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González-Torres L, García-Paz V, Meijide A, Goikoetxea MJ, Salgado MA, Sanz ML, Vila L. Local allergic rhinitis in children: Clinical characteristics and role of basophil activation test as a diagnostic tool. Int J Pediatr Otorhinolaryngol 2023; 172:111645. [PMID: 37481991 DOI: 10.1016/j.ijporl.2023.111645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/12/2023] [Accepted: 07/02/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Local allergic rhinitis (LAR) is a condition involving a localized nasal allergic response in absence of systemic atopy. Most studies on LAR have been performed in adults. We aimed to describe clinical characteristics of LAR pediatric patients, its clinical evolution over a 7-year follow-up period and to study the role of basophil activation test (BAT), for its diagnosis. METHODS Forty-four children with non-allergic rhinitis (NAR) were included (24 males, 20 females, aged under 15 years). Nasal allergen provocation test (NAPT) and BAT were performed with Dermatophagoides pteronyssinus and Phleum pratense. RESULTS Seven patients (16%) were diagnosed of LAR. Six reacted to D pteronyssinus and one to P pratense. All LAR and 86% of NAR patients presented perennial symptoms. Fifty-seven percent of NAR and LAR patients referred persistent symptoms. Around half of NAR and LAR patients reported mild-moderate clinical manifestations. Three LAR patients associated conjunctival symptoms, proportionally more than NAR patients (19%, 7 out of 37). NAR patients presented bronchial asthma (n = 10) more frequently than LAR children (n = 1). More than half of LAR and NAR patients presented family history of atopy. BAT was negative in all LAR patients. On follow-up, 3 LAR patients and 10 of the 25 NAR patients who agreed to be retested, presented systemic sensitization. Dust mites were the most frequent allergen involved. CONCLUSIONS LAR should be ruled out in children with NAR. Almost half of children with LAR develop systemic sensitization over time. BAT shows low sensitivity for the diagnosis of LAR in children.
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Affiliation(s)
- L González-Torres
- Allergy Pediatric Unit, Complexo Hospitalario Universitario, A Coruña, Spain
| | - V García-Paz
- Allergy Pediatric Unit, Complexo Hospitalario Universitario, A Coruña, Spain
| | - A Meijide
- Allergy Unit, Complexo Hospitalario Universitario de Vigo, Spain
| | - M J Goikoetxea
- Allergy Unit, Clinica Universitaria de Navarra, Pamplona, Spain
| | - M A Salgado
- Allergy Unit, Clinica Universitaria de Navarra, Pamplona, Spain
| | - M L Sanz
- Allergy Unit, Clinica Universitaria de Navarra, Pamplona, Spain
| | - L Vila
- Allergy Pediatric Unit, Complexo Hospitalario Universitario, A Coruña, Spain.
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Jiménez-Amezcua I, González-Prada A, Díez-Municio M, Soria AC, Ruiz-Matute AI, Sanz ML. Simultaneous microwave-assisted extraction of bioactive compounds from aged garlic. J Chromatogr A 2023; 1704:464128. [PMID: 37302253 DOI: 10.1016/j.chroma.2023.464128] [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: 03/31/2023] [Revised: 05/16/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
In this work, the simultaneous extraction of bioactives (organosulfur compounds, such as S-allyl-L-cysteine (SAC), carbohydrates, such as neokestose and neonystose, and total phenolic compounds) from aged garlic has been optimized for the first time to obtain multifunctional extracts for further application as food ingredients. Analytical methods using liquid chromatography coupled to mass spectrometry (HPLC-MS) and by hydrophilic interaction liquid chromatography with evaporative light scattering detection (HILIC-ELSD) were also previously optimized. High sensitivity (limits of detection between 0.013 and 0.77 µg mL-1) and appropriate repeatability (< 12%) and accuracy (> 92%) for the analysis of bioactives were achieved. After selecting water as the extraction solvent and microwave-assisted extraction (MAE) as the most efficient technique, operation conditions were optimized using a Box-Behnken experimental design (60 min; 120 °C; 0.05 g mL-1; 1 cycle) to maximize the content of bioactives from different aged garlic samples. Regarding organosulfur compounds, only SAC (traces-2.32 mg g-1 dry sample) and cycloalliin (1.23-3.01 mg g-1 dry sample) were detected in all samples, while amino acids such as arginine (0.24-3.45 mg g-1 dry sample) and proline (0.43-3.91 mg g-1 dry sample) were, in general, the most abundant. Bioactive carbohydrates (from trisaccharides to nonasaccharides) were only detected in fresh garlic and aged garlic processed under mild conditions, whereas all garlic extracts showed antioxidant activity. The developed MAE methodology is shown as a successful alternative to other procedures for the simultaneous extraction of aged garlic bioactives intended by the food and nutraceutical industries, among others.
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Affiliation(s)
- I Jiménez-Amezcua
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva, 3, Madrid 28006, Spain; Pharmactive Biotech Products SLU, Faraday, 7, Madrid 28049, Spain
| | - A González-Prada
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva, 3, Madrid 28006, Spain
| | - M Díez-Municio
- Pharmactive Biotech Products SLU, Faraday, 7, Madrid 28049, Spain
| | - A C Soria
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva, 3, Madrid 28006, Spain
| | - A I Ruiz-Matute
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva, 3, Madrid 28006, Spain
| | - M L Sanz
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva, 3, Madrid 28006, Spain.
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Villa López G, Valero Zanuy MA, González Barrios I, Maíz Jiménez M, Gomis Muñóz P, León Sanz M. Acute Hypertriglyceridemia in Patients with COVID-19 Receiving Parenteral Nutrition. Nutrients 2021; 13:2287. [PMID: 34371797 PMCID: PMC8308259 DOI: 10.3390/nu13072287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022] Open
Abstract
Hypertriglyceridemia is a metabolic complication associated with parenteral nutrition (PN). It is unknown if patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 are more at risk. Our aim was to describe the incidence, risk factors and clinical impact of hypertriglyceridemia in critically ill patients with ARDS-COVID-19 receiving PN. We designed a cohort study of patients with ARDS-COVID-19 infection that required admission to critical care units and nutritional support with PN. Individual PN prescriptions for macronutrients and insulin were provided. Lipid emulsion contained fish oil (SMOFlipid® or Lipoplus®). Hypertriglyceridemia was defined as plasma levels above 400 mg/dL. Eighty-seven patients, 66.6% men, 60.1 ± 10.8 years old, BMI 29.1 ± 5.6 kg/m2, 71% of whom received lopinavir/ritonavir, 56% received Propofol and 55% received Tocilizumab were included. The incidence of hypertriglyceridemia was 37 × 100 patient-days with PN. This complication was more frequent in obese patients (OR 3.34; 95% CI, 2.35-4.33) and in those treated with lopinavir/ritonavir (OR 4.98; 95% CI, 3.60-6.29) or Propofol (OR 2.45; 95% CI, 1.55-3.35). Total mortality was 33.3%, similar between the type of lipid emulsion (p = 0.478). On average, patients with hypertriglyceridemia had a longer requirement of PN compared to the group without elevated triglycerides (TG), probably because of their longer survival (p = 0.001). TG higher than 400 mg/dL was not a protective factor for mortality (OR 0.31; 95% CI, 0.01-1.30). In conclusion, the incidence of hypertriglyceridemia was 37 × 100 patient-days with PN. The risk of this complication is associated with obesity and the use of lopinavir/ritonavir or Propofol.
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Affiliation(s)
- Gema Villa López
- Clinical Nutrition Unit, Department of Endocrinology and Nutrition, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041 Madrid, Spain; (G.V.L.); (M.A.V.Z.); (M.M.J.)
| | - Maria Angeles Valero Zanuy
- Clinical Nutrition Unit, Department of Endocrinology and Nutrition, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041 Madrid, Spain; (G.V.L.); (M.A.V.Z.); (M.M.J.)
| | - Ivan González Barrios
- Department of Pharmacy, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (I.G.B.); (P.G.M.)
| | - Maria Maíz Jiménez
- Clinical Nutrition Unit, Department of Endocrinology and Nutrition, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041 Madrid, Spain; (G.V.L.); (M.A.V.Z.); (M.M.J.)
| | - Pilar Gomis Muñóz
- Department of Pharmacy, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (I.G.B.); (P.G.M.)
| | - Miguel León Sanz
- Clinical Nutrition Unit, Department of Endocrinology and Nutrition, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041 Madrid, Spain; (G.V.L.); (M.A.V.Z.); (M.M.J.)
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Librizzi S, Miguel GA, Villa G, Aramendi M, Hawkins F, Sanz ML, Díaz-Guerra GM. Osteoporosis and recent-onset diabetes after liver transplantation: A common link? Bone Rep 2021. [DOI: 10.1016/j.bonr.2021.100986] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Loinaz Segurola C, Ochando Cerdán F, Vicente López E, Serrablo Requejo A, López Cillero P, Gómez Bravo MÁ, Fabregat Prous J, Varo Pérez E, Miyar de León A, Fondevila Campo C, Valdivieso López A, Blanco Fernández G, Sánchez B, López Andújar R, Fundora Suárez Y, Cugat Andorra E, Díez Valladares L, Herrera Cabezón J, García Gil A, Morales Soriano R, Pardo Sánchez F, Sabater Ortí L, López Baena JÁ, Muñoz Bellvís L, Martín Pérez E, Pérez Saborido B, Suárez Muñoz MÁ, Meneu Día JC, Albiol Quer M, Sanjuanbenito Dehesa A, Ramia Ángel JM, Pereira Pérez F, Paseiro Crespo G, Palomo Sánchez JC, León Sanz M. Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain. NUTR HOSP 2020; 37:238-242. [PMID: 32090583 DOI: 10.20960/nh.02895] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: a survey on peri-operative nutritional support in pancreatic and biliary surgery among Spanish hospitals in 2007 showed that few surgical groups followed the 2006 ESPEN guidelines. Ten years later we sent a questionnaire to check the current situation. Methods: a questionnaire with 21 items sent to 38 centers, related to fasting time before and after surgery, nutritional screening use and type, time and type of peri-operative nutritional support, and number of procedures. Results: thirty-four institutions responded. The median number of pancreatic resections (head/total) was 29.5 (95% CI: 23.0-35; range, 5-68) (total, 1002); of surgeries for biliary malignancies (non-pancreatic), 9.8 (95% CI: 7.3-12.4; range, 2-30); and of main biliary resections for benign conditions, 10.4 (95% CI: 7.6-13.3; range, 2-33). Before surgery, only 41.2% of the sites used nutritional support (< 50% used any nutritional screening procedure). The mean duration of preoperative fasting for solid foods was 9.3 h (range, 6-24 h); it was 6.6 h for liquids (range, 2-12). Following pancreatic surgery, 29.4% tried to use early oral feeding, but 88.2% of the surveyed teams used some nutritional support; 26.5% of respondents used TPN in 100% of cases. Different percentages of TPN and EN were used in the other centers. In malignant biliary surgery, 22.6% used TPN always, and EN in 19.3% of cases. Conclusions: TPN is the commonest nutrition approach after pancreatic head surgery. Only 29.4% of the units used early oral feeding, and 32.3% used EN; 22.6% used TPN regularly after surgery for malignant biliary tumours. The 2006 ESPEN guideline recommendations are not regularly followed 12 years after their publication in our country.
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Escobar-Arnanz J, Sanz ML, Ros M, Sanz J, Ramos L. Potential of topological descriptors to model the retention of polychlorinated biphenyls in different gas chromatography stationary phases, including ionic liquid-based columns. J Chromatogr A 2020; 1616:460844. [PMID: 31952814 DOI: 10.1016/j.chroma.2019.460844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/26/2019] [Accepted: 12/31/2019] [Indexed: 10/25/2022]
Abstract
The aim of this study was to develop a statistical model based on a set of intuitive topological descriptors that will help to determine the influence of the polychlorinated biphenyls (PCBs) structural features on the chromatographic behavior of these analytes in a variety of gas chromatographic stationary phases, including the highly polar ionic liquid (IL)-based SLB-IL76 and SLB-IL60 columns. The model was developed using the stepwise multiple linear regression method, and constructed through several levels of increasing complexity to make evident the relative influence of the selected descriptors. The proposed model was easy to implement and provided similar satisfactory results irrespective of the dependent variables used (i.e., retention index or retention time) or the chromatographic conditions applied (i.e., pseudo-isotherm and programmed temperature) for IL-based phases. The model also allowed the correct prediction of the elution order of selected PCBs in these and other less polar phases evaluated (i.e., SW-10, DB-17, ZB-5 and HT-8). To our knowledge, this is the first models based on topological descriptors described in the literature that provided a satisfactory fitting of the PCB behavior in IL-based phases. Our results indicated that the mechanism governing the chromatographic separation of PCBs in these highly polar columns showed significant differences compared with those observed in other less polar stationary phases.
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Affiliation(s)
- J Escobar-Arnanz
- Department of Instrumental Analysis and Environmental Chemistry, IQOG-CISC, Juan de la Cierva 3, 28006 Madrid, Spain
| | - M L Sanz
- Department of Instrumental Analysis and Environmental Chemistry, IQOG-CISC, Juan de la Cierva 3, 28006 Madrid, Spain
| | - M Ros
- Department of Instrumental Analysis and Environmental Chemistry, IQOG-CISC, Juan de la Cierva 3, 28006 Madrid, Spain
| | - J Sanz
- Department of Instrumental Analysis and Environmental Chemistry, IQOG-CISC, Juan de la Cierva 3, 28006 Madrid, Spain
| | - L Ramos
- Department of Instrumental Analysis and Environmental Chemistry, IQOG-CISC, Juan de la Cierva 3, 28006 Madrid, Spain.
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Mena-García A, Rodríguez-Sánchez S, Ruiz-Matute AI, Sanz ML. Exploitation of artichoke byproducts to obtain bioactive extracts enriched in inositols and caffeoylquinic acids by Microwave Assisted Extraction. J Chromatogr A 2019; 1613:460703. [PMID: 31753483 DOI: 10.1016/j.chroma.2019.460703] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/08/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
Abstract
Byproducts from artichoke represent the majority of the mass collected from the plant and constitute an interesting source of bioactive compounds such as inositols and caffeoylquinic acids. In this work, a microwave assisted extraction (MAE) methodology was developed for the simultaneous extraction of these compounds from artichoke stalks, leaves, receptacles and external bracts. Optimal MAE conditions to maximize the extraction of these bioactives and the antioxidant activity were 97 °C, 3 min, ethanol:water (50:50, v/v). Moreover, a GC-MS methodology was also developed for the simultaneous determination of these compounds in a single run; optimal derivatization conditions were achieved using hexamethyldisilazane and N,O-bis(trimethylsilyl)trifluoroacetamide with 1% trimethylchlorosilane. Artichoke receptacle extracts were the richest in caffeoylquinic acids (28-35 mg g-1 dry sample), followed by the bracts (9-18 mg g-1 dry sample), while those from leaves showed the highest concentrations of inositols (up to 15 mg g-1 dry sample). Receptacle extracts also had the highest antioxidant activity (123 mg TE g-1 dry sample) and the greatest concentration of total phenolic compounds (47 mg GAE g-1 dry sample). Therefore, the developed methodology could be considered as a valuable procedure to obtain and characterize bioactive ingredients with industrial interest from artichoke byproducts, opening new routes of revalorization of artichoke agro-industrial residues.
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Affiliation(s)
- A Mena-García
- Instituto de Química Orgánica General (CSIC) Juan de la Cierva, 3, 28006 Madrid, Spain
| | - S Rodríguez-Sánchez
- Instituto de Química Orgánica General (CSIC) Juan de la Cierva, 3, 28006 Madrid, Spain
| | - A I Ruiz-Matute
- Instituto de Química Orgánica General (CSIC) Juan de la Cierva, 3, 28006 Madrid, Spain.
| | - M L Sanz
- Instituto de Química Orgánica General (CSIC) Juan de la Cierva, 3, 28006 Madrid, Spain
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Salvatore Benito A, Valero Zanuy MÁ, Alarza Cano M, Ruiz Alonso A, Alda Bravo I, Rogero Blanco E, Maíz Jiménez M, León Sanz M. Adherence to Mediterranean diet: A comparison of patients with head and neck cancer and healthy population. ACTA ACUST UNITED AC 2019; 66:417-424. [PMID: 30683496 DOI: 10.1016/j.endinu.2018.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 08/03/2018] [Revised: 11/26/2018] [Accepted: 12/02/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE The traditional Mediterranean diet (MD) is associated to a lower risk of suffering multiple tumors. However, few studies have analyzed the relationship between MD and the risk of developing head and neck cancer (HNC). A case-control study comparing adherence to MD was conducted in patients diagnosed with HNC and healthy population. PATIENTS AND METHODS The level of adherence to MD was assessed using the 14-item MEDAS (Mediterranean Diet Adherence Screener) questionnaire, used in the PREDIMED study, in patients diagnosed with HNC at 12de Octubre Hospital in Madrid (cases) and in healthy subjects enrolled in a nearby primary health care center (controls). Adherence was stratified based on the score as low (≤7points), medium (8-9points), and high (≥10points). The odds ratio (OR) for developing HNC was estimated based on different factors. RESULTS A sample of 168 subjects (100 controls and 68 cases) was analyzed. Smoking (OR, 2.98 [95%CI: 1.44-6.12]; P=.003) and alcohol consumption (OR, 2.72 [95%CI: 1.39-5.33], P=.003) were strongly associated to HNC. However, medium-high adherence to MD was associated to a lower risk of developing HNC (OR, 0.48 [95%CI: 0.20-1.07], P=.052). CONCLUSIONS Consistent medium-high adherence to MD contributes to decrease the risk of developing HNC.
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Affiliation(s)
- Adriana Salvatore Benito
- Unidad de Nutrición, Servicio de Endocrinología y Nutrición, Hospital 12 de Octubre, Madrid, España
| | - M Ángeles Valero Zanuy
- Unidad de Nutrición, Servicio de Endocrinología y Nutrición, Hospital 12 de Octubre, Madrid, España.
| | - Marina Alarza Cano
- Servicio de Oncología Radioterápica, Hospital 12 de Octubre, Madrid, España
| | - Ana Ruiz Alonso
- Servicio de Oncología Radioterápica, Hospital 12 de Octubre, Madrid, España
| | - Irene Alda Bravo
- Servicio de Oncología Radioterápica, Hospital 12 de Octubre, Madrid, España
| | | | - María Maíz Jiménez
- Unidad de Nutrición, Servicio de Endocrinología y Nutrición, Hospital 12 de Octubre, Madrid, España
| | - Miguel León Sanz
- Unidad de Nutrición, Servicio de Endocrinología y Nutrición, Hospital 12 de Octubre, Madrid, España
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García-Lirio E, Gonzalez Diaz C, Gonzalez Hermosa A, Gamboa P, Aranguren R, Sanz ML. Oral Immunotherapy With Egg and Milk: Changes in Peripheral Serum Cytokines Are Not Predictive Factors for Severe Adverse Reactions or for the Final Report. J Investig Allergol Clin Immunol 2018; 28:24-28. [DOI: 10.18176/jiaci.0212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Martínez-Aranguren R, Martínez-Botas J, Díaz-Perales A, Villalba M, de la Hoz B, Gómez F, Bartra J, Blanca-López N, Alvarado MI, Moya C, Feo Brito F, Alonso MD, González-Mancebo E, Terrados S, García BE, Gamboa P, Parra A, D´Amelio C, Goikoetxea MJ, Sanz ML. Clinical Performance of Commercial ISAC 112 Allergen Microarray Versus Noncommercial RIRAAF Platform for the Diagnosis of Plant Food and Olive Pollen Allergies. J Investig Allergol Clin Immunol 2016; 26:185-7. [DOI: 10.18176/jiaci.00168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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García BE, Martínez-Aranguren R, Bernad Alonso A, Gamboa P, Feo Brito F, Bartra J, Blanca-López N, Gómez F, Alvarado MI, Fernández J, Alonso MD, Gonzalez-Mancebo E, Moya C, Parra A, Terrados S, Sola L, Goikoetxea MJ, Sanz ML. Is the ISAC 112 Microarray Useful in the Diagnosis of Pollinosis in Spain? J Investig Allergol Clin Immunol 2016; 26:92-9. [DOI: 10.18176/jiaci.0052] [Citation(s) in RCA: 7] [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] [Indexed: 11/20/2022] Open
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Goikoetxea MJ, Martínez-Aranguren R, Gamboa P, Garcia BE, Gómez F, Bartra J, Parra A, Alvarado MI, Alonso MI, González E, Terrados S, Moya C, Blanca N, Feo-Brito F, Villalba M, Díaz-Perales A, Sanz ML. Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area? J Investig Allergol Clin Immunol 2016; 26:31-39. [PMID: 27012014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy. OBJECTIVE To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy. METHODS sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cora 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges. RESULTS Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP-sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P < .05). Similar rates of Cora 8 and Jug r 3 sensitization were detected by both techniques. CONCLUSIONS The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved.
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Álvarez Hernández J, León Sanz M, Planas Vilá M, Araujo K, García de Lorenzo A, Celaya Pérez S. PREVALENCE AND COSTS OF MALNUTRITION IN HOSPITALIZED DYSPHAGIC PATIENTS: A SUBANALYSIS OF THE PREDYCES STUDY. NUTR HOSP 2015; 32:1830-6. [PMID: 26545558 DOI: 10.3305/nh.2015.32.4.9700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION dysphagia and malnutrition are conditions that frequently appear together in hospitalized patients. OBJECTIVES the main purpose of this study was to analyze the prevalence of malnutrition in patients with dysphagia included in the PREDyCES study as well as to determine its clinical and economic consequences. METHODS this is a substudy of an observational, cross-sectional study conducted in 31 sites all over Spain. RESULTS 352 dysphagic patients were included. 45.7% of patients presented with malnutrition (NRS-2002 ≥ 3) at admission and 42.2% at discharge. In elderly patients (≥ 70 years old) prevalence of malnutrition was even higher: 54.6% at admission and 57.5% at discharge. Also, prevalence of malnutrition was higher in urgent admissions versus those scheduled (45.7% vs 33.3%; p < 0.05) and when admitted to small hospitals vs. large hospitals (62.8% vs 43.9%; p < 0.001). In-hospital length of stay was higher in malnourished patients compared to those well-nourished (11.5 ± 7.1 days vs. 8.8 ± 6.05 days; p < 0.001), and in malnourished patients a tendency towards increase related-costs was also observed, even though it was not statistically significant (8 004 ± 5 854 € vs. 6 967 ± 5 630 €; p = 0.11). Length of stay was also higher in elderly patients (≥ 70 y/o) vs adults (< 70 y/o). 25% of dysphagic patients and 34.6% of malnourished patients with dysphagia received nutritional support during hospitalization. DISCUSSION these results confirm that in patients with dysphagia, malnutrition is a prevalent and under recognized condition, that also relates to prolonged hospitalizations.
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Corzo N, Alonso JL, Azpiroz F, Calvo MA, Cirici M, Leis R, Lombó F, Mateos-Aparicio I, Plou FJ, Ruas-Madiedo P, Rúperez P, Redondo-Cuenca A, Sanz ML, Clemente A. [Prebiotics: concept, properties and beneficial effects]. NUTR HOSP 2015; 31 Suppl 1:99-118. [PMID: 25659062 DOI: 10.3305/nh.2015.31.sup1.8715] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Prebiotics are non-digestible food ingredients (oligosaccharides) that reach the colon and are used as substrate by microorganisms producing energy, metabolites and micronutrients used for the host; in addition they also stimulate the selective growth of certain beneficial species (mainly bifidobacteria and lactobacilli) in the intestinal microbiota. In this article, a multidisciplinary approach to understand the concept of prebiotic carbohydrates, their properties and beneficial effects in humans has been carried out. Definitions of prebiotics, reported by relevant international organizations and researchers, are described. A comprehensive description of accepted prebiotics having strong scientific evidence of their beneficial properties in humans (inulin-type fructans, FOS, GOS, lactulose and human milk oligosaccharides) is reported. Emerging prebiotics and those which are in the early stages of study have also included in this study. Taken into account that the chemical structure greatly influences carbohydrates prebiotic properties, the analytical techniques used for their analysis and characterization are discussed. In vitro and in vivo models used to evaluate the gastrointestinal digestion, absorption resistance and fermentability in the colon of prebiotics as well as major criteria to design robust intervention trials in humans are described. Finally, a comprehensive summary of the beneficial effects of prebiotics for health at systemic and intestinal levels is reported. The research effort on prebiotics has been intensive in last decades and has demonstrated that a multidisciplinary approach is necessary in order to claim their health benefits.
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Affiliation(s)
- N Corzo
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM) Madrid..
| | - J L Alonso
- Departamento de Ingeniería Química, Universidad de Vigo. Facultad de Ciencias, Campus de Ourense, Ourense
| | - F Azpiroz
- Servicio de Aparato Digestivo, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona
| | - M A Calvo
- Grupo de investigación en Microbiología aplicada y medio-ambiental, Facultad de Veterinaria, Universidad Autónoma de Barcelona, Campus de Bellaterra, Barcelona
| | - M Cirici
- BENEO. Connecting nutrition and health, BENEO-Ibérica Barcelona
| | - R Leis
- Unidad de Gastroenterología, Hepatología y Nutrición Pediátrica, Dpto. Pediatría, Hospital Clínico Universitario de Santiago, Área de Gestión Integrada de Santiago, Universidad de Santiago de Compostela
| | - F Lombó
- Grupo de Investigación de Biotecnología y Terapia Experimental basada en Nutraceúticos (BITTEN), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Facultad de Medicina, Oviedo
| | - I Mateos-Aparicio
- Departamento de Nutrición y Bromatología II, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid
| | - F J Plou
- Grupo de Biocatálisis Aplicada, Instituto de Catálisis y Petroleoquímica, CSIC, Madrid
| | - P Ruas-Madiedo
- Departamento de Microbiología y Bioquímica de Productos Lácteos, Instituto de Productos Lácteos de Asturias - (IPLA-CSIC) Asturias
| | - P Rúperez
- Departamento de Metabolismo y Nutrición, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC) Madrid
| | - A Redondo-Cuenca
- Departamento de Nutrición y Bromatología II, Bromatología, Facultad de Farmacia, Universidad Complutense de Madrid
| | - M L Sanz
- Departamento de Análisis Instrumental y Química Ambiental, Instituto de Química Orgánica General (CSIC), Madrid
| | - A Clemente
- Departamento de Fisiología y Bioquímica de la Nutrición Animal, Estación Experimental del Zaidin (CSIC), Granada. España
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Goikoetxea MJ, Berroa F, Cabrera-Freitag P, Ferrer M, Núñez-Córdoba JM, Sanz ML, Gastaminza G. Do Skin Prick Test and In Vitro Techniques Diagnose Sensitization to Peach Lipid Transfer Protein and Profilin Equally Well in Allergy to Plant Food and Pollen? J Investig Allergol Clin Immunol 2015; 25:283-287. [PMID: 26310043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE To compare the skin prick test (SPT) with in vitro techniques (single and multiplex fluorescence enzyme-immunoassay [FEIA]) for detecting sensitization to profilin and lipid transfer protein (LTP). METHODS We retrospectively studied 181 patients with pollen and/or plant food allergy and 61 controls. SPT was performed with date palm profilin (Pho d 2) and peach LTP (Pru p 3), and specific IgE (sIgE) to Phl p 12 and Pru p 3 was analyzed using single FEIA and microarray. RESULTS Fifteen of 201 patients with negative results for LTP in the SPT were sensitized to this allergen in the in vitro tests, and 18 of 41 patients with positive results for LTP in the SPT were not sensitized according to the in vitro tests. Seventeen of 186 patients with negative results for profilin in the SPT were sensitized to Phl p 12 by serum sIgE, and 30 out of 56 patients with positive results for profilin in SPT were not sensitized to Phl p 12 according to the other tests. Moderate agreement was observed between the 3 techniques studied. CONCLUSIONS SPT is a sensitive technique for detecting sensitization to LTP and profilin. Its results are similar to those of in vitro techniques, especially in patients with negative SPT results for peach LTP and palm tree profilin.
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Martínez-Aranguren RM, Gamboa PM, García-Lirio E, Asturias J, Goikoetxea MJ, Sanz ML. In vivo and in vitro testing with rAni s 1 can facilitate diagnosis of Anisakis simplex allergy. J Investig Allergol Clin Immunol 2014; 24:431-438. [PMID: 25668895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Traditional diagnostic tests such as skin prick tests (SPT) and specific IgE (slgE) against whole Anisakis simplex extract have low specificity. Consequently, allergy to A simplex is overdiagnosed. OBJECTIVE Our aim was to compare tests used in component-resolved diagnosis. METHODS We evaluated 34 patients with allergy to A simplex, 15 patients with acute urticaria who were sensitized to A simplex but had no clinical history of allergy to A simplex, and 10 patients allergic to seafood. SPT, slgE (ELISA and ISAC-I 12), and the basophil activation test (BAT) were performed with A simplex whole extract and the molecular components rAni s 1, rAni s 3, and nPen m 1. Sensitivity and specificity were calculated and compared with different cutoffs. RESULTS With the A simplex whole extract, SPT, slgE, and BAT yielded specificity values of 72%, 68%, and 70%, respectively, with a cutoff (wheal size) of 11.2 mm, an slgE value of 7.9 kUAIL, and a stimulation index of 1.9. Specificity increased to 100% using the molecular component rAni s 1 with SPT, slgE by ELISA, and ISAC-112. Neither rAni s 3 sensitization nor cross-reactivity with Pen m 1 was observed in patients sensitized to A simplex. CONCLUSION rAni s 1 is recognized by 100% of our patients and is able to distinguish between patients allergic to A simplex and patients with acute urticaria who are sensitized to A simplex but have no clinical history of allergy to this parasite.
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Garrido-Fernández S, García BE, Sanz ML, Echechipía S, Lizaso MT, Tabar AI. Are basophil activation and sulphidoleukotriene determination useful tests for monitoring patients with peach allergy receiving sublingual immunotherapy with a Pru p 3-enriched peach extract? J Investig Allergol Clin Immunol 2014; 24:106-113. [PMID: 24834773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Treatment of food allergy essentially consists of food avoidance, but immunotherapy with food is emerging as a new therapeutic option. OBJECTIVE To evaluate clinical improvement and immunological changes in patients with peach allergy following sublingual immunotherapy (SLIT) with a Prup3 quantified peach extract. METHODS A randomized, double-blind, placebo-controlled clinical trial with peach SLIT was conducted. We assessed clinical efficacy after 6 months of treatment by means of double-blind, placebo-controlled oral challenges with peach and also evaluated immunological changes (basophil activation test [BAT] and determination of sulphidoleukotriene production) following stimulation with peach peel and pulp, rPrup3, rMald 1, and rMal d 4 stimulation. We also measured specific IgE and IgG4 to Pru p3. RESULTS After 6 months of SLIT (T6), the active group showed a 3-fold improvement in tolerance to Prup3 and a significant increase in IgE to rPrup3 and in sLT production following stimulation with peach peel and rPrup3. There was also a significant increase in BAT results after stimulation with rPrup3 at 1 month of SLIT (T1). Statistically significant between-group differences were only observed for BAT with peach peel and pulp at T1 and T6 and for BAT with rPru p3 at T6. No changes were observed in BAT with rMal d 1 or rMal d 4 or in IgG4 levels to nPrup3. CONCLUSIONS SLIT with a Pru p 3 quantified peach extract is clinically effective and leads to an increase in basophil activation and sulphidoleukotriene production following stimulation with rPru p3 and peach peel in the first months of treatment.
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Rodríguez-Sánchez S, Galindo-Iranzo P, Soria AC, Sanz ML, Quintanilla-López JE, Lebrón-Aguilar R. Characterization by the solvation parameter model of the retention properties of commercial ionic liquid columns for gas chromatography. J Chromatogr A 2013; 1326:96-102. [PMID: 24373774 DOI: 10.1016/j.chroma.2013.12.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 07/04/2013] [Revised: 12/06/2013] [Accepted: 12/09/2013] [Indexed: 10/25/2022]
Abstract
For the first time, four commercial ionic liquid columns (SLB-IL59, SLB-IL76, SLB-IL82 and SLB-IL100) for gas chromatography have been comprehensively evaluated in terms of efficiency, polarity and solvation properties. Grob tests and McReynolds constants showed that they were all high-efficiency columns of high polarity, but with low inertness to compounds with hydrogen bonding capabilities. The solvation parameter model was used to characterize the solvation interactions of the four columns in the 80-160°C temperature range. Results revealed that all the ionic liquids studied can be considered moderately hydrogen-bond acid and highly cohesive stationary phases, on which the dominant contributions to retention were the dipolar-type and hydrogen-bond base interactions, while π-π and n-π interactions were barely significant. The SLB-IL59 column provided the best separation of homologs, while the SLB-IL76 and SLB-IL100 columns had the most basic and the most acidic phases, respectively. A principal component analysis for the commonly used stationary phases in capillary GC showed that these commercial ionic liquid columns fill an empty area of the available selectivity space, which clearly enhances the separation capacity of this technique.
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Affiliation(s)
- S Rodríguez-Sánchez
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva 3, 28006 Madrid, Spain
| | - P Galindo-Iranzo
- Instituto de Química-Física "Rocasolano" (CSIC), Serrano 119, 28006 Madrid, Spain
| | - A C Soria
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva 3, 28006 Madrid, Spain
| | - M L Sanz
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva 3, 28006 Madrid, Spain
| | - J E Quintanilla-López
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva 3, 28006 Madrid, Spain
| | - R Lebrón-Aguilar
- Instituto de Química-Física "Rocasolano" (CSIC), Serrano 119, 28006 Madrid, Spain.
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Ruiz-Aceituno L, Carrero-Carralero C, Ramos L, Martinez-Castro I, Sanz ML. Development of a carbohydrate silylation method in ionic liquids for their gas chromatographic analysis. Anal Chim Acta 2013; 787:87-92. [PMID: 23830425 DOI: 10.1016/j.aca.2013.05.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 05/20/2013] [Accepted: 05/23/2013] [Indexed: 11/16/2022]
Abstract
This paper reports on the feasibility of silylation of low molecular weight carbohydrates dissolved in different ionic liquids (ILs) for their further analysis by gas chromatography (GC). Derivatization reagents (nature and amounts), temperature and time of reaction and stirring conditions were evaluated for different carbohydrates (i.e., glucose, mannose, fructose and lactose) dissolved in 1-ethyl-3-methylimidazolium dicyanamide [EMIM][DCA]. Evaluation of conformational isomerism of glucose dissolved in [EMIM][DCA] revealed the effect of the time of dissolution in the equilibration of α- and β-furanoses (up to 3% and 6%, respectively, after 70 h of incubation) and that 21 h sufficed to obtain results similar to those provided by the reference method involving pyridine. Once optimized, the proposed derivatization procedure provided satisfactory yields (i.e., close to 100%) using 100 μL of trimethylsilylimidazole (TMSI) at mild conditions (25°C) for a relatively short time (1h) for most of the investigated carbohydrates. Under these experimental conditions, linear responses (i.e., R(2) better than 0.974) were obtained in the tested range of 0.25-1mg of the derivatized target compounds. Other reagents, such as N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA)+1% trimethylchlorosilane (TMCS), were successfully used under ultrasonic conditions for aldose monosaccharides and disaccharides derivatization, while BSTFA was useful for ketose monosaccharides. The possibility of using the proposed method for the derivatization of selected carbohydrates dissolved in different ILs and the efficiency of the method applied to the analysis of carbohydrates present in real samples (fruit juices) have also been investigated.
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20
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Idoate MA, Echeveste J, Gil P, Sanz ML, Ferrer M. Expression of the basophil-specific antibodies 2D7 and BB1 in patients with cutaneous Mastocytosis. J Investig Allergol Clin Immunol 2013; 23:392-397. [PMID: 24459815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND 2D7 and BB1 are thought to be basophil-specific markers. In this study, we tested both antibodies in different skin and mast cell disorders with the aim of determining whether it was possible to differentiate between benign and aggressive presentations of mastocytosis. METHODS Using the antibodies 2D7, BB1, and c-Kit, we performed an immunohistochemical study of skin biopsy specimens from patients with cutaneous mastocytosis (15 urticaria pigmentosa and telangiectatic macularis eruptive perstans) and liver or bone marrow biopsy specimens from patients with systemic mastocytosis. A basophil leukemia cell line was used as a reference. Peripheral blood basophils from healthy donors were used as controls. RESULTS We observed intense expression of 2D7 and BB1 in all skin biopsy specimens from patients with cutaneous mastocytosis. Immunostaining of liver and bone marrow specimens from patients with systemic mastocytosis with 2D7 and BB1 antibodies was negative. Specimens from patients with either type of mastocytosis showed similarly strong expression of c-Kit. The basophil cell line showed a 2D7 and a BB1 profile, with intense expression of c-Kit. Peripheral blood basophils exhibited notable immunostaining for 2D7, BB1, and c-Kit. CONCLUSIONS 2D7 and BB1 are expressed in cutaneous mastocytosis, although this expression is lost when mast cell proliferation is systemic, thus reflecting either a different cellular differentiation stage or the presence of basophils in these skin diseases.
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Affiliation(s)
- M A Idoate
- Department of Pathology, School of Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - J Echeveste
- Department of Pathology, School of Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - P Gil
- Department of Dermatology, School of Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - M L Sanz
- Department of Allergy and Clinical Immunology, School of Medicine, Clinica Universidad de Navarra, Pamplona, Spain
| | - M Ferrer
- Department of Allergy and Clinical Immunology, School of Medicine, Clinica Universidad de Navarra, Pamplona, Spain
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Mayorga C, Sanz ML, Gamboa P, Garcia-Aviles MC, Fernandez J, Torres MJ. In vitro methods for diagnosing nonimmediate hypersensitivity reactions to drugs. J Investig Allergol Clin Immunol 2013; 23:213-225. [PMID: 23964550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Nonimmediate drug hypersensitivity reactions (DHRs) are difficult to manage in daily clinical practice, mainly owing to their heterogeneous clinical manifestations and the lack of selective biological markers. In vitro methods are necessaryto establish a diagnosis, especially given the low sensitivity of skin tests and the inherent risks of drug provocation testing. In vitro evaluation of nonimmediate DHRs must include approaches that can be applied during the different phases of the reaction. During the acute phase, monitoring markers in both skin and peripheral blood helps to discriminate between immediate and nonimmediate DHRs with cutaneous responses and to distinguish between reactions that, although they present similar clinical symptoms, are produced by different immunological mechanisms and therefore have a different treatment and prognosis. During the resolution phase, in vitro testing is used to detect the response of T cells to drug stimulation; however, this approach has certain limitations, such as the lack of validated studies assessing sensitivity. Moreover, in vitro tests indicate an immune response that is not always related to a DHR. In this review, members of the Immunology and Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) provide an overview of the most widely used in vitro tests for evaluating nonimmediate DHRs.
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MESH Headings
- Antigen-Antibody Complex/analysis
- Antigen-Antibody Complex/immunology
- Antigens, CD/analysis
- Antigens, CD/immunology
- Antigens, Differentiation, T-Lymphocyte/analysis
- Antigens, Differentiation, T-Lymphocyte/immunology
- Biomarkers/analysis
- Drug Hypersensitivity/diagnosis
- Drug Hypersensitivity/immunology
- Drug Hypersensitivity/pathology
- Enzyme-Linked Immunosorbent Assay
- Flow Cytometry
- Humans
- Hypersensitivity, Delayed/diagnosis
- Hypersensitivity, Delayed/immunology
- Hypersensitivity, Delayed/pathology
- Immunoglobulin E/analysis
- Immunoglobulin E/immunology
- Lectins, C-Type/analysis
- Lectins, C-Type/immunology
- Lymphocyte Activation
- Real-Time Polymerase Chain Reaction
- Skin/immunology
- Skin/pathology
- Skin Tests
- T-Lymphocytes/immunology
- T-Lymphocytes/pathology
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Affiliation(s)
- C Mayorga
- Allergy Service, Carlos Haya Hospital, Malaga, Spain
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Goikoetxea MJ, Sanz ML, García BE, Mayorga C, Longo N, Gamboa PM, Barber D, Caballero Molina T, de la Calle Toral A, Escribano Mora L, García Martinez JM, Labrador M, López Hoyos M, Martínez Quesada J, Monteseirin Mateo J. Recommendations for the use of in vitro methods to detect specific immunoglobulin E: are they comparable? J Investig Allergol Clin Immunol 2013; 23:448-455. [PMID: 24654308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Total and specific immunoglobulin (Ig) E can be detected in vitro using several commercially available methods. The largest share of the global market for these methods is held by the ImmunoCAP technique (Thermo Fisher, previously Phadia), Immulite (Siemens), and Hytec-288 (Hycor). Most comparative studies examine Immulite and ImmunoCAP, which differ methodologically but use similar units of measurement relative to the same standard of total IgE (WHO IgE Standard 75/502). Despite their similarity, these kits differ in their quantification of specific IgE, which varies depending on the allergen studied.Thus, specific IgE results obtained with ImmunoCAP and Immulite are not interchangeable. It is important to bear this in mind, especially when determining cutoff points as predictors of a response to oral challenge with specific food allergens. The method used in practice must be the same as the one in the publication guiding clinical decision making. We analyze differences between ImmunoCAP and ISAC microarray, 2 methods from the same manufacturer used to detect IgE to specific proteins (purified or recombinant).The results show that the IgE values obtained with ImmunoCAP are not equivalent to the corresponding values obtained with the ISAC microarray system.
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Martínez-Aranguren R, Gamboa PM, García-Lirio E, Goikoetxea MJ, Gastaminza G, Sanz ML. In vitro production of Ag-specific IFN-gamma in patients with delayed hypersensitivity to amoxicillin. J Investig Allergol Clin Immunol 2013; 23:125-126. [PMID: 23654080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- R Martínez-Aranguren
- Department ofAllergology and Clinical Immunology, Clinica Universidad de Navarra, Pamplona, Spain
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Madrigal-Burgaleta R, Berges-Gimeno MP, Angel-Pereira D, Guillen-Ponce C, Sanz ML, Alvarez-Cuesta E. Desensitizing oxaliplatin-induced fever: a case report. J Investig Allergol Clin Immunol 2013; 23:435-436. [PMID: 24459821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
| | | | - D Angel-Pereira
- Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
| | - C Guillen-Ponce
- Medical Oncology Division, Ramon y Cajal University Hospital, Madrid, Spain
| | - M L Sanz
- Department of Allergology and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain
| | - E Alvarez-Cuesta
- Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
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de las Marinas MD, Martorell C, Martorell A, Cerdá JC, Felix R, Guaita M, Sanz ML. Basophil activation test is a useful tool in occupational asthma due to iroko wood. J Investig Allergol Clin Immunol 2013; 23:512-514. [PMID: 24654319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
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Goikoetxea MJ, Lafuente A, de la Borbolla JM, Moncada R, Sanz ML, Gastaminza G. Early diagnosis of an allergic reaction to cisatracurium. J Investig Allergol Clin Immunol 2013; 23:69-71. [PMID: 23653984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- M J Goikoetxea
- Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain
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Barber D, Arias J, Boquete M, Cardona V, Carrillo T, Gala G, Gamboa P, García-Robaina JC, Hernández D, Sanz ML, Tabar AI, Vidal C, Ipsen H, de la Torre F, Lombardero M. Analysis of mite allergic patients in a diverse territory by improved diagnostic tools. Clin Exp Allergy 2012; 42:1129-38. [PMID: 22702511 DOI: 10.1111/j.1365-2222.2012.03993.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND There are few studies comparing the sensitization with mite allergens from different mite species which could potentially be the cause of allergy. OBJECTIVE To improve the diagnosis of mite allergic patients from a diverse territory in which D. pteronyssinus/D. farinae mites together with storage mites could be present in the environment. METHODS Four hundred and seventy-seven patients (both children and adults) from different regions, covering the main mite prevalent areas of Spain, were recruited. sIgE to eight allergens was measured together with SPT to whole mite extracts, level of mite allergen exposure, and specific IgG(4) . BAT and CAST was performed in a subgroup of patients. RESULTS D. pteronyssinus and L. destructor were more prevalent in Atlantic areas, whereas D. farinae predominate in Mediterranean areas. About 90% of patients were sensitized to group 1 and/or group 2 allergens. Group 2 was the most prevalent, and the IgE response/intensity of sensitization in BAT was higher. sIgE to Der p 2/Der f 2 was almost fully cross-reactive, but no cross-reactivity was detected with Lep d 2. Group 1 allergens were also cross-reactive, but in some patients a species-specific response was observed. sIgE to Lep d 2 was associated with SPT results to storage mites. Sensitization to Der p 1 was more frequent in children, whereas Lep d 2 sensitization was more frequent in adults. A higher ratio IgE/IgG(4) to Der p 2 was associated with the presence of allergic asthma. CONCLUSION An improved diagnosis algorithm has been established. Group 2 allergens seem to have a leading role in mite allergy, but as group 1 sensitization could be species-specific in some patients and its prevalence is higher in children, an adequate balance on major mite species and major allergens must be consider in the design of mite allergy vaccines.
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Affiliation(s)
- D Barber
- Departamento de I+D, ALK-Abelló, Madrid/Hørsholm, Spain/Denmark.
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Ruiz-Aceituno L, Ramos L, Martinez-Castro I, Sanz ML. Low molecular weight carbohydrates in pine nuts from Pinus pinea L. J Agric Food Chem 2012; 60:4957-4959. [PMID: 22533651 DOI: 10.1021/jf2048959] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Low molecular weight carbohydrates in pine nuts from Pinus pinea L. (n = 7) have been studied by gas chromatography-mass spectrometry as their trimethylsilyl oximes. Besides previously reported components, such as glucose, fructose, sucrose, and raffinose, several soluble carbohydrates have been identified for the first time in this product, including saccharides (galactose, maltose, and planteose) and cyclitols (pinitol, galactinol, galactopinitol A1, fagopyritol B1, and other glycosyl-inositols). Most abundant cyclitols were chiro-inositol, fagopyritol B1, and pinitol, with concentrations ranging from 126.7 to 222.1 mg (100 g)(-1), 94.2 to 177.1 mg (100 g)(-1), and 51.2 to 282.8 mg (100 g)(-1), respectively.
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Affiliation(s)
- L Ruiz-Aceituno
- Instituto de Química Orgánica General (CSIC), Juan de la Cierva 3, 28006 Madrid, Spain
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Gamboa PM, Asturias J, Martínez R, Antépara I, Jáuregui I, Urrutia I, Fernández J, Sanz ML. Diagnostic utility of components in allergy to Anisakis simplex. J Investig Allergol Clin Immunol 2012; 22:13-19. [PMID: 22448449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND In our region, Anisakis allergy is responsible for 8% of acute urticarial reactions, 25% of which progress to anaphylactic shock. The poor specificity of skin tests and in vitro specific immunoglobulin (Ig) E means that Anisakis allergy is frequently overdiagnosed. OBJECTIVE We studied the diagnostic value of 2 Anisakis allergens: rAni s 1 and rAni s 3. METHODS Skin tests, the basophil activation test (BAT), and specific IgE determination were performed with rAni s 1 and 3 in 25 patients allergic to Anisakis, 17 atopic controls, and 10 controls with acute urticaria and positive skin test and sIgE results for Anisakis, but no allergy to Anisakis. RESULTS For rAni s1, skin tests had a sensitivity and specificity of 100% and specific IgE had a sensitivity and specificity of 100% in the atopic control group and 90% in the urticaria control group. BAT had a sensitivity of 96.8% and a specificity of 100% in the atopic control group and 66.7% in the urticaria control group. For rAni s 3, only 1 patient had positive specific IgE results to rAni s 3. All other techniques gave negative results in patients and controls CONCLUSIONS rAni s 1 is the major allergen of Anisakis and the target allergen when diagnosing allergy to Anisakis, rAni s 3 is not relevant when attempting to explain false-positive results.
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Affiliation(s)
- P M Gamboa
- Hospital de Basurto, Servicio de Alergologia, Bilbao, Spain.
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Javaloyes G, Goikoetxea MJ, García Núñez I, Sanz ML, Blanca M, Scheurer S, Vieths S, Ferrer M. Performance of different in vitro techniques in the molecular diagnosis of peanut allergy. J Investig Allergol Clin Immunol 2012; 22:508-513. [PMID: 23397673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Peanut allergy is an increasingly serious disorder with a heterogeneous pattern of sensitization across different countries. In vitro diagnostic techniques may help in establishing these patterns. OBJECTIVES To analyze the usefulness of determining specific immunoglobulin E (sIgE) with the ImmunoCAP fluorescence enzyme immunoassay (FEIA), the ImmunoCAP ISAC CRD103 microarray (ISAC), and the basophil activation test (BAT) in the molecular diagnosis of peanut allergy. METHODS In 26 peanut-allergic patients, sIgE antibodies against allergic components were measured with FEIA, ISAC, and BAT. RESULTS The major peanut component in our population wasAra h 9.The detection of sIgE toAra h 9 using FEIA and BAT with this allergen yielded a sensitivity of 92% and 88% and a specificity of 95% and 100%, respectively. Overall diagnosis of peanut allergy by ISAC showed a sensitivity of 11% but a specificity of 95% since Ara h 9 was not present in the microarray version used. There was diagnostic agreement between the 3 techniques for the peanut allergens studied. CONCLUSIONS The determination of sIgE to Ara h 9 using FEIA and BAT offers high sensitivity and specificity in the diagnosis of peanut allergy in the Spanish population. The CRD103 version of ISAC is not of value in our region as it does not include the most common allergen, Ara h 9.
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Affiliation(s)
- G Javaloyes
- Department of Allergy and Clinical Immunology, Clinica Universidad de Navarra, Pamplona, Spain
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31
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López-Hoyos M, Lizaso MT, Rodríguez JJ, Sanz ML, Labrador-Horrillo M, Ramos R, Martín-Esteban M, Pastor R, Hernández MD, Casas ML, Peláez A, García BE. Quantitative measurement of allergen-specific immunoglobulin E levels in mass units (ng/mL): an interlaboratory comparison. J Investig Allergol Clin Immunol 2012; 22:387-389. [PMID: 23101323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- M López-Hoyos
- Servicio Inmunología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain.
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Gonzalez-Quintela A, Valcarcel C, Campos J, Alonso M, Sanz ML, Vidal C. Biologic activity of cross-reactive carbohydrate determinants in heavy drinkers. Clin Exp Allergy 2011; 41:759-61. [PMID: 21457167 DOI: 10.1111/j.1365-2222.2011.03735.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Palacín A, Tordesillas L, Gamboa P, Sanchez-Monge R, Cuesta-Herranz J, Sanz ML, Barber D, Salcedo G, Díaz-Perales A. Characterization of peach thaumatin-like proteins and their identification as major peach allergens. Clin Exp Allergy 2011; 40:1422-30. [PMID: 20701616 DOI: 10.1111/j.1365-2222.2010.03578.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Peach is the most important fruit related to food allergy in the Mediterranean area. Pru p 3, its lipid transfer protein, has been described as the principal allergen responsible for cross-reactivities with other foods and pollen and the severity of clinical symptoms. However, the involvement of other allergenic families cannot be ruled out. Thaumatin-like proteins (TLPs) have been described as food allergen in several fruits, such as apple, cherry, kiwi and banana, and pollen. OBJECTIVE To identify members of the TLP family in peach fruit and to characterize putative allergens. METHODS Through two-dimensional (2D) electrophoresis of peach extract and immunodetections with a pool of peach-allergic patients, IgE-binding spots were identified and the corresponding proteins purified and characterized as allergens by in vitro and in vivo assays. Three isoforms, belonging to the TLP family, were purified by different chromatographic systems and characterized by N-terminal amino acid sequences, molecular weight determination (MALDI) and enzymatic activity analysis (beta-1,3-gluconase test and inhibition growth of fungi). In the same way, their IgE-binding capacity and allergenic activity were tested by ELISA assays, basophil activation tests and skin prick tests (SPT). RESULTS Two peach-TLPs, Pru p 2.0101 and Pru p 2.0201, were identified as IgE-binding spots by 2D electrophoresis. Another peach-TLP, Pru p 2.0301, was cloned and produced as recombinant protein in a yeast system. The three isoforms were purified and characterized as TLPs by immunoblotting with anti-chestnut TLP antibodies and anti-plant N-asparagine complex glycan (anti-cross-reactive carbohydrate determinant). All of them showed beta-1,3-glucanase activity and inhibition of fungal growth. The three TLPs were recognized by around 50% of the sera from 31 patients analysed in ELISA experiments. All three gave a positive response to an SPT and/or in basophil activation experiments. CONCLUSION Three isoforms, belonging to the TLP family, were identified in peach as principal allergens. Their prevalence, observed in in vitro, ex vivo and in vivo analyses, suggests that they are important allergens and should therefore be included in the routine diagnosis of peach allergy, at least in the Mediterranean area.
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Affiliation(s)
- A Palacín
- Unidad de Bioquímica, Departamento de Biotecnología, E.T.S. Ingenieros Agrónomos, UPM, Madrid, Spain
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34
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Cabrera-Freitag P, Escalada J, Goikoetxea MJ, Laguna S, Sanz ML, Gastaminza G. A severe case of lipoatrophy due to human insulin and insulin analogs in a patient with diabetes: is an immunological mechanism involved? J Investig Allergol Clin Immunol 2011; 21:417-419. [PMID: 21905513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- P Cabrera-Freitag
- Department of Allergology and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
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35
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Cabrera-Freitag P, Ferrer M, Martínez R, Javaloyes G, Sanz ML. The basophil activation test as a promising diagnostic tool in hypersensitivity to chironomid larvae. J Investig Allergol Clin Immunol 2011; 21:158-159. [PMID: 21462811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- P Cabrera-Freitag
- Department of Allergology and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
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36
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Sánchez Morillas L, Rojas Pérez-Ezquerra P, Reaño Martos M, Sanz ML, Laguna Martínez JJ. Urticaria due to antihistamines. J Investig Allergol Clin Immunol 2011; 21:66-68. [PMID: 21370726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
H1-antihistamines are probably the most frequently used drugs in allergic diseases, with widely established efficacy, tolerance, and safety. We report a patient with urticaria due to ingestion of ebastine and fexofenadine. Skin prick tests, patch tests, and basophil activation tests with the implicated drugs and antihistamines from other families were negative. The oral challenges with the implicated antihistamines and other antihistamines tested were positive, but the patient tolerated an oral challenge with cetirizine. We present a patient with urticaria induced by different antihistamines in whom the diagnosis was established by oral challenge. The mechanism of sensitization remains unclear.
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Affiliation(s)
- L Sánchez Morillas
- Allergology Department, Hospital Central de la Cruz Roja, Madrid, Spain.
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37
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Pérez-Ezquerra PR, Morillas LS, Martínez JJL, Fernández GD, Gomez-Tembleque MDP, Alvarez AS, Sanz ML. Anaphylaxis to omeprazole. Cross-reactivity with the other proton pump inhibitors. Allergol Immunopathol (Madr) 2011; 39:54. [PMID: 20678852 DOI: 10.1016/j.aller.2010.03.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 03/30/2010] [Indexed: 11/29/2022]
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38
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Gastaminza G, de la Borbolla JM, Goikoetxea MJ, Escudero R, Antón J, Espinós J, Lacasa C, Fernández-Benítez M, Sanz ML, Ferrer M. A new rapid desensitization protocol for chemotherapy agents. J Investig Allergol Clin Immunol 2011; 21:108-112. [PMID: 21462800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Desensitization has been used for some decades to treat patients with the allergenic drug when an alternative drug with similar efficacy and safety is not available. We present the results from a series of oncology patients desensitized at our hospital during the last 2 years. OBJECTIVE To assess the efficacy of a new desensitization protocol in patients allergic to chemotherapy drugs. METHODS We performed an observational retrospective study of 11 women (6 breast cancer and 5 ovarian cancer) who underwent our desensitization protocol. Four patients had immediate reactions to carboplatin, 3 to docetaxel, 3 to paclitaxel, and 1 to both docetaxel and paclitaxel. Premedication was administered in all cases. A 5-step protocol based on 5 different dilutions of the drugs was used. RESULTS We performed 39 desensitization procedures: 14 to carboplatin, 3 to oxaliplatin, 16 to docetaxel, and 6 to paclitaxel. Eight patients tolerated the full dose in 36 procedures. One patient suffered an anaphylactic reaction to carboplatin that reverted with treatment. One patient had dyspnea after a paclitaxel cycle. One patient experienced dyspnea due to chronic pulmonary thromboembolism related to her disease. CONCLUSION Desensitization is a useful procedure in patients who are allergic to their chemotherapy agents.
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Affiliation(s)
- G Gastaminza
- Department of Allergology and Clinical Immunology, Clinica Universidad de Navarra, Pamplona, Spain.
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39
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Cabrera-Freitag P, Goikoetxea MJ, Gamboa PM, Martínez-Aranguren R, Beorlegui C, Fernández J, Sanz ML. A study of the variability of the in vitro component-based microarray ISAC CDR 103 technique. J Investig Allergol Clin Immunol 2011; 21:414-415. [PMID: 21905510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- P Cabrera-Freitag
- Department of Allergology and Clinical Immunology, University Clinic of Navarra, Pamplona, Spain
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40
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Ruiz-Matute AI, Hernández-Hernández O, Rodríguez-Sánchez S, Sanz ML, Martínez-Castro I. Derivatization of carbohydrates for GC and GC-MS analyses. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 879:1226-40. [PMID: 21186143 DOI: 10.1016/j.jchromb.2010.11.013] [Citation(s) in RCA: 237] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 09/29/2010] [Accepted: 11/08/2010] [Indexed: 11/26/2022]
Abstract
GC and GC-MS are excellent techniques for the analysis of carbohydrates; nevertheless the preparation of adequate derivatives is necessary. The different functional groups that can be found and the diversity of samples require specific methods. This review aims to collect the most important methodologies currently used, either published as new procedures or as new applications, for the analysis of carbohydrates. A high diversity of compounds with diverse functionalities has been selected: neutral carbohydrates (saccharides and polyalcohols), sugar acids, amino and iminosugars, polysaccharides, glycosides, glycoconjugates, anhydrosugars, difructose anhydrides and products resulting of Maillard reaction (osuloses, Amadori compounds). Chiral analysis has also been considered, describing the use of diastereomers and derivatives to be eluted on chiral stationary phases.
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Affiliation(s)
- A I Ruiz-Matute
- Instituto de Fermentaciones Industriales-CIAL (CSIC), Juan de la Cierva 3, 28006 Madrid, Spain
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41
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González-de-Olano D, Alvarez-Twose I, Morgado JM, Esteban López MI, Vega Castro A, Díaz de Durana MDA, Sánchez-Muñoz L, Matito A, de la Hoz Caballer B, Sanz ML, Orfao A, Escribano L. Evaluation of basophil activation in mastocytosis with Hymenoptera venom anaphylaxis. Cytometry B Clin Cytom 2010; 80:167-75. [PMID: 21520404 DOI: 10.1002/cyto.b.20577] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 09/01/2010] [Accepted: 09/30/2010] [Indexed: 11/08/2022]
Abstract
BACKGROUND Basophil activation tests (BATs) have been demonstrated to be useful in detecting IgE-mediated sensitization by measuring basophil activation surface markers (CD63 and CD203c). Hymenoptera venom is one of the best known mediators-release trigger in patients with systemic mastocytosis (SM). The aim of this study was to investigate the use of BATs as an additional diagnostic tool in patients with mastocytosis suffering from hymenoptera venom anaphylaxis (HVA). METHODS A total of 22 patients with history of HVA and SM, together with a group of 11 patients with HVA in whom SM was ruled out after a complete bone marrow study, were analyzed. RESULTS Among 11 SM patients who had specific serum IgE (sIgE) against hymenoptera venom and an evaluable BAT, a positive BAT was found in nine. Additionally, a positive BAT was detected in three of seven patients who had no sIgE. These three patients had low levels of total IgE compared with control population (mean of 20 vs. 78 IU/mL); one had discontinued immunotherapy after 5 years, when sIgE levels had turned negative, and, in the other two patients, BAT identified the culprit insect. CONCLUSIONS BAT is a useful complementary diagnostic tool to sIgE in mastocytosis patients with HVA, and it may contribute to predict or confirm these nearly fatal reactions, especially before discontinuing venom immunotherapy in patients who are negative for skin tests or sIgE or display low total IgE levels; in such cases, it also provides evidence on the culprit insect prompting HVA.
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42
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Cernadas JR, Brockow K, Romano A, Aberer W, Torres MJ, Bircher A, Campi P, Sanz ML, Castells M, Demoly P, Pichler WJ. General considerations on rapid desensitization for drug hypersensitivity - a consensus statement. Allergy 2010; 65:1357-66. [PMID: 20716314 DOI: 10.1111/j.1398-9995.2010.02441.x] [Citation(s) in RCA: 236] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Drug hypersensitivity reactions can occur with most drugs, are unpredictable, may affect any organ or system, and range widely in clinical severity from mild pruritus to anaphylaxis. In most cases, the suspected drug is avoided in the future. However, for certain patients, the particular drug may be essential for optimal therapy. Under these circumstances, desensitization may be performed. Drug desensitization is defined as the induction of a temporary state of tolerance of a compound responsible for a hypersensitivity reaction. It is performed by administering increasing doses of the medication concerned over a short period of time (from several hours to a few days) until the total cumulative therapeutic dose is achieved and tolerated. It is a high-risk procedure used only in patients in whom alternatives are less effective or not available after a positive risk/benefit analysis. Desensitization protocols have been developed and are used in patients with allergic reactions to antibiotics (mainly penicillin), insulins, sulfonamides, chemotherapeutic and biologic agents, and many other drugs. Desensitization is mainly performed in IgE-mediated reactions, but also in reactions where drug-specific IgE have not been demonstrated. Desensitization induces a temporary tolerant state, which can only be maintained by continuous administration of the medication. Thus, for treatments like chemotherapy, which have an average interval of 4 weeks between cycles, the procedure must be repeated for every new course. In this paper, some background information on rapid desensitization procedures is provided. We define the drugs and drug reactions indicated for such procedures, describe the possible mechanism of action, and discuss the indications and contraindications. The data should serve as background information for a database (accessible via the EAACI-homepage) with standardized protocols for rapid desensitization for antibiotics, chemotherapeutic agents, monoclonal antibodies/fusion proteins, and other drugs.
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Affiliation(s)
- J R Cernadas
- Department of Allergy and Clinical Immunology, Medical University, H. S. João, Porto, Portugal.
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Sanz ML, Gamboa PM. Effect of in vitro aspirin stimulation on basophils in patients with aspirin-exacerbated respiratory disease. Clin Exp Allergy 2010; 40:520; author reply 520-1. [PMID: 20082616 DOI: 10.1111/j.1365-2222.2009.03451.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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44
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García JM, Gamboa P, de la Calle A, Hernández MD, Caballero MT, García BE, Labrador M, Lahoz C, Longo Areso N, López Hoyos M, Martínez Quesada J, Mayorga L, Monteseirin FJ, Sanz ML. Diagnosis and management of immunodeficiencies in adults by allergologists. J Investig Allergol Clin Immunol 2010; 20:185-194. [PMID: 20635783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Primary immunodeficiencies (PIDs) are genetic diseases that cause alterations in the immune response and occur with an increased rate of infection, allergy, autoimmune disorders, and cancer. They affect adults and children, and the diagnostic delay, morbidity, effect on quality of life, and socioeconomic impact are important. Therapy (gamma-globulin substitution in most cases) is highly effective. We examine adult PIDs and their clinical presentation and provide a sequential and directed framework for their diagnosis. Finally, we present a brief review of the most important adult PIDs, common variable immunodeficiency, including diagnosis, pathogenesis, clinical signs, and disease management.
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Affiliation(s)
- J M García
- Department of Pediatric Allergology and Clinical Immunology, Hospital de Cruces, Baracaldo-Vizcaya, Spain.
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Sousa N, Martínez-Aranguren R, Fernández-Benitez M, Ribeiro F, Sanz ML. Comparison of basophil activation test results in blood preserved in acid citrate dextrose and EDTA. J Investig Allergol Clin Immunol 2010; 20:535-536. [PMID: 21243941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- N Sousa
- Immunoallergology Department, Coimbra University Hospitals, Portugal.
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46
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De Weck AL, Sanz ML, Gamboa PM, Jermann JM, Kowalski M, Medrala W, Sainte-Laudy J, Schneider MS, Weber JM, Wolanczyk-Medrala A. Nonsteroidal anti-inflammatory drug hypersensitivity syndrome: a multicenter study. II. Basophil activation by nonsteroidal anti-inflammatory drugs and its impact on pathogenesis. J Investig Allergol Clin Immunol 2010; 20:39-57. [PMID: 20232773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Patients who are clinically hypersensitive to nonsteroidal anti-inflammatory drugs (NSAIDs) sometimes present basophil activation in vitro, and in 50% of cases a parallel response to release of sulfidoleukotrienes (cellular allergen stimulation test) is observed. These phenomena occur not only in clinically hypersensitive patients, but also in some healthy controls who tolerate NSAIDs. MATERIAL AND METHODS We studied 16 clinically hypersensitive patients, 22 controls tolerating NSAIDs, and 29 healthy blood donors (clinical NSAID status unknown) using 2 different basophil isolation techniques (buffy coat or plasma leukocytes). RESULTS In a population of 13 aspirin-tolerant healthy controls and 29 healthy blood donors, basophil activation with aspirin, diclofenac, and naproxen was analyzed at 4 different concentrations. The results in the 2 groups were quite similar in qualitative terms. Choosing a cutoff of 5% and a stimulation index >2, the proportion of positive results increased with the concentration. There were more positive results at all concentrations using the plasma leukocyte technique. CONCLUSIONS The most important finding of this study is that basophil activation by NSAIDs occurs not only in clinically hypersensitive patients but also, to a very variable extent and on an individual basis, in apparently normal healthy individuals who tolerate NSAIDs. The phenomenon is clearly dose-related, and hypersensitive patients seem to react to lower NSAID concentrations.
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Affiliation(s)
- A L De Weck
- Department of Allergology and Clinical Immunology, University of Navarra, Pamplona, Spain
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47
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Mayorga C, Sanz ML, Gamboa PM, García BE, Caballero MT, García JM, Labrador M, Lahoz C, Longo Areso N, López Hoyos M, Martínez Quesada J, Monteseirín FJ. In vitro diagnosis of immediate allergic reactions to drugs: an update. J Investig Allergol Clin Immunol 2010; 20:103-109. [PMID: 20461964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Evaluation of allergic reactions to drugs is difficult because of the poor sensitivity of in vivo tests, which makes controlled administration of the drug necessary to confirm the diagnosis. In vitro tests are important in order to avoid the risks of in vivo testing. In the present review, we describe the different methods for detecting immunoglobulin (Ig) E antibodies that are specific to drugs involved in the development of type I (immediate) reactions. The 2 main in vitro methods are immunoassays and the basophil activation test, both of which have sufficient sensitivity and specificity for the detection of specific IgE antibodies, although with a limited number of drugs, and they have proven complementary to in vivo methods. We show the importance of the allergological workup of the patient within less than 1 year from the occurrence of the allergic reaction in order to obtain positive results in both in vivo and in vitro tests.
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Affiliation(s)
- C Mayorga
- Research Laboratory, Fundación IMABIS--Carlos Haya Hospital, Malaga, Spain.
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Cabrera-Freitag P, Gastaminza G, Goikoetxea MJ, Lafuente A, de la Borbolla JM, Sanz ML. Immediate allergic reaction to atropine in ophthalmic solution confirmed by basophil activation test. Allergy 2009; 64:1388-9. [PMID: 19392999 DOI: 10.1111/j.1398-9995.2009.02052.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Cabrera-Freitag
- Department of Allergology and Clinical Immunology, Collaborative Center of GA(2)LEN, University Clinic of Navarra, Pamplona, Spain.
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Asturias JA, Ibarrola I, Arilla MC, Vidal C, Ferrer A, Gamboa PM, Viñuela JE, Sanz ML, Andreu C, Martínez A. Engineering of major house dust mite allergens Der p 1 and Der p 2 for allergen-specific immunotherapy. Clin Exp Allergy 2009; 39:1088-98. [PMID: 19400901 DOI: 10.1111/j.1365-2222.2009.03264.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Specifically designed recombinant allergens with reduced IgE reactivity are promising candidates for a more defined, effective, and safer specific immunotherapy (SIT). OBJECTIVE We sought to obtain hypoallergenic hybrid molecules which could potentially be applied to house dust mite (HDM) allergy treatment. METHODS Two hybrid molecules (QM1 and QM2) derived from the two major Dermatophagoides pteronyssinus allergens, Der p 1 and Der p 2, were engineered by PCR, produced in Escherichia coli, and purified. The overall IgE-binding capacity of the hybrids was compared with their single components by Western blot, specific IgE, skin prick test (SPT), and IgE-inhibition assays. T cell proliferation assay were performed to confirm their retention of T cell reactivity. Immune responses to the hybrid molecules were studied in BALB/c mice. RESULTS The IgE reactivity of both hybrid proteins was strongly reduced as evaluated by in vitro methods. Furthermore, in vivo SPTs performed on 106 HDM-allergic patients showed that the hybrid proteins had a significantly lower potency to induce cutaneous reactions than the individual components. Hybrid molecules induced higher T cell proliferation responses than those produced by an equimolecular mixture of Der p 1 and Der p 2. Immunization of mice with the hybrid proteins induced Der p 1- and Der p 2-specific IgG, which inhibited the binding of allergic patients' IgE to these natural allergens. CONCLUSION QM1 and QM2 hybrids exhibited less IgE-binding activity but preserved immunogenicity and fulfilled the basic requirements for hypoallergenic molecules suitable for a future SIT of HDM allergy.
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Affiliation(s)
- J A Asturias
- Bial-Arístegui, Research & Development Department, Bilbao, Spain.
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Blanca M, Romano A, Torres MJ, Férnandez J, Mayorga C, Rodriguez J, Demoly P, Bousquet PJ, Merk HF, Sanz ML, Ott H, Atanasković-Marković M. Update on the evaluation of hypersensitivity reactions to betalactams. Allergy 2009; 64:183-93. [PMID: 19133923 DOI: 10.1111/j.1398-9995.2008.01916.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hypersensitivity reactions to betalactams (BLs) are classified as immediate or nonimmediate. The former usually appear within 1 h of drug-intake and are mediated by specific IgE-antibodies. Nonimmediate reactions are those occurring more than 1 h after drug-intake, and they can be T-cell mediated. The diagnostic evaluation of allergic reactions to BLs has changed over the last 5 years, for several reasons. Major and minor determinants are no longer commercially available for skin testing in many countries. In immediate allergic reactions, the sensitivity of skin testing and immunoassays is decreasing and new in vitro methods, such as the basophil activation test, are gaining importance for diagnosis. For nonimmediate reactions, skin testing appears to be less sensitive than previous results, although more studies need to be carried out in this direction. Nevertheless, the drug provocation test is still necessary for diagnosis.
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Affiliation(s)
- M Blanca
- Allergy Service, Carlos Haya Hospital, Malaga, Spain
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