWienAustria
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Widenka KJ, Kosiorowska M, Jakob H, Pacini D, Hemmer W, Grabenwoeger M, Sioris T, Moritz A, Tsagakis K. Early and midterm results of frozen elephant trunk operation with Evita open stent-graft in patients with Marfan syndrome: results of a multicentre study. BMC Cardiovasc Disord 2022; 22:333. [PMID: 35883019 PMCID: PMC9317434 DOI: 10.1186/s12872-022-02777-5] [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: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background Endovascular treatment of patients with Marfan syndrome (MFS) is not recommended. Hybrid procedures such as frozen elephant trunk (FET), which combines stent-graft deployment with an integrated non-stented fabric graft for proximal grafting and suturing, have not been previously evaluated. The aim of this study was to assess the safety and feasibility of FET operation in patients with MFS. Methods Patients enrolled in the International E-vita Open Registry (IEOR) who underwent FET procedure between January 2001 and February 2020 meeting Ghent criteria for MFS were included in the study. Early and midterm results were retrospectively analyzed. Preoperative, postoperative and follow-up computed tomography angiography scans were analysed. Results We analyzed 37 patients [mean age 38 ± 11 years, 65% men]. Acute or chronic aortic dissection was present in 35 (95%) patients (14 and 21 patients respectively). Two (5%) patients had an aneurysm without dissection. Malperfusion syndrome was present in 4 patients. Twenty-nine (78%) patients had history of aortic surgical interventions. The 30-day and in-hospital mortality amounted to 8 and 14% respectively. False lumen exclusion was present in 73% in stented segment in last postoperative CT. The overall 5-year survival was 71% and freedom from reintervention downstream was 58% at 5 years. Of the nine patients who required reintervention for distal aortic disease, one patient died. Conclusions FET operation for patients with MFS can be performed with acceptable mortality and morbidity. In long-term follow-up no reinterventions on the aortic arch were required. FET allows for easier second stage operations providing platform for surgical and endovascular reinterventions.
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Affiliation(s)
- Kazimierz Jan Widenka
- Department of Cardiac Surgery, University of Rzeszow Poland, 60 Lwowska Street 60, 35-301, Rzeszow, Poland.
| | - Monika Kosiorowska
- Department of Cardiac Surgery, University of Rzeszow Poland, 60 Lwowska Street 60, 35-301, Rzeszow, Poland
| | - Heinz Jakob
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, Essen, Germany
| | - Davide Pacini
- Department of Cardiac Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Wolfgang Hemmer
- Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
| | | | - Thanos Sioris
- Tampere University Hospital Heart Center, Tampere, Finland
| | - Anton Moritz
- Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - Konstantinos Tsagakis
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, Essen, Germany
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Heindl B, Braunsteiner T, Klug L, Wantke F, Hemmer W, Wöhrl S. Häufigkeit positiver Allergietests bei Kindern, Erwachsenen und Senioren. Allergo J 2022. [DOI: 10.1007/s15007-022-4990-2] [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: 11/24/2022]
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Voth V, Merk DR, Roser D, Hemmer W, Seeburger J, Liebrich M. Isolated Aortic Valve Cusp Reconstruction in the Adult Population: Long-Term Single-Center Experience. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- V. Voth
- Cardiac Surgery, Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
| | - D. R. Merk
- Cardiac Surgery, Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
| | - D. Roser
- Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
| | - W. Hemmer
- Sana Stuttgart, Stuttgart, Deutschland
| | | | - M. Liebrich
- Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
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Liebrich M, Merk DR, Roser D, Hemmer W, Seeburger J, Voth V. Comparison of Bicuspid and Tricuspid Aortic Valve Cusp Reconstruction: Single-Center Experience. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. Liebrich
- Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
| | - D. R. Merk
- Cardiac Surgery, Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
| | - D. Roser
- Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
| | - W. Hemmer
- Sana Stuttgart, Stuttgart, Deutschland
| | | | - V. Voth
- Cardiac Surgery, Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
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Román-Carrasco P, Hemmer W, Cabezas-Cruz A, Hodžić A, de la Fuente J, Swoboda I. The α-Gal Syndrome and Potential Mechanisms. Front Allergy 2021; 2:783279. [PMID: 35386980 PMCID: PMC8974695 DOI: 10.3389/falgy.2021.783279] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022] Open
Abstract
The α-Gal syndrome is a complex allergic disease characterized by the development of specific IgE antibodies against the carbohydrate galactose-α-1,3-galactose (α-Gal), an oligosaccharide present in cells and tissues of non-primate mammals. Individuals with IgE antibodies to α-Gal suffer from a delayed form of anaphylaxis following red meat consumption. There are several features that make the α-Gal syndrome such a unique allergic disease and distinguish it from other food allergies: (1) symptoms causing IgE antibodies are directed against a carbohydrate moiety, (2) the unusual delay between the consumption of the food and the onset of the symptoms, and (3) the fact that primary sensitization to α-Gal occurs via tick bites. This review takes a closer look at the immune response against α-Gal, in healthy and in α-Gal allergic individuals. Furthermore, the similarities and differences between immune response against α-Gal and against the other important glycan moieties associated with allergies, namely cross-reactive carbohydrate determinants (CCDs), are discussed. Then different mechanisms are discussed that could contribute to the delayed onset of symptoms after consumption of mammalian meat. Moreover, our current knowledge on the role of tick bites in the sensitization process is summarized. The tick saliva has been shown to contain proteins carrying α-Gal, but also bioactive molecules, such as prostaglandin E2, which is capable of stimulating an increased expression of anti-inflammatory cytokines while promoting a decrease in the production of proinflammatory mediators. Together these components might promote Th2-related immunity and trigger a class switch to IgE antibodies directed against the oligosaccharide α-Gal. The review also points to open research questions that remain to be answered and proposes future research directions, which will help to get a better understanding and lead to a better management of the disease.
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Affiliation(s)
- Patricia Román-Carrasco
- Molecular Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | | | - Alejandro Cabezas-Cruz
- Anses, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Adnan Hodžić
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - José de la Fuente
- SaBio, Instituto de Investigación de Recursos Cinegéticos, IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Ines Swoboda
- Molecular Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
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Hemmer W, Liebrich M, Seeburger J, Voth V. Ross-Operation bei Erwachsenen – „Full-root“-Technik. Z Herz- Thorax- Gefäßchir 2021. [DOI: 10.1007/s00398-021-00466-7] [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: 10/19/2022]
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12
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Hemmer W, Sestak‐Greinecker G, Braunsteiner T, Wantke F, Wöhrl S. Molecular sensitization patterns in animal allergy: Relationship with clinical relevance and pet ownership. Allergy 2021; 76:3687-3696. [PMID: 33914361 DOI: 10.1111/all.14885] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 10/13/2020] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND In vitro diagnosis using single molecules is increasingly complementing conventional extract-based diagnosis. We explored in routine patients with animal allergy to what extent molecules can explain polysensitization and identify primary sensitizers and how individual IgE patterns correlate with previous pet ownership and clinical relevance. METHODS Serum samples from 294 children and adults with suspect allergic rhino-conjunctivitis or asthma and a positive skin prick test to cat, dog and/or horse were tested by ImmunoCAP for IgE antibodies against eleven different allergens from cat (Fel d 1,2,4,7), dog (Can f 1,2,3,4,5,6) and horse (Equ c 1). RESULTS Patients monosensitized to cat (40.8%) or dog (6.1%) showed simple IgE patterns dominated by Fel d 1 (93%) and Can f 5 (67%), respectively. Double-sensitization to cat+dog (25.9%), cat+horse (5.4%) and polysensitization (20.7%) was associated with an increasing prevalence of the cross-reactive lipocalins Fel d 4/Can f 6/Equ c 1 and Fel d 7/Can f 1. While these lipocalins were not reliable markers for genuine sensitization per se, comparison of sIgE levels may give a clue on the primary sensitizer. Sensitizations to dog appeared to result from cross-reactivity with cat in 48%, with half of these sensitizations lacking clinical relevance. Individual sensitization patterns strongly mirrored current or previous pet ownership with the exception of Fel d 1 which regularly caused sensitization also in non-owners. CONCLUSIONS Allergen components can reasonably illuminate the molecular basis of animal (poly)sensitization in the majority of patients and are helpful in distinguishing between primary sensitization and sometimes less relevant cross-reactivity.
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Üzülmez Ö, Kalic T, Mayr V, Lengger N, Tscheppe A, Radauer C, Hafner C, Hemmer W, Breiteneder H. The Major Peanut Allergen Ara h 2 Produced in Nicotiana benthamiana Contains Hydroxyprolines and Is a Viable Alternative to the E. Coli Product in Allergy Diagnosis. Front Plant Sci 2021; 12:723363. [PMID: 34671372 PMCID: PMC8522509 DOI: 10.3389/fpls.2021.723363] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/17/2021] [Indexed: 05/12/2023]
Abstract
Peanut allergy is a potentially life-threatening disease that is mediated by allergen-specific immunoglobulin E (IgE) antibodies. The major peanut allergen Ara h 2, a 2S albumin seed storage protein, is one of the most dangerous and potent plant allergens. Ara h 2 is posttranslationally modified to harbor four disulfide bridges and three hydroxyprolines. These hydroxyproline residues are required for optimal IgE-binding to the DPYSPOHS motifs representing an immunodominant IgE epitope. So far, recombinant Ara h 2 has been produced in Escherichia coli, Lactococcus lactis, Trichoplusia ni insect cell, and Chlamydomonas reinhardtii chloroplast expression systems, which were all incapable of proline hydroxylation. However, molecular diagnosis of peanut allergy is performed using either natural or E. coli-produced major peanut allergens. As IgE from the majority of patients is directed to Ara h 2, it is of great importance that the recombinant Ara h 2 harbors all of its eukaryotic posttranslational modifications. We produced hydroxyproline-containing and correctly folded Ara h 2 in the endoplasmic reticulum of leaf cells of Nicotiana benthamiana plants, using the plant virus-based magnICON® transient expression system with a yield of 200 mg/kg fresh biomass. To compare prokaryotic with eukaryotic expression methods, Ara h 2 was expressed in E. coli together with the disulfide-bond isomerase DsbC and thus harbored disulfide bridges but no hydroxyprolines. The recombinant allergens from N. benthamiana and E. coli were characterized and compared to the natural Ara h 2 isolated from roasted peanuts. Natural Ara h 2 outperformed both recombinant proteins in IgE-binding and activation of basophils via IgE cross-linking, the latter indicating the potency of the allergen. Interestingly, significantly more efficient IgE cross-linking by the N. benthamiana-produced allergen was observed in comparison to the one induced by the E. coli product. Ara h 2 from N. benthamiana plants displayed a higher similarity to the natural allergen in terms of basophil activation due to the presence of hydroxyproline residues, supporting so far published data on their contribution to the immunodominant IgE epitope. Our study advocates the use of N. benthamiana plants instead of prokaryotic expression hosts for the production of the major peanut allergen Ara h 2.
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Affiliation(s)
- Öykü Üzülmez
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Tanja Kalic
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Vanessa Mayr
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Nina Lengger
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Angelika Tscheppe
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Christian Radauer
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute for Dermatological Research, St. Pölten, Austria
| | | | - Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
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Liebrich M, Charitos EI, Schlereth S, Meißner H, Trabold T, Geisbüsch P, Hemmer W, Seeburger J, Voth V. The zone 2 concept and distal stent graft positioning in TH 2-3 are associated with high rates of secondary aortic interventions in frozen elephant trunk surgery. Eur J Cardiothorac Surg 2021; 60:343-351. [PMID: 33864058 DOI: 10.1093/ejcts/ezab132] [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: 09/08/2020] [Revised: 12/29/2020] [Accepted: 01/13/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The goal of this study was to investigate the association between the localization of the distal anastomosis (zone 2/3), the stent graft length (100-160 mm), the position of the distal end of the hybrid prosthesis and the need for secondary aortic intervention (SAI) in acute and chronic thoracic aortic disease after the frozen elephant trunk procedure. METHODS From 2009 through 2020, a total of 232 patients (137 men; mean age, 61.7 ± 13.8 years) were treated with the frozen elephant trunk procedure. The main indications were acute aortic dissection type A (n = 106, 46%), chronic aortic dissection type A (n = 52, 22%) and degenerative thoracic aortic aneurysm (n = 74, 32%). RESULTS The rate of SAI was significantly higher when we performed a distal anastomosis in zone 2 rather than in zone 3, whereas the rate of SAI was less frequent if the distal positioning of the hybrid prosthesis was below TH 4-5. Combining the zone 2 concept and the short stent graft length (100 mm) was associated with a significantly higher rate of SAIs. Patients with a distal anastomosis in zone 2 were significantly less likely to have a recurrent laryngeal nerve injury (P < 0.001). However, no association between a specific arch zone of a distal anastomosis and the occurrence of spinal cord injury was observed. CONCLUSIONS Rates of SAIs are highest in patients who were treated with a distal anastomosis in zone 2 and a short stent graft (100 mm) with the distal end of the hybrid prosthesis at vertebral level TH 2-3.
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Affiliation(s)
| | | | | | - Helfried Meißner
- Department of Vascular and Endovascular Surgery, Katharinenhospital, Stuttgart, Germany
| | - Tobias Trabold
- Department of Diagnostic and Interventional Radiology, Katharinenhospital, Stuttgart, Germany
| | - Philipp Geisbüsch
- Department of Vascular and Endovascular Surgery, Katharinenhospital, Stuttgart, Germany
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15
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Liebrich M, Charitos EI, Dingemann C, Roser D, Seeburger J, Hemmer W, Voth V. The reinforced full-root technique for the Ross operation: surgical considerations and operative insights. Ann Cardiothorac Surg 2021; 10:485-490. [PMID: 34422560 DOI: 10.21037/acs-2020-rp-22] [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: 10/15/2020] [Accepted: 05/12/2021] [Indexed: 11/06/2022]
Abstract
Background Surgical treatment of young and middle-aged patients suffering from aortic valve disease remains an unresolved issue due to the limited durability of bioprosthetic heart valve replacements and the valve-related morbidity of patients with mechanical valve substitutes. Theoretically, the "living valve" principle of the Ross operation may represent a potentially viable solution to this dilemma. In this paper, we report on the surgical techniques of the Ross procedure and present long-term post-operative outcomes using the reinforced full-root technique. Methods From 1995 to 2020, a total of 832 consecutive patients (mean age, 43.4±13.7 years; 617 males) underwent a Ross operation using the full-root technique. Patients were prospectively monitored with clinical and echocardiographic follow-up. Total follow-up was 9,046 patients-years and was 92% complete. Mean-follow-up was 10.9±6.9 years (range, 0-24.9 years). Results Survival at twenty years was 92% (95% CI: 90-94%). Freedom from autograft or right ventricle to pulmonary artery connection reoperation at twenty years was 79% (95% CI: 74-85%). Eighty-nine pulmonary autograft reoperations had to be performed in eighty patients; salvage of the pulmonary autograft could be performed in forty-six of them. Fifty-seven patients required sixty-three reoperations on the right ventricle to pulmonary artery connection. Major cerebral bleeding occurred in one patient and neurological events in seventeen patients, respectively. Conclusions Over a follow-up interval of up to twenty-five years, the Ross operation with the reinforced full-root technique demonstrated excellent survival in young and middle-aged patients. The rate of pulmonary autograft and right ventricular outflow graft reoperations were low in this patient subset. Therefore, the Ross operation with the reinforced full-root technique represents an enduring and valid treatment option in young and middle-aged patients suffering from aortic valve disease.
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Affiliation(s)
| | | | | | - Detlef Roser
- Sana Cardiac Surgery Stuttgart, Stuttgart, Germany
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16
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Curin M, Huang HJ, Garmatiuk T, Gutfreund S, Resch-Marat Y, Chen KW, Fauland K, Keller W, Zieglmayer P, Zieglmayer R, Lemell P, Horak F, Hemmer W, Focke-Tejkl M, Flicker S, Vrtala S, Valenta R. IgE Epitopes of the House Dust Mite Allergen Der p 7 Are Mainly Discontinuous and Conformational. Front Immunol 2021; 12:687294. [PMID: 34220841 PMCID: PMC8241568 DOI: 10.3389/fimmu.2021.687294] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 03/29/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background Several studies indicate that Der p 7 is an important and clinically relevant allergen of Dermatophagoides pteronyssinus which should be included in vaccines for treatment of house dust mite (HDM) allergy. Aim of this study was to characterize the IgE epitopes of Der p 7. Methods Recombinant Der p 7 was expressed and purified, analyzed for fold by circular dichroism and tested for its allergenic activity by basophil activation. Seven overlapping, surface-exposed peptides (P1–P7) with a length of 27 to 37 amino acids, which spanned the Der p 7 sequence, were synthesized and tested for IgE reactivity and allergenic activity by basophil activation assay. Carrier-bound peptides were studied for their ability to induce allergen-specific IgG antibodies in rabbits. Peptide-specific antibodies were used to inhibit allergic patients` IgE binding to Der p 7 by ELISA for mapping of IgE epitopes. Results rDer p 7 showed high allergenic activity comparable with Der p 5, Der p 21, and Der p 23. None of the seven tested peptides showed any IgE reactivity or allergenic activity when tested with HDM- allergic patients indicating lack of sequential IgE epitopes on Der p 7. IgE inhibition experiments using anti-peptide specific IgGs and molecular modeling enabled us to identify discontinuous, conformational IgE epitopes of Der p 7. Conclusion and Clinical Relevance IgE epitopes of Der p 7 belong to the conformational and discontinuous type whereas sequential Der p 7 peptides lack IgE reactivity. It should thus be possible to construct hypoallergenic vaccines for Der p 7 based on carrier-bound allergen peptides.
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Affiliation(s)
- Mirela Curin
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Huey-Jy Huang
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Tetiana Garmatiuk
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Sandra Gutfreund
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Yvonne Resch-Marat
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Kuan-Wei Chen
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Kerstin Fauland
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Walter Keller
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - Petra Zieglmayer
- Vienna Challenge Chamber, Vienna, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | | | | | | | | | - Margarete Focke-Tejkl
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Sabine Flicker
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Susanne Vrtala
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria.,Department of Clinical Immunology and Allergy, Sechenov First State Medical University, Moscow, Russia.,NRC Institute of Immunology FMBA of Russia, Moscow, Russia
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17
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Wöhrl S, Ostermayer C, Sesztak-Greinecker G, Jarisch R, Hemmer W, Wantke F. Drug-specific history, skin and in vitro tests can reduce the need for drug provocation tests in betalactam-hypersensitivity. Allergol Int 2021; 70:244-251. [PMID: 33191122 DOI: 10.1016/j.alit.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Many patients report questionable drug hypersensitivity reactions (DHR) to betalactam antibiotics. A workup is required for objectivation. Direct drug provocation tests (DPTs) omitting a prior allergy workup are increasingly recommended as the primary diagnostic approach. However, apart from the risk of severe side effects, DPTs often are a scarce resource in overloaded healthcare-systems. We investigated how many cases can be solved by drug-specific history, drug-specific IgE, and skin tests obviating the need for DPT. METHODS We conducted a chart review in a retrospective cohort of 932 patients in an allergy outpatient centre from 2016 to 2017. Patients had been submitted to drug-specific history and specific IgE-, skin prick-, intradermal- and patch-tests with early and late readings with a series of penicillins and cephalosporins but DPTs were no option. RESULTS Overall, positive in vitro and/or skin tests were found in 96/932 (10.3%) patients. Drug-specific IgE was detected in 40/932 (4.3%) patients, 61/787 (7.8%) patients had positive skin tests. In vitro tests to Pencillin V showed the highest rate of positivity 24/479 (5.0%) and early readings of ampicillin the highest amongst the skin tests (3/49, 6.1%). Immediate skin tests were more often positive than delayed ones (75:45). The combination of all parameters including drug-specific history solved 346/932 (37.1%) cases while 586/932 (62.9%) remained unresolved. Self-reported DHR could be less often confirmed in females and young children (p < 0.05). CONCLUSIONS Testing with betalactams applying simple, cheap, and safe skin and blood tests can solve a third of DHR-cases on a high throughput scale.
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18
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Voth V, Liebrich M, Trabold T, Hemmer W, Seeburger J. Complete-Island/Partial-Island Technique and Types of Complex Transposition for Surgical Management of Supra-Aortic Vessel Involvement during the Frozen Elephant Trunk Procedure in Acute/Chronic Type-A Aortic Dissection: Midterm Results from 158 Patients. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Liebrich M, Charitos E, Stadler C, Roser D, Merk DR, Doll N, Hemmer W, Voth V. Additional cusp reconstruction does not compromise valve durability and mid-term survival after the David procedure: results from 449 patients. Eur J Cardiothorac Surg 2020; 58:1072-1079. [PMID: 32408342 DOI: 10.1093/ejcts/ezaa149] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate whether additional cusp interventions and valve types affect aortic valve-related reoperation and mortality rates after the David procedure. METHODS Between 1997 and 2018, a total of 449 patients {372 males; mean age 54.2 [standard deviation (SD) 15.2] years, range: 12.7-79.9 years} underwent elective valve-sparing aortic root replacement (David procedure) for aortic regurgitation and were prospectively followed up clinically and echocardiographically. RESULTS The follow-up was 94% complete. Cumulative follow-up time was 2268 patient-years [mean follow-up time 5.1 (4.3 SD) years]. Thirty-day mortality was 2.2% (n = 10). Late (>30 days) survival did not differ from that of the age- and gender-matched general population. Freedom from reoperation in patients without additional cusp reconstruction was 94% [95% confidence interval (CI) 91-98] and 92% (95% CI 88-97) at 5 and 10 years, respectively, which was not significantly different (P = 1) for patients who did require additional cusp reconstruction 98% (95% CI 95-100) and 89% (95% CI 81-99). In patients with tricuspid aortic valves (n = 338), freedom from reoperation was 96% (95% CI 94-99) and 93% (95% CI 88-97) at 5 and 10 years, respectively. Patients with bicuspid aortic valves (n = 111) had a freedom from reoperation of 94% (95% CI 89-99) at 5 years and 88% (95% CI 79-98) at 10 years (P = 0.021 for the comparison to tricuspid aortic valve). Overall, 23 patients (5%; 1%/patient-year) required reoperation with a mean interval of 4.5 (4.8 SD) months. CONCLUSIONS The David procedure revealed low mid-term reoperation risk and excellent survival independent of adjunctive cusp interventions/valve morphology and is comparable with that of the age- and gender-matched general population.
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Affiliation(s)
- Markus Liebrich
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | | | - Charlotte Stadler
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Detlef Roser
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Denis R Merk
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Nicolas Doll
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Wolfgang Hemmer
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Vladimir Voth
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
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20
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Hamilton RG, Hemmer W, Nopp A, Kleine-Tebbe J. Advances in IgE Testing for Diagnosis of Allergic Disease. J Allergy Clin Immunol Pract 2020; 8:2495-2504. [PMID: 32717438 DOI: 10.1016/j.jaip.2020.07.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 01/10/2023]
Abstract
Since its discovery in 1967, IgE antibody detection in skin and blood has identified a state of allergic sensitization and served as a necessary but not sufficient risk factor that requires objective symptoms to make the definitive diagnosis of human allergic disease. More recently, quantitative IgE antibody levels in serum against allergenic extracts, molecules, and epitopes have pushed its application into more accurately identifying the specificity of the allergic response for targeting immunotherapy, predicting allergic symptom severity after allergen exposure, and attempting to distinguish tolerance from food allergy. This review examines new in vivo and in vitro developments in the design, performance, interference, and application of the methods used to identify allergic sensitization. The increasing accepted applications of molecular allergen and allergen epitope-based IgE antibody measurements, especially as applied to food allergy diagnosis and management, are highlighted as state-of-the-art advances. Despite these major advances in allergic sensitization documentation, their ultimate value requires integration by the clinician with the patient's history and pretest probability of disease.
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Affiliation(s)
- Robert G Hamilton
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
| | | | - Anna Nopp
- Department of Clinical Science and Education, Karolinska Institutet, Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Jörg Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Ackermann & Kleine-Tebbe, Berlin, Germany
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Román-Carrasco P, Hemmer W, Klug C, Friedrich A, Stoll P, Focke-Tejkl M, Altmann F, Quirce S, Swoboda I. Individuals with IgE antibodies to α-Gal and CCD show specific IgG subclass responses different from subjects non-sensitized to oligosaccharides. Clin Exp Allergy 2020; 50:1107-1110. [PMID: 32578253 PMCID: PMC7540519 DOI: 10.1111/cea.13695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 05/22/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Christoph Klug
- Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Anja Friedrich
- Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Peter Stoll
- Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Margarete Focke-Tejkl
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Friedrich Altmann
- Department of Chemistry, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Ines Swoboda
- Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
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22
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Tsagakis K, Pacini D, Grabenwöger M, Borger MA, Goebel N, Hemmer W, Laranjeira Santos A, Sioris T, Widenka K, Risteski P, Mascaro J, Rudez I, Zierer A, Mestres CA, Ruhparwar A, Di Bartolomeo R, Jakob H. Results of frozen elephant trunk from the international E-vita Open registry. Ann Cardiothorac Surg 2020; 9:178-188. [PMID: 32551250 DOI: 10.21037/acs-2020-fet-25] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Over the years, frozen elephant trunk (FET) has become the treatment of choice for multisegmental thoracic aortic disease. This multicenter study presents the evolution of FET results using the E-vita Open hybrid graft with respect to institutional experience and time. Methods The data of International E-vita Open registry were studied according to the institutional experience of the participating centers (high- versus low-volume centers) and according to the evolution of FET treatment during time (1st period, 2005-2011 versus 2nd period, 2012-2018). Overall, 1,165 patients were enrolled in the study with a wide variety of multisegmental thoracic aortic pathologies and aortic emergencies. Participating centers determined their own surgical protocol. Results The overall 30-day mortality was 12%. Short- and long-term survival were higher in high- versus low-volume centers (P=0.048 and P=0.013, respectively). In the 2nd time period, cerebral complications were reduced significantly (P=0.015). Incidence of permanent spinal cord-related symptoms was reduced to 3% in the 2nd time period, but did not reach statistical significance. Hypothermic circulatory arrest time (P<0.001) and incidence of postoperative temporary renal replacement therapy (P=0.008) were significantly reduced in the 2nd time period. Ten-year survival and freedom from aortic-related death rates were 46.6% and 85.7%, respectively, for the entire group. The freedom from distal aortic re-interventions for a new or progressive residual aortic disease was 76.0%. Conclusions Evolution of FET arch repair techniques with the E-vita Open graft and increasing institutional experience were associated with improved results. Progression of residual aortic disease makes close follow-up with aortic imaging mandatory in such patients.
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Affiliation(s)
- Konstantinos Tsagakis
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, Essen, Germany
| | - Davide Pacini
- Department of Cardiac Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Martin Grabenwöger
- Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria
| | - Michael A Borger
- Department of Cardiac Surgery, Leipzig Heart Center, University of Leipzig, Leipzig, Germany
| | - Nora Goebel
- Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany
| | - Wolfgang Hemmer
- Department of Cardiac Surgery, Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
| | | | - Thanos Sioris
- Tampere University Hospital Heart Center, Tampere, Finland
| | | | - Petar Risteski
- Department of Thoracic and Cardiovascular Surgery, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - Jorge Mascaro
- Department of Cardiothoracic Surgery, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Igor Rudez
- Department of Cardiac and Transplant Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Andreas Zierer
- Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Kepler University Hospital Linz, Johannes Kepler University Linz, Linz, Austria
| | - Carlos A Mestres
- Department of Cardio Vascular Surgery, Hospital Clinico, University of Barcelona, Barcelona, Spain.,Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Arjang Ruhparwar
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, Essen, Germany
| | - Roberto Di Bartolomeo
- Department of Cardiac Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Heinz Jakob
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, Essen, Germany
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Hodžić A, Mateos-Hernández L, Fréalle E, Román-Carrasco P, Alberdi P, Pichavant M, Risco-Castillo V, Le Roux D, Vicogne J, Hemmer W, Auer H, Swoboda I, Duscher GG, de la Fuente J, Cabezas-Cruz A. Infection with Toxocara canis Inhibits the Production of IgE Antibodies to α-Gal in Humans: Towards a Conceptual Framework of the Hygiene Hypothesis? Vaccines (Basel) 2020; 8:E167. [PMID: 32268573 PMCID: PMC7349341 DOI: 10.3390/vaccines8020167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 02/17/2020] [Revised: 03/16/2020] [Accepted: 03/29/2020] [Indexed: 02/07/2023] Open
Abstract
α-Gal syndrome (AGS) is a type of anaphylactic reaction to mammalian meat characterized by an immunoglobulin (Ig)E immune response to the oligosaccharide α-Gal (Galα1-3Galβ1-4GlcNAc-R). Tick bites seems to be a prerequisite for the onset of the allergic disease in humans, but the implication of non-tick parasites in α-Gal sensitization has also been deliberated. In the present study, we therefore evaluated the capacity of helminths (Toxocara canis, Ascaris suum, Schistosoma mansoni), protozoa (Toxoplasma gondii), and parasitic fungi (Aspergillus fumigatus) to induce an immune response to α-Gal. For this, different developmental stages of the infectious agents were tested for the presence of α-Gal. Next, the potential correlation between immune responses to α-Gal and the parasite infections was investigated by testing sera collected from patients with AGS and those infected with the parasites. Our results showed that S. mansoni and A. fumigatus produce the terminal α-Gal moieties, but they were not able to induce the production of specific antibodies. By contrast, T. canis, A. suum and T. gondii lack the α-Gal epitope. Furthermore, the patients with T. canis infection had significantly decreased anti-α-Gal IgE levels when compared to the healthy controls, suggesting the potential role of this nematode parasite in suppressing the allergic response to the glycan molecule. This rather intriguing observation is discussed in the context of the 'hygiene hypothesis'. Taken together, our study provides new insights into the relationships between immune responses to α-Gal and parasitic infections. However, further investigations should be undertaken to identify T. canis components with potent immunomodulatory properties and to assess their potential to be used in immunotherapy and control of AGS.
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Affiliation(s)
- Adnan Hodžić
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - Lourdes Mateos-Hernández
- UMR BIPAR, INRAE, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94706 Maisons-Alfort, France; (L.M.-H.); (D.L.R.)
| | - Emilie Fréalle
- CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019–UMR 8204–CIIL–Center for Infection and Immunity of Lille, University of Lille, F-59000 Lille, France;
- CHU Lille, Laboratory of Parasitology and Mycology, F-59000 Lille, France;
| | - Patricia Román-Carrasco
- Molecular Biotechnology Section, FH Campus Wien, University of Applied Sciences, 1030 Vienna, Austria; (P.R.-C.); (I.S.)
| | - Pilar Alberdi
- SaBio, Instituto de Investigación en Recursos Cinegéticos (IREC-CSIC-UCLM-JCCM), Ronda de Toledo s/n, 13005 Ciudad Real, Spain; (P.A.); (J.d.l.F.)
| | - Muriel Pichavant
- CHU Lille, Laboratory of Parasitology and Mycology, F-59000 Lille, France;
| | - Veronica Risco-Castillo
- EA 7380 Dynamyc, UPEC, USC, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94706 Maisons-Alfort, France;
| | - Delphine Le Roux
- UMR BIPAR, INRAE, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94706 Maisons-Alfort, France; (L.M.-H.); (D.L.R.)
| | - Jérôme Vicogne
- CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019–UMR9017–CIIL–Center for Infection and Immunity of Lille, University of Lille, F-59000 Lille, France;
| | | | - Herbert Auer
- Department of Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Ines Swoboda
- Molecular Biotechnology Section, FH Campus Wien, University of Applied Sciences, 1030 Vienna, Austria; (P.R.-C.); (I.S.)
| | | | - José de la Fuente
- SaBio, Instituto de Investigación en Recursos Cinegéticos (IREC-CSIC-UCLM-JCCM), Ronda de Toledo s/n, 13005 Ciudad Real, Spain; (P.A.); (J.d.l.F.)
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA
| | - Alejandro Cabezas-Cruz
- UMR BIPAR, INRAE, ANSES, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94706 Maisons-Alfort, France; (L.M.-H.); (D.L.R.)
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24
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Aboud A, Fujita B, Stierle U, Hemmer W, Lange R, Franke U, Leyh R, Laufer G, Sievers HH, Ensminger S. Long-Term Outcomes for Patients Undergoing the Ross Procedure in 10 European Heart Centers: An Update from the Ross Registry. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Liebrich M, Schlereth S, Roser D, Strauss H, Merk DR, Hupp T, Doll N, Voth V, Hemmer W. Hans Georg Borst Preis: Midterm Results with the Frozen-Elephant Trunk Technique (E-vita Open) in Thoracic Aortic Disease: A Single-Center Experience in 199 Patients. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Román‐Carrasco P, Lieder B, Somoza V, Ponce M, Szépfalusi Z, Martin D, Hemmer W, Swoboda I. Only α-Gal bound to lipids, but not to proteins, is transported across enterocytes as an IgE-reactive molecule that can induce effector cell activation. Allergy 2019; 74:1956-1968. [PMID: 31102539 PMCID: PMC6852507 DOI: 10.1111/all.13873] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 01/09/2019] [Revised: 04/09/2019] [Accepted: 04/18/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND The oligosaccharide galactose-α-1,3-galactose (α-Gal), present in mammalian proteins and lipids, causes an unusual delayed allergic reaction 3 to 6 hours after ingestion of mammalian meat in individuals with IgE antibodies against α-Gal. To better understand the delayed onset of allergic symptoms and investigate whether protein-bound or lipid-bound α-Gal causes these symptoms, we analyzed the capacity of α-Gal conjugated proteins and lipids to cross a monolayer of intestinal cells. METHODS Extracts of proteins and lipids from beef were prepared, subjected to in vitro digestions, and added to Caco-2 cells grown on permeable supports. The presence of α-Gal in the basolateral medium was investigated by immunoblotting, thin-layer chromatography with immunostaining and ELISA, and its allergenic activity was analyzed in a basophil activation test. RESULTS After addition of beef proteins to the apical side of Caco-2 cells, α-Gal containing peptides were not detected in the basolateral medium. Those peptides that crossed the Caco-2 monolayer did not activate basophils from an α-Gal allergic patient. Instead, when Caco-2 cells were incubated with lipids extracted from beef, α-Gal was detected in the basolateral medium. Furthermore, these α-Gal lipids were able to activate the basophils of an α-Gal allergic patient in a dose-dependent manner. CONCLUSION Only α-Gal bound to lipids, but not to proteins, is able to cross the intestinal monolayer and trigger an allergic reaction. This suggests that the slower digestion and absorption of lipids might be responsible for the unusual delayed allergic reactions in α-Gal allergic patients and identifies glycolipids as potential allergenic molecules.
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Affiliation(s)
| | - Barbara Lieder
- Department of Physiological Chemistry, Faculty of Chemistry University of Vienna Vienna Austria
| | - Veronika Somoza
- Department of Physiological Chemistry, Faculty of Chemistry University of Vienna Vienna Austria
| | - Marta Ponce
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Zsolt Szépfalusi
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Diana Martin
- Departamento de Producción y Caracterización de Nuevos Alimentos Instituto de Investigación en Ciencias de la Alimentación (CIAL) (CSIC‐UAM) Madrid Spain
| | | | - Ines Swoboda
- Molecular Biotechnology Section University of Applied Sciences Vienna Austria
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27
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Tscheppe A, Palmberger D, van Rijt L, Kalic T, Mayr V, Palladino C, Kitzmüller C, Hemmer W, Hafner C, Bublin M, van Ree R, Grabherr R, Radauer C, Breiteneder H. Development of a novel Ara h 2 hypoallergen with no IgE binding or anaphylactogenic activity. J Allergy Clin Immunol 2019; 145:229-238. [PMID: 31525384 PMCID: PMC7100897 DOI: 10.1016/j.jaci.2019.08.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 02/06/2019] [Revised: 07/31/2019] [Accepted: 08/16/2019] [Indexed: 02/03/2023]
Abstract
Background To date, no safe allergen-specific immunotherapy for patients with peanut allergy is available. Previous trials were associated with severe side effects. Objective We sought to determine the relative importance of conformational and linear IgE-binding epitopes of the major peanut allergen Ara h 2 and to produce a hypoallergenic variant with abolished anaphylactogenic activity. Methods Wild-type Ara h 2 and a mutant lacking the loops containing linear IgE epitopes were produced in insect cells. Conformational IgE epitopes were removed by unfolding these proteins through reduction and alkylation. IgE binding was tested by means of ELISA with sera from 48 Ara h 2–sensitized patients with peanut allergy. Basophil activation and T-cell proliferation were tested with blood samples from selected patients. Anaphylactogenic potency was tested by using intraperitoneal challenge of mice sensitized intragastrically to peanut extract. Results Patients’ IgE recognized conformational and linear epitopes in a patient-specific manner. The unfolded mutant lacking both types of epitopes displayed significantly lower IgE binding (median ELISA OD, 0.03; interquartile range, 0.01-0.06) than natural Ara h 2 (median ELISA OD, 0.99; interquartile range, 0.90-1.03; P < .01). Basophil activation by unfolded mutant Ara h 2 was low (median area under the curve, 72 vs 138 for native wild-type Ara h 2; P < .05), but its ability to induce T-cell proliferation was retained. Unfolded mutants without conformational epitopes did not induce anaphylaxis in peanut-sensitized mice. Conclusions By removing conformational and linear IgE epitopes, a hypoallergenic Ara h 2 mutant with abolished IgE binding and anaphylactogenic potency but retained T-cell activation was generated.
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Affiliation(s)
- Angelika Tscheppe
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Dieter Palmberger
- Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Leonie van Rijt
- Department of Experimental Immunology, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tanja Kalic
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Vanessa Mayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Chiara Palladino
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Claudia Kitzmüller
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Christine Hafner
- Department of Dermatology, University Hospital St Pölten, Karl Landsteiner University of Health Sciences, St Pölten, and the Karl Landsteiner Institute for Dermatological Research, St Pölten, Austria
| | - Merima Bublin
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Reingard Grabherr
- Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Christian Radauer
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
| | - Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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28
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Van Hemelen D, Hemmer W, Kmenta M, Berger UB, Kinaciyan T, Bohle B, Jahn-Schmid B. Dramatically decreased T cell responses but persistent IgE upon reduced pollen exposure. Immunobiology 2019; 224:645-648. [PMID: 31402150 PMCID: PMC6941935 DOI: 10.1016/j.imbio.2019.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/21/2019] [Accepted: 07/30/2019] [Indexed: 11/18/2022]
Abstract
Mugwort pollen allergy is frequent in parts of Europe. As mugwort pollen
contains only one major allergen, Art v 1, which harbors only one T cell
epitope, we employed mugwort pollen allergy as a model to study
allergen-specific T cell responses. However, after 2004, we noticed a drastic
decrease in the T cell responses to Art v 1 and eventually it became almost
impossible to detect allergen-specific responses at the T cell level in
mugwort-allergic individuals. To explain this observation, we retrospectively
investigated the local exposure to mugwort pollen and its possible correlation
to the frequency and reactivity of allergen-specific T cells. The total annual
pollen indices dramatically dropped after 2004 and never reached previous levels
again. Local sensitization to mugwort pollen and serum IgE antibodies specific
for Art v 1 remained unchanged until 2015. Our mugwort pollen model shows that
specific IgE-levels are maintained for extremely long time periods in spite of a
long-term reduction of natural allergen exposure to levels that are too low to
boost specific T cells.
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Affiliation(s)
- Dries Van Hemelen
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Austria
| | | | | | | | - Tamar Kinaciyan
- Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria
| | - Barbara Bohle
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Austria
| | - Beatrice Jahn-Schmid
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Austria.
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29
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Cabezas-Cruz A, Hodžić A, Román-Carrasco P, Mateos-Hernández L, Duscher GG, Sinha DK, Hemmer W, Swoboda I, Estrada-Peña A, de la Fuente J. Environmental and Molecular Drivers of the α-Gal Syndrome. Front Immunol 2019; 10:1210. [PMID: 31214181 PMCID: PMC6554561 DOI: 10.3389/fimmu.2019.01210] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [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: 03/14/2019] [Accepted: 05/13/2019] [Indexed: 12/20/2022] Open
Abstract
The α-Gal syndrome (AGS) is a type of allergy characterized by an IgE antibody (Ab) response against the carbohydrate Galα1-3Galβ1-4GlcNAc-R (α-Gal), which is present in glycoproteins from tick saliva and tissues of non-catarrhine mammals. Recurrent tick bites induce high levels of anti-α-Gal IgE Abs that mediate delayed hypersensitivity to consumed red meat products in humans. This was the first evidence that tick glycoproteins play a major role in allergy development with the potential to cause fatal delayed anaphylaxis to α-Gal-containing foods and drugs and immediate anaphylaxis to tick bites. Initially, it was thought that the origin of tick-derived α-Gal was either residual blood meal mammalian glycoproteins containing α-Gal or tick gut bacteria producing this glycan. However, recently tick galactosyltransferases were shown to be involved in α-Gal synthesis with a role in tick and tick-borne pathogen life cycles. The tick-borne pathogen Anaplasma phagocytophilum increases the level of tick α-Gal, which potentially increases the risk of developing AGS after a bite by a pathogen-infected tick. Two mechanisms might explain the production of anti-α-Gal IgE Abs after tick bites. The first mechanism proposes that the α-Gal antigen on tick salivary proteins is presented to antigen-presenting cells and B-lymphocytes in the context of Th2 cell-mediated immunity induced by tick saliva. The second mechanism is based on the possibility that tick salivary prostaglandin E2 triggers Immunoglobulin class switching to anti-α-Gal IgE-producing B cells from preexisting mature B cells clones producing anti-α-Gal IgM and/or IgG. Importantly, blood group antigens influence the capacity of the immune system to produce anti-α-Gal Abs which in turn impacts individual susceptibility to AGS. The presence of blood type B reduces the capacity of the immune system to produce anti-α-Gal Abs, presumably due to tolerance to α-Gal, which is very similar in structure to blood group B antigen. Therefore, individuals with blood group B and reduced levels of anti-α-Gal Abs have lower risk to develop AGS. Specific immunity to tick α-Gal is linked to host immunity to tick bites. Basophil activation and release of histamine have been implicated in IgE-mediated acquired protective immunity to tick infestations and chronic itch. Basophil reactivity was also found to be higher in patients with AGS when compared to asymptomatic α-Gal sensitized individuals. In addition, host resistance to tick infestation is associated with resistance to tick-borne pathogen infection. Anti-α-Gal IgM and IgG Abs protect humans against vector-borne pathogens and blood group B individuals seem to be more susceptible to vector-borne diseases. The link between blood groups and anti-α-Gal immunity which in turn affects resistance to vector-borne pathogens and susceptibility to AGS, suggests a trade-off between susceptibility to AGS and protection to some infectious diseases. The understanding of the environmental and molecular drivers of the immune mechanisms involved in AGS is essential to developing tools for the diagnosis, control, and prevention of this growing health problem.
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Affiliation(s)
- Alejandro Cabezas-Cruz
- UMR BIPAR, INRA, ANSES, Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Adnan Hodžić
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | - Lourdes Mateos-Hernández
- UMR BIPAR, INRA, ANSES, Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Georg Gerhard Duscher
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Deepak Kumar Sinha
- Biology Center, Institute of Parasitology, Czech Academy of Sciences, Ceské Budějovice, Czechia
| | | | - Ines Swoboda
- Molecular Biotechnology Section, University of Applied Sciences, Vienna, Austria
| | | | - José de la Fuente
- SaBio, Instituto de Investigación de Recursos Cinegéticos, IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain.,Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, United States
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30
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Liebrich M, Tzanavaros I, Doll N, Hemmer W. The David procedure for surgical management of neo-aortic root dilatation following the arterial switch operation: Technical aspects. Multimed Man Cardiothorac Surg 2019; 2019. [PMID: 30990578 DOI: 10.1510/mmcts.2019.013] [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: 11/06/2022]
Abstract
Progressive neo-aortic/pulmonary root dilatation and associated valve regurgitation if translocated into the aortic position, remains a major drawback and serious late complication following the arterial switch operation. This video tutorial presents the technical aspects and a step-by-step illustration of the valve-sparing reimplantation technique, which allows the neo-aortic valve to be maintained late after the arterial switch operation.
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31
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Liebrich M, Voth V, Doll N, Hemmer W. Preservation of a Regurgitant Quadricuspid Pulmonary Autograft by the David Procedure. Ann Thorac Surg 2019; 108:e165-e167. [PMID: 30797796 DOI: 10.1016/j.athoracsur.2019.01.037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/18/2018] [Accepted: 01/13/2019] [Indexed: 11/15/2022]
Abstract
We report a case in which a quadricuspid pulmonary valve was used for the Ross operation in a young male patient. The patient demonstrated severe pulmonary autograft regurgitation due to a neosinus of Valsalva aneurysm 16 years after the primary operation. Preservation of the quadricuspid pulmonary autograft was performed by the David procedure, resulting in a competent valve function.
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32
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Liebrich M, Stadler C, Voth V, Roser D, Merk R, Doll N, Hemmer W. Freedom from Aortic Valve–Related Reoperation and Long-Term Survival after the David Procedure: A Single-Center Experience in 500 Patients. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - C. Stadler
- Sana Cardiac Surgery, Stuttgart, Germany
| | - V. Voth
- Sana Cardiac Surgery, Stuttgart, Germany
| | - D. Roser
- Sana Cardiac Surgery, Stuttgart, Germany
| | - R. Merk
- Sana Cardiac Surgery, Stuttgart, Germany
| | - N. Doll
- Sana Cardiac Surgery, Stuttgart, Germany
| | - W. Hemmer
- Sana Cardiac Surgery, Stuttgart, Germany
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33
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Pecha S, Burger H, Möller V, Madej T, Osswald B, Maali A, De Simone R, Monsefi N, Ziaukas V, Erler S, Elfarra H, Perthel M, Hemmer W, Ghaffari N, Sandhaus T, Busk H, Schmitto J, Bärsch V, Easo J, Treede H, Albert M, Nägele H, Zenker D, Hegazy Y, Ahmadi D, Ehrlich W, Knaut M, Reichenspurner H, Butter C, Hakmi S. The German Laser Lead Extraction Registry: GALLERY. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Pecha
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - H. Burger
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - V. Möller
- Herzzentrum Brandenburg, Kardiologie, Bernau bei Berlin, Germany
| | - T. Madej
- Herzzentrum Dresden, Klinik für Herzchirurgie, Dresden, Germany
| | - B. Osswald
- Universitätsklinikum Düsseldorf, Klinik für Kardiovaskuläre Chirurgie, Düsseldorf, Germany
| | - A. Maali
- Herzzentrum Coswig, Herz- und Gefäßchirurgie, Coswig, Germany
| | - R. De Simone
- Universitätsklinikum Heidelberg, Klinik für Herzchirurgie, Heidelberg, Germany
| | - N. Monsefi
- Universitätsklinikum Frankfurt, Thorax-, Herz- und Thorakale Gefäßchirurgie, Frankfurt am Main, Germany
| | - V. Ziaukas
- Schüchtermann-Klinik, Herzchirurgie, Bad Othenfelde, Germany
| | - S. Erler
- Herz- und Gefässzentrum, Klinik für Herz-Thorax-Chirurgie, Bad Bevensen, Germany
| | - H. Elfarra
- Universitätsklinikum Marburg, Herz- und Thorakale Gefäßchirurgie, Marburg, Germany
| | - M. Perthel
- Herzzentrum Bad Segeberg, Herzchirurgie, Bad Segeberg, Germany
| | - W. Hemmer
- Sana Herzchirurgie Stuttgart, Hemmer, Stuttgart, Germany
| | - N. Ghaffari
- Helios Klinik für Herzchirurgie Karlsruhe, Herzchirurgie, Karlsruhe, Germany
| | - T. Sandhaus
- Universitätsklinikum Jena, Klinik für Herz- und Thoraxchirurgie, Jena, Germany
| | - H. Busk
- Universitätsklinikum Magdeburg, Herz- und Thoraxchirurgie, Magdeburg, Germany
| | - J. Schmitto
- Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany
| | - V. Bärsch
- Helios Klinikum Siegburg, Herzchirurgie und Thoraxchirurgie, Siegburg, Germany
| | - J. Easo
- Klinikum Oldenburg, Universitätsklinik für Herzchirurgie, Oldenburg, Germany
| | - H. Treede
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Herzchirurgie, Halle (Saale), Germany
| | - M. Albert
- Robert-Bosch-Krankenhaus, Herz- und Gefäßchirurgie, Stuttgart, Germany
| | - H. Nägele
- Albertinen Herz- und Gefäßzentrum, Herzinsuffizienz- und Devicetherapie, Hamburg, Germany
| | - D. Zenker
- Universitätsmedizin Göttingen, Klinik für Thorax-, Herz- und Gefäßchirurgie, Göttingen, Germany
| | - Y. Hegazy
- Herzzentrum Lahr, Herz-, Thorax- und Gefäßchirurgie, Lahr, Germany
| | - D. Ahmadi
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - W. Ehrlich
- Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany
| | - M. Knaut
- Herzzentrum Dresden, Klinik für Herzchirurgie, Dresden, Germany
| | - H. Reichenspurner
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
| | - C. Butter
- Herzzentrum Brandenburg, Kardiologie, Bernau bei Berlin, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany
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Liebrich M, Voth V, Doll N, Hemmer W. Reconstruction of regurgitant bicuspid aortic valve (Sievers type 1, L/R, I) with raphe resection and concomitant pericardial patch-augmentation: A standardized approach. Multimed Man Cardiothorac Surg 2018; 2018. [PMID: 30265460 DOI: 10.1510/mmcts.2018.054] [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: 11/06/2022]
Abstract
A major limitation of the more widespread application of aortic valve reconstruction is the lack of a common framework for valve assessment that could be used to guide a standardized approach to aortic valve repair, similar to that used in reconstructive mitral valve surgery. Most patients with a regurgitant aortic valve are young and possess a specific subtype of a bicuspid aortic valve according to the Sievers classifications system. This video tutorial presents the technical aspects of a standardized approach for reconstruction of the regurgitant bicuspid aortic valve (Sievers type 1, L/R), which was developed during the past decade.
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Curin M, Garmatiuk T, Resch-Marat Y, Chen KW, Hofer G, Fauland K, Keller W, Hemmer W, Vrtala S, Focke-Tejkl M, Valenta R. Similar localization of conformational IgE epitopes on the house dust mite allergens Der p 5 and Der p 21 despite limited IgE cross-reactivity. Allergy 2018; 73:1653-1661. [PMID: 29319884 PMCID: PMC6055609 DOI: 10.1111/all.13398] [Citation(s) in RCA: 17] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Due to high IgE recognition frequency and high allergenic activity, Der p 5 and Der p 21 are clinically important house dust mite (HDM) allergens. The objective of this study was to characterize the immunodominant IgE epitopes of Der p 5 and Der p 21 responsible for their high allergenic activity. METHODS A panel of 12 overlapping peptides spanning the Der p 5 and Der p 21 sequence were synthesized to search for sequential IgE epitopes by direct testing for allergic patients' IgE reactivity. Peptide-specific antibodies raised in rabbits were used in inhibition studies for localizing conformational IgE epitopes which were visualized on the surfaces of the allergen structures by molecular modelling. IgE cross-reactivity between the allergens was investigated by IgE inhibition studies. RESULTS Immunodominant IgE epitopes defined by allergic patients' IgE on Der p 5 and Der p 21 were primarily of the conformational, discontinuous type including N- and C-terminal portions of the protein. They could be located on each allergen on one area with similar localization, but despite similar structure of the allergens, no relevant IgE cross-reactivity could be detected. CONCLUSION Our study shows that Der p 5 and Der p 21 contain a major conformational IgE epitope-containing area located on similar portions of their structure, but they lack relevant IgE cross-reactivity. These data are important for the development of modern allergy vaccines based on defined molecules for allergen-specific immunotherapy of HDM allergy.
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Affiliation(s)
- M. Curin
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - T. Garmatiuk
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - Y. Resch-Marat
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - K. W. Chen
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - G. Hofer
- Institute of Molecular Biosciences; BioTechMed; University of Graz; Graz Austria
| | - K. Fauland
- Institute of Molecular Biosciences; BioTechMed; University of Graz; Graz Austria
| | - W. Keller
- Institute of Molecular Biosciences; BioTechMed; University of Graz; Graz Austria
| | - W. Hemmer
- FAZ - Floridsdorf Allergy Center; Vienna Austria
| | - S. Vrtala
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - M. Focke-Tejkl
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - R. Valenta
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
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Palladino C, Narzt MS, Bublin M, Schreiner M, Humeniuk P, Gschwandtner M, Hafner C, Hemmer W, Hoffmann-Sommergruber K, Mildner M, Palomares O, Gruber F, Breiteneder H. Peanut lipids display potential adjuvanticity by triggering a pro-inflammatory response in human keratinocytes. Allergy 2018; 73:1746-1749. [PMID: 29747215 PMCID: PMC6095042 DOI: 10.1111/all.13475] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. Palladino
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - M. S. Narzt
- Department of Dermatology; Division of Biology and Pathobiology of the Skin; Medical University of Vienna; Vienna Austria
- Christian Doppler Laboratory for Biotechnology of Skin Aging; Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - M. Bublin
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - M. Schreiner
- Institute of Food Science; University of Natural Resources and Life Sciences (BOKU); Vienna Austria
| | - P. Humeniuk
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - M. Gschwandtner
- Department of Dermatology; Division of Biology and Pathobiology of the Skin; Medical University of Vienna; Vienna Austria
| | - C. Hafner
- Department of Dermatology; University Hospital St. Poelten; Karl Landsteiner University of Health Sciences; St. Poelten Austria
- Karl Landsteiner Institute of Dermatological Research; Karl Landsteiner Gesellschaft; St. Poelten Austria
| | - W. Hemmer
- Floridsdorf Allergy Center; Vienna Austria
| | | | - M. Mildner
- Department of Dermatology; Division of Biology and Pathobiology of the Skin; Medical University of Vienna; Vienna Austria
| | - O. Palomares
- Department of Biochemistry and Molecular Biology; School of Chemistry; Complutense University of Madrid; Madrid Spain
| | - F. Gruber
- Department of Dermatology; Division of Biology and Pathobiology of the Skin; Medical University of Vienna; Vienna Austria
- Christian Doppler Laboratory for Biotechnology of Skin Aging; Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - H. Breiteneder
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
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Liebrich M, Voth V, Tzanavaros I, Hemmer W. Endokarditis nach Aorta-ascendens-Ersatz. Z Herz- Thorax- Gefäßchir 2017. [DOI: 10.1007/s00398-017-0149-y] [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: 11/24/2022]
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Hemmer W, Sesztak-Greinecker G, Wöhrl S, Wantke F. Food allergy to millet and cross-reactivity with rice, corn and other cereals. Allergol Int 2017; 66:490-492. [PMID: 27939330 DOI: 10.1016/j.alit.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022] Open
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Götte J, Hemmer W, Roser D, Liebrich M, Doll N. Redo Aortic Valve Implantation After Full Root Replacement Using A Sutureless Valve Prosthesis. Ann Thorac Surg 2017; 102:e421-e422. [PMID: 27772598 DOI: 10.1016/j.athoracsur.2016.01.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 12/24/2015] [Accepted: 01/11/2016] [Indexed: 11/26/2022]
Abstract
We report the case of a 83-year-old man who had undergone a full root replacement with a stentless bioprosthesis 15 years earlier. He was now diagnosed with severe aortic valve regurgitation secondary to leaflet degeneration, moderate mitral regurgitation, and single-vessel coronary artery disease. To reduce cross-clamp time and technical difficulties a sutureless aortic prosthesis was used. His surgery and postoperative course were uneventful. This is the first report of the successful use of a sutureless aortic valve prosthesis in a patient after bioprosthetic full root replacement who required additional mitral repair and coronary artery bypass surgery.
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Affiliation(s)
- Julia Götte
- Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany.
| | | | - Detlef Roser
- Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
| | | | - Nicolas Doll
- Sana Cardiac Surgery Stuttgart GmbH, Stuttgart, Germany
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Kari F, Richardt D, Beyersdorf F, Doll N, Hemmer W, Liebrich M, Reichenspurner H, Detter C, Sievers H. Bicuspid Aortic Valve-Sparing Root Surgery: What Is the Fate of Residual Aortic Regurgitation? Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F.A. Kari
- Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
| | - D. Richardt
- Cardiac and Thoracic Vascular Surgery, University Heart Center Lübeck, Lübeck, Germany
| | - F. Beyersdorf
- Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
| | - N. Doll
- Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - W. Hemmer
- Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - M. Liebrich
- Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - H. Reichenspurner
- Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - C. Detter
- Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - H.H. Sievers
- Cardiac and Thoracic Vascular Surgery, University Heart Center Lübeck, Lübeck, Germany
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Merz C, Böthig D, Liebrich M, Scheid M, Hemmer W, Doll N, Horke A, Haverich A, Tzanavaros I. 25 Years of Experience in Pediatric Pacing: Is There an Achilles Heel? Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- C. Merz
- Medizinische Hochschule Hannover, Hannover, Germany
| | - D. Böthig
- Medizinische Hochschule Hannover, Hannover, Germany
| | | | - M. Scheid
- Sana Cardiac Surgery, Stuttgart, Germany
| | - W. Hemmer
- Sana Cardiac Surgery, Stuttgart, Germany
| | - N. Doll
- Sana Cardiac Surgery, Stuttgart, Germany
| | - A. Horke
- Medizinische Hochschule Hannover, Hannover, Germany
| | - A. Haverich
- Medizinische Hochschule Hannover, Hannover, Germany
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Tscheppe A, Palmberger D, Radauer C, Bublin M, Hafner C, Hemmer W, Mayr V, Palladino C, Gepp B, Lengger N, Grabherr R, Breiteneder H. Influence of Conformational and Linear IgE Epitopes on Ara h 2-Specific IgE-Binding. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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43
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Liebrich M, Voth V, Hupp T, Richter GM, Doll KN, Hemmer W. Aortenbogenchirurgie. Z Herz- Thorax- Gefäßchir 2016. [DOI: 10.1007/s00398-016-0084-3] [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: 10/21/2022]
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Hemmer W, Sesztak-Greinecker G, Wantke F, Wohrl S. Usefulness of Component-Resolved Diagnosis (CRD) in Patients with Pet Allergy. J Allergy Clin Immunol 2016. [DOI: 10.1016/j.jaci.2015.12.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Schrautzer C, Bokanovic D, Hemmer W, Lang R, Hawranek T, Schwarz I, Aberer W, Sturm E, Sturm GJ. Sensitivity and specificity of Hymenoptera allergen components depend on the diagnostic assay employed. J Allergy Clin Immunol 2016; 137:1603-5. [PMID: 26768412 DOI: 10.1016/j.jaci.2015.10.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/04/2015] [Accepted: 10/05/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Christoph Schrautzer
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Danijela Bokanovic
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | | | - Roland Lang
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - Thomas Hawranek
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - Ines Schwarz
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Werner Aberer
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Eva Sturm
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Gunter Johannes Sturm
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria; Allergy Outpatient Clinic Reumannplatz, Vienna, Austria.
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Kari FA, Doll KN, Hemmer W, Liebrich M, Sievers HH, Richardt D, Reichenspurner H, Detter C, Siepe M, Czerny M, Beyersdorf F. Survival and freedom from aortic valve-related reoperation after valve-sparing aortic root replacement in 1015 patients. Interact Cardiovasc Thorac Surg 2015; 22:431-8. [DOI: 10.1093/icvts/ivv354] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/16/2015] [Indexed: 11/14/2022] Open
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47
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Kari FA, Doll KN, Hemmer W, Liebrich M, Sievers HH, Richardt D, Reichenspurner H, Detter C, Siepe M, Czerny M, Beyersdorf F. Residual and Progressive Aortic Regurgitation After Valve-Sparing Root Replacement: A Propensity-Matched Multi-Institutional Analysis in 764 Patients. Ann Thorac Surg 2015; 101:1500-6. [PMID: 26704413 DOI: 10.1016/j.athoracsur.2015.10.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/23/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Residual/progressive aortic regurgitation (rAR, pAR) after valve-sparing aortic root replacement (V-SARR) can lead to reoperations. We sought to characterize risk factors of mild rAR and pAR after V-SARR in a multicenter cohort. The effect of additional cusp repair on valve function was analyzed using propensity matching. METHODS A total of 1,015 patients after V-SARR were identified with (n = 288, 28%) or without additional cusp/commissure repair (n = 727, 72%) at four cardiac units in Germany. A total of 764 patients fulfilling transthoracic echocardiography follow-up-criteria comprised the study cohort. Logistic regression was used for risk factor analysis with endpoints rAR, new onset AR, and pAR. t tests and analyses of variance were used for between-group differences. The effects of additional cusp repair on valve function were studied comparing propensity-matched quintiles. RESULTS The incidence of rAR was 29%, with influencing factors aneurysm size (p = 0.07) and preoperative aortic valve function (p = 0.08). It was found more often among nonsyndromic patients (34% vs. 14%; OR, 0.4; p < 0.001). Progression of rAR was detectable in 30% after a mean of 4.3 years. The progression rate of rAR ∼ 0.3 grades per patient-year within the first 5 years. When quintiles identified by propensity score were compared, additional cusp repair was linked to new onset AR (p = 0.016) while it was not linked to rAR (p = 0.14) or pAR (p = 0.5). CONCLUSIONS The incidences of rAR and pAR are considerable after V-SARR. Patients should be operated on before large aneurysms are present. New onset AR after an initially good functional result is more likely after an additional cusp repair, while rAR and pAR are not influenced by cusp repair.
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Affiliation(s)
- Fabian A Kari
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany.
| | | | | | | | - Hans-Hinrich Sievers
- Department of Heart and Thoracic Vascular Surgery, University Hospital Lübeck, Lübeck, Germany
| | - Doreen Richardt
- Department of Heart and Thoracic Vascular Surgery, University Hospital Lübeck, Lübeck, Germany
| | | | | | - Matthias Siepe
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
| | - Martin Czerny
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
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Spangenberg B, Futterknecht S, Hemmer W. An extraction method for 17α-ethinylestradiol from water using a new kind of monolithic stir-bar. JPC-J PLANAR CHROMAT 2015. [DOI: 10.1556/1006.2015.28.6.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Liebrich M, Hemmer W, Uhlemann F, Merz C, Voth W, Scheid M, Tzanavaros I. A Novel Designed Valved Conduit for RVOT Reconstruction in Grown-up Congenital Heart Patients: a Glimpse Down the Road. Thorac Cardiovasc Surg 2015; 64:36-43. [PMID: 26474008 DOI: 10.1055/s-0035-1564930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND A plethora of valves and valve conduits are available for reconstruction of the right ventricular outflow tract (RVOT) for grown-up congenital heart patients. However, for several reasons, the ideal pulmonary valve substitute still remains the subject of debate. In this study, we investigated the preliminary clinical and echocardiographic results after implantation of the RVOT Elan (Vascutek, Renfrewshire, United Kingdom) conduit in adolescents and adults. MATERIAL AND METHODS Between October 2012 and December 2014, a total of 27 patients (19 males, mean age: 23.7 ± 22.5; range: 9-74 years) received a RVOT Elan conduit for RVOT reconstruction and were prospectively followed up clinically and echocardiographically. Twenty-five patients had previous cardiac surgery. The median number of prior operations per patient was 2 (range: 1-4). Tetralogy of Fallot was the most common diagnosis (n = 7). RESULTS At a mean follow-up time of 0.9 ± 0.61 years (100% complete), all patients (27 of 27) were alive and in New York Heart Association Class I. Adverse events defined as valve failure, thrombosis, embolism, bleeding, or endocarditis did not occur. Freedom from reoperation in general was 100%. At 1-year follow-up, median peak pressure gradients (Δ Pmax) across the RVOT Elan conduit were 15 ± 3.2; 15.3 ± 2.1Δ, 16 ± 4.8, and 16.3 ± 5.1 mm Hg for the 19 (n = 3), 21 (n = 3), 23 (n = 6), and 25 mm (n = 15) conduit size, respectively. CONCLUSION The RVOT Elan conduit revealed excellent preliminary clinical and hemodynamic performances independent from the underlying cardiac pathology with insignificant transvalvular gradients and nonturbulent flow characteristics.
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Affiliation(s)
- Markus Liebrich
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Wolfgang Hemmer
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Frank Uhlemann
- Department of Pediatric Cardiology/Pulmonology and Intensive Care Medicine, Olgahospital, Stuttgart, Germany
| | - Constanze Merz
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Wladimir Voth
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
| | - Michael Scheid
- Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany
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Niederberger V, Marth K, Eckl-Dorna J, Focke-Tejkl M, Weber M, Hemmer W, Berger U, Neubauer A, Stolz F, Henning R, Valenta R. Skin test evaluation of a novel peptide carrier-based vaccine, BM32, in grass pollen-allergic patients. J Allergy Clin Immunol 2015; 136:1101-3.e8. [PMID: 26048664 DOI: 10.1016/j.jaci.2015.03.034] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 02/28/2015] [Accepted: 03/06/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Verena Niederberger
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
| | - Katharina Marth
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria; Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Julia Eckl-Dorna
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Margarete Focke-Tejkl
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Milena Weber
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Uwe Berger
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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