Haploidentical stem cell transplantation in a boy with chronic granulomatous disease

Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): A. Regueiro-García, S. Fariña-Nogueira, J.Á. Porto-Arceo, J.M. Couselo-Sánchez
Chronic granulomatous disease is a primary immunodeficiency caused by mutations in any one of the five components of the NADPH oxidase in phagocytic leucocytes. This causes impaired microbial killing, which leads to severe life-threatening bacterial and fungal infections. Currently, allogenic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for chronic granulomatous disease, although gene therapy may provide a new therapeutic option for the treatment of patients with CGD. Haploidentical HSCT provides a potentially curative treatment option for patients who lack a suitably HLA-matched donor, but only a few cases have been reported in the literature. Herein, we report a boy with X-linked chronic granulomatous disease treated successfully by haploidentical HSCT with post-transplant cyclophosphamide using a treosulfan-based conditioning regimen.



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The roles of toll like receptor 3, 7 and 8 in allergic rhinitis pathogenesis

Publication date: Available online 3 February 2018
Source:Allergologia et Immunopathologia
Author(s): A. Golshiri-Isfahani, M. Amizadeh, M.K. Arababadi
Allergic rhinitis, as an allergic and nasal hypersensitivity disease, is associated with the inflammation of nasal mucosa. It appears that innate immune receptors are the important risk factors in the pathogenesis of the inflammatory disease. Toll-like receptors (TLRs) are the most important receptors of innate immunity; their crucial roles in the recognition of allergens and subsequently pathogenesis of allergic diseases have been evaluated recently. TLR3, 7 and 8 are the intracellular members of the innate immune receptors and recognize intracellular single and double strand RNAs. This review article collected the investigations regarding the roles of TLR3, 7 and 8 in the allergic rhinitis pathogenesis.



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Assessment of IL-31 levels and disease severity in children with atopic dermatitis

Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): D. Ozceker, M. Bulut, A. Celik Ozbay, F. Dilek, M. Koser, Z. Tamay, N. Guler
Introduction and objectivesAtopic dermatitis is a chronic, relapsing, highly pruritic, inflammatory skin disease characterized by typical localization with increasing prevalence of 10–20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective.The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively.Material and methodsOne hundred thirty-five children were enrolled in the study in total, 70 children with diagnosis of atopic dermatitis and 65 healthy children in control group. Data on demographic features (age, gender, family history of atopy) and laboratory values of serum eosinophil, total IgE, IgM, IgA, IgG levels and skin prick test results were collected through patient files. The disease severity was assessed by SCORAD index. IL-31 levels were measured with human IL-31 ELISA kit.ResultsThe statistical analysis showed that IL-31 level was significantly higher in AD patients than in the control group (AD vs CG, p 0.0001). There was no significant difference in IL-31 levels between the three subgroups divided according to the SCORAD severity score (p:0.27).ConclusionIL-31 levels were significantly higher in AD patients compared to control group but irrelevant to the disease severity.



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Knowledge on asthma, food allergies, and anaphylaxis: Assessment of elementary school teachers, parents/caregivers of asthmatic children, and university students in Uruguaiana, in the state of Rio Grande do Sul, Brazil

Publication date: Available online 12 January 2018
Source:Allergologia et Immunopathologia
Author(s): M. Urrutia-Pereira, L.P. Mocellin, R.B. de Oliveira, L. Simon, L. Lessa, D. Solé
IntroductionAllergic diseases have become an increasingly common reality in the last years, extending beyond the family context.ObjectiveAssessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil.Method577 individuals (PC – N=111; EST – N=177; US – N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis.ResultsAlthough PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students.ConclusionDespite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.



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Is vitamin D level associated with the natural course of atopic dermatitis?

Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): M. Dogru
Introduction and objectivesAtopic dermatitis (AD) is a chronic inflammatory disease of the skin. Apart from its well-known role on calcium metabolism, vitamin D is reported to affect skin functions. The study aims were to: compare the vitamin D levels of children with AD and healthy children; investigate the relationship between the severity of AD and vitamin D levels; and investigate the effect of vitamin D on the natural course of AD.Patients or materials and methodsSixty-nine patients with AD were enrolled. Seventy healthy children were assigned as control group. Clinical and demographic features of groups were recorded. The skin prick test, eosinophil counts, immunoglobulin (Ig) E levels and serum 25 OH cholecalciferol (25OHD3) levels were measured. After at least 4 years of follow-up, patients were re-evaluated for natural course of AD.ResultsMean 25OHD3 level was lower in patient group vs. control group; 19.86±6.7ng/mL (min–max: 6.8–40) vs. 24.07±9.08ng/mL, respectively, (p=0.002). Mean 25OHD3 levels, and vitamin D status were significantly different between AD severity groups. (p<0.05). In terms of vitamin D status in the pairwise comparison, vitamin D deficiency was greater in children with severe and moderate AD groups (respectively, p=0.005, p=0.018). In Tukey's post hoc analysis for 25OHD3 level, the 25OHD3 levels of severe AD are significantly lower than mild or moderate AD (respectively, p=0.001, p=0.026). There was a negative correlation between 25OHD3 levels and severity of AD (r=−0.480; p=0.001). In patients reassessed after 4 years: age, the age of AD onset, vitamin D deficiency, SCORAD level and severe AD were higher in the persistent group vs. remission group, 25OHD3 levels were higher in the remission group vs. persistent group (p<0.05).ConclusionsMean vitamin D levels were lower in patients with AD. A negative correlation between vitamin D levels and disease severity was documented. Vitamin D may affect the natural course of atopic dermatitis. There is a need for more comprehensive studies in this regard.



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Evaluation of an intervention to improve the management of allergens in school food services in the city of Barcelona

Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): M. Fontcuberta-Famadas, G. Serral, M.J. López, P. Balfagón, E. García-Cid, L. Caballé-Gavaldà
BackgroundAn intervention to promote the development of an allergen control plan (ACP) and preventive measures for the management of allergens in school food services was implemented in all schools of Barcelona city over a three-year period (2013–2015) by the public health services. The present study aimed to assess changes regarding the management of food allergens in school food services in Barcelona after an intervention conducted by the public health services of the city.MethodsSchool meal operators of a random sample of 117 schools were assessed before and after the intervention using a structured questionnaire. The questionnaire collected general information on the students and their demand for special menus, and included 17 closed questions regarding the implementation of specific preventive measures for the management of allergens. Based on these 17 questions, a food safety score was calculated for each school. The improvement in these scores was evaluated.ResultsThe results showed positive increments in the percentage of implementation of 12 of the 17 preventive measures assessed. The percentage of school food services with an implemented ACP increased by 49%. Schools with external and internal food supplies increased their scores by 16.5% and 19.6%, respectively. The greatest improvements were observed in smaller food services and in schools located in districts with low gross household incomes.ConclusionsThe intervention was effective in improving school food services' management of allergens and in reducing the differences found among food services in the pre-intervention survey. We must also focus efforts on reducing socio-economic inequalities linked to the management of allergens.



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Adherence to pharmacotherapy improves school performance in children with rhinitis and asthma

Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): J. Sánchez, A. Sánchez, R. Cardona
BackgroundAdherence to pharmacotherapy reduces symptoms of asthma and rhinitis, however, little is known of its impact on school performance.ObjectiveTo evaluate the impact of pharmacotherapy in absenteeism and school performance in a child population.MethodsA cross-sectional study, carried out in eight schools. All participants and their parents were given a questionnaire assessing parameters related to respiratory diseases and pharmacotherapy. Data on school performance was obtained from the academic history of each child who participated in the study. Adherence to pharmacotherapy was classified as a correct use of therapy for more than five days per week.Results1109 children agreed to participate. Students were divided into two groups: symptomatic (36%) and asymptomatic (63%). The symptomatic group had a higher frequency of school absenteeism (1 vs. 3.1days/year/patient p<0.01) and lower academic performance (failed: 20% vs. 33% p<0.01). After dividing the symptomatic group between adherents and non-adherents to the pharmacotherapy, the group of adherents had a similar school performance to the asymptomatic group and it was significantly different from the no-adherent group.ConclusionRespiratory symptoms are associated with poor school performance and with an increase in school absenteeism, but adherence to pharmacotherapy can reduce these negative impacts in children.



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Development and characterization of an allergoid of cat dander for immunotherapy

Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): J.P. Sola, Y. Pedreño, A. Cerezo, M. Peñalver-Mellado
BackgroundAllergy to cats is a frequent cause of sensitization to indoor allergens and currently there are few alternatives to specific immunotherapy with cat native extracts. The objective is to develop and characterize a new allergoid to increase the tools available for use in clinical practice.MethodsThe allergoid cat dander extract (ACD) was developed from a native cat dander extract (NCD) by modification with glutaraldehyde, and the optimal process control was determined by SDS-PAGE, DOT BLOT and determination of free amine groups. The ACD was characterized in protein profile by SDS-PAGE, size exclusion chromatography (SEC) and peptide footprint. The allergenic profile of ACD was determined by immunoblot, IgE CAP inhibition and IgG competition ELISA. The major allergen content in NCD was obtained by the ELISA sandwich protocol and was extrapolated to ACD.ResultsThe control process determined the optimal development of the allergoid. The ACD obtained contains 182.28μg/mg of protein and 11.90μg/mg of Fel d 1. SDS-PAGE and SEC confirmed the presence of high molecular weight proteins in ACD, and the peptide footprint showed the presence of Fel d 1 and Fel d 7. The high degree of polymerization was evidenced with the determination of the reduction of lysine residues in the allergoid, resulting 91.96%. The ACD showed a significant loss of allergenicity respect to NCD, while the IgG-binding capacity was maintained.ConclusionsThe ACD obtained presents a good safety profile, so would be a good alternative for treatment of cat allergy.



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Acknowledgment to reviewers

Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2





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Sublingual immunotherapy in children

Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
Author(s): M. Tortajada-Girbés, C. Rivas-Juesas




https://ift.tt/2Gpr4pH

An international comparison of risk factors between two regions with distinct differences in asthma prevalence

Publication date: Available online 24 March 2018
Source:Allergologia et Immunopathologia
Author(s): K. Madani, E. Vlaski, D.C. Rennie, M. Sears, J.A. Lawson
Background and purposeInvestigation of the geographic variation in asthma prevalence can improve our understanding of asthma etiology and management. The purpose of our investigation was to compare the prevalence of asthma and wheeze among adolescents living in two distinct international regions and to investigate reasons for observed differences.MethodsA cross-sectional survey of 13–14 year olds was completed in Saskatoon, Canada (n=1200) and Skopje, Republic of Macedonia (n=3026), as part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 study. Surveys were self-completed by students following the ISAAC protocol. Multiple logistic regression models were used to investigate associations with reports of asthma and current wheeze. A mediation analysis was then completed.ResultsAsthma prevalence was much higher in Saskatoon than Skopje (21.3% vs. 1.7%) as was the prevalence of current wheeze (28.2% vs. 8.8%). Higher paracetamol (acetaminophen) use was a consistent risk factor for asthma and wheeze in both locations and showed dose-response relationships. In both countries, paracetamol use and physical activity mediated some of the association for both asthma and wheeze. In Saskatoon, among those with current wheeze, 42.6% reported ever having a diagnosis of asthma compared to 10.2% among Skopje adolescents.ConclusionsThe results suggest that the variation in risk factors between the two locations may explain some of the differences in the prevalence of asthma and wheeze between these two study sites. However, diagnostic labeling patterns should not be ruled out as another potential explanatory factor.



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Efficacy and safety of sublingual immunotherapy with Dermatophagoides farinae drops in pre-school and school-age children with allergic rhinitis

Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
Author(s): L.-X. Tang, X.-J. Yang, P.-P. Wang, W.-T. Ge, J. Zhang, Y.-L. Guo, J. Lu, J. Tai, Y.-M. Zhang, X. Ni
BackgroundThe safety and efficacy of sublingual immunotherapy (SLIT) have been confirmed by many studies. However, in China, the research on efficacy and safety in young and older children with allergic rhinitis (AR) is still rare.ObjectiveThe aim of this retrospective study is to evaluate the efficacy and safety of SLIT with Dermatophagoides farinae drops in pre-school and school-age children with AR.MethodsA total of 282 subjects aged 2–13 years with AR received a two-year course of sublingual immunotherapy along with pharmacotherapy. According to the age, patients were defined as the pre-school group (2–6 years old, n=116) and school-age group (7–13 years old, n=166). Total nasal rhinitis symptom scores (TNSS), visual analogue score (VAS) and total medication scores (TMS) were evaluated at four time points: baseline, after SLIT for half a year, one year and two years. The adverse events (AEs) were evaluated at each visit.ResultsAfter two-year SLIT, the four rhinitis symptom scores, TNSS, VAS and TMS scores were significantly lower than baseline (all P<0.05). The comparison of efficacy between one and two-year duration showed no significant difference in global clinical outcomes (all P>0.05). In addition, there were no significant differences between the pre-school and school-age group in TNSS (all P>0.05), VAS (all P>0.05) and TMS scores (P>0.05) after SLIT for half a year, one year and two years. No severe systemic AEs were reported.ConclusionSLIT with D. farinae drops is clinically effective and safe in pre-school and school-age patients with house dust mites (HDMs)-induced AR.



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Diagnostic criteria for acute food protein-induced enterocolitis syndrome. Is the work in progress?

Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): S. Miceli Sopo, G. Bersani, C. Fantacci, A. Romano, S. Monaco
Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergic disorder. Some diagnostic criteria have been published for acute FPIES. Of course, they are not all the same, so the clinician must choose which ones to adopt for his/her clinical practice. We present here a brief review of these criteria and, through two clinical cases, show how the choice of one or the other can change the diagnostic destiny of a child with suspect FPIES.



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Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis

Publication date: Available online 12 January 2018
Source:Allergologia et Immunopathologia
Author(s): E. Skylogianni, M. Triga, K. Douros, K. Bolis, K.N. Priftis, S. Fouzas, M.B. Anthracopoulos
BackgroundEpidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the existence of SAD in non-asthmatic children with AR and to assessed its ability to predict the development of asthma.MethodsSeventy-three 6-year-old children with intermittent moderate-severe AR but without asthma symptoms/medication within the last two years, underwent spirometry and measurement of respiratory resistance (Rrs) and reactance (Xrs) before and after bronchodilation (BD) (300mcg salbutamol). Lung function measurements were performed in the absence of nasal symptoms and repeated at AR exacerbation. SAD was defined as >30% decrease in Rrs or >50% increase in Xrs at 6 or 8Hz post-BD. Participants were followed for five years.ResultsTwenty-three children (31.5%) developed asthma; this group presented significant post-BD changes in Rrs and Xrs, but only at AR exacerbation. The ability of these changes to predict the development of asthma was exceptional and superior to that of the spirometric parameters. SAD (22 children, 30.1%), emerged as the single most efficient predictor of asthma, independently of other risk factors such as parental asthma, personal history of eczema and type of allergic sensitisation.ConclusionSAD precedes the development of asthma in children with AR. Changes in respiratory impedance at AR exacerbation may assist in identifying those at risk to progress to asthma.



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Increase of natural killer cells in children with liver transplantation-acquired food allergy

Publication date: Available online 16 February 2018
Source:Allergologia et Immunopathologia
Author(s): F. Mori, C. Angelucci, A. Cianferoni, S. Barni, G. Indolfi, A. Casini, G. Mangone, M. Materassi, N. Pucci, C. Azzari, E. Novembre
BackgroundTransplantation-acquired food allergies (TAFA) are frequently reported and considered to be caused by immunosuppressive therapy.The aim of this study was to investigate the allergic and immunologic responses in children who had liver or kidney transplantations.MethodsTwelve children receiving liver transplantations and 10 children receiving kidney transplantations were investigated. All children underwent the allergy work-up and in most of them, lymphocyte screening and serum cytokine measurements were also performed.ResultsTAFA were found in 7/12 (58%) children with liver transplantations and in none of the 10 children with kidney transplantations. The mean age at transplantation was significantly lower in children who underwent liver transplantations (p<0.001). The immunosuppressive therapy administered to children with liver transplantation was tacrolimus in 11 patients and cyclosporine in one patient, while all 10 children with kidney transplantation received tacrolimus plus mycophenolate. The most common antigenic food was egg. The natural killer (NK) cell numbers were significantly higher in liver-transplant children than in kidney-transplant children. No significant differences were found in the serum cytokine levels.ConclusionsThis study confirms that liver-transplant children treated with tacrolimus alone have a higher risk of developing TAFA than kidney-transplant children treated with tacrolimus plus mycophenolate. NK cells might be involved in this difference.



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Exposure to dogs but not cats is associated to a decrease in the prevalence in atopic dermatitis amongst school-children

Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): M. Bedolla-Barajas, J. Morales-Romero, T.I. Bedolla-Pulido, T.R. Bedolla-Pulido, C. Meza-López, N.A. Pulido-Guillén
IntroductionThe association regarding the exposure to pets, especially cats and dogs, and the prevalence of allergic diseases is inconsistent.ObjectiveWe analyzed the role played by early exposure to dogs or cats in the prevalence of allergic diseases amongst school-aged children.MethodThrough a cross-sectional study, we examined 756 children, aged 6–7; these candidates were selected through cluster sampling. We inquired about the exposure that these children had had to dogs and cats, and whether these pets spent most of their time indoors or outdoors during the first year of the child's life. In order to identify the prevalence of allergic diseases and their symptoms, each child's parent completed the International Study of Asthma and Allergies in Childhood questionnaire.ResultsExposure to outdoor dogs was associated to nocturnal coughing, odds ratio (OR) 0.64, with a confidence interval of 95% (95% CI) 0.43–0.95 and with atopic dermatitis (OR: 0.39; 95% CI: 0.20–0.76). Interestingly, exposure to outdoor cats was associated to nocturnal coughing (OR: 0.51; 95% CI: 0.32–0.83) and current rhinitis symptoms (OR: 0.59; 95% CI 0.36–0.97). After carrying out the multivariate analyses, only exposure to dogs, both indoor and outdoor, was significantly associated to a decrease in the prevalence of atopic dermatitis OR 0.40 (95% CI: 0.20–0.79) and OR 0.38 (95% CI: 0.18–0.83), respectively.ConclusionOur findings suggest that exposure to dogs, whether they be indoor or outdoor pets, is associated to a decreased prevalence in atopic dermatitis.



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Pine nut allergy in Korean children: Clinical characteristics and diagnostic values of specific IgE against pine nuts

Publication date: Available online 12 February 2018
Source:Allergologia et Immunopathologia
Author(s): E. Lee, K. Jeong, J. Lee, S. Lee
BackgroundHypersensitivity reactions to pine nuts in children have been occasionally encountered recently, although reports on pine nut allergy cases are rare worldwide. The study aimed to feature clinical and laboratory findings pertaining to pine nut allergy in Korean children.MethodsForty-two subjects were enrolled through a retrospective review of medical records, from September 2010 to December 2015, at the Department of Pediatrics in Ajou University Hospital. The demographic profiles, clinical characteristics, and laboratory findings were evaluated.ResultsTwenty-four patients showed immediate-type reactions after exposure to pine nuts (the allergic group), while the remaining 18 were atopic controls, who exhibited no allergic symptoms (the tolerant group). The median age of the subjects in the allergic group was three years. More than half of the subjects in this group experienced allergic symptoms within 5min, and seven of them experienced anaphylaxis. The median level of pine nut-specific immunoglobulin E (sIgE) in the allergic group (1.62kUA/L) was significantly higher (p=0.014) than that in the tolerant group (0.11kUA/L), with an optimal cut-off level of 0.40kUA/L (sensitivity, 66.7% and specificity, 77.8%). The positive decision point of pine nut-sIgE (specificity, 100%) to distinguish the allergic and tolerant groups was 2.84kUA/L. However, there was no difference in pine nut-sIgE levels between the anaphylaxis and non-anaphylaxis cases.ConclusionAbout 30% of children with pine nut allergy experienced anaphylaxis. The optimal cut-off level of pine nut-sIgE to distinguish the allergic and tolerant groups was 0.40kUA/L and the positive decision point was 2.84kUA/L.



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Immunomodulation of allergic response in children and adolescents: What we can learn from lymphatic filarial infection

Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
Author(s): A.M. Aguiar-Santos, S. Montenegro, Z. Medeiros, A. Rocha, C.N.L. Morais, A.R. Silva, C. Bonfim, T.R. Costa, E.S.C. Sarinho
BackgroundAlthough it is well known that allergic diseases involve a strong Th2 immune response, with production of high levels of specific IgE allergen, knowledge on the association between filarial infection and allergies, among paediatric patients is scarce.ObjectiveTo evaluate the allergic response patterns in cases of filarial infection by comparing peripheral eosinophils, total IgE levels, immediate hypersensitivity and cytokine levels in children and adolescents in Brazil.MethodsThis was an exploratory study with three groups: (I) with filarial infection and without allergic diseases; (II) without filarial infection and with allergic diseases; and (III) without filarial infection and without allergic diseases. The prick test and specific IgE tests for aeroallergens were performed using five antigens. Peripheral eosinophils and total IgE were also evaluated. IL-4 and IL-5 were determined using whole-blood culture stimulated by three antigens.ResultsEosinophilia and elevated levels of total IgE (≥400IU/dl) were observed in all groups. The prick test was positive in 56.6% of the cases. Group I presented hypersensitive responses similar to the allergic disease groups. In the whole-blood culture stimulated by Dermatophagoides pteronyssinus, average IL-4 production did not differ significantly among the groups, but IL5 production resulting from stimulation was greater in the allergic disease groups (p<0.05).ConclusionsThe allergic response pattern in group with filarial infection was similar to that of the groups with and without allergic diseases, but the response to IL-5 in the culture stimulated by D. pteronyssinus was an exclusive characteristic of the allergic group.



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Fluticasone in mild to moderate atopic dermatitis relapse: A randomized controlled trial

Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): E. Rubio-Gomis, I. Martinez-Mir, F.J. Morales-Olivas, A. Martorell-Aragones, V. Palop-Larrea, A. Bernalte-Sesé, J.C. Cerda-Mir, P. Polo-Martín, I. Febrer, L. Aranda-Grau, I. Llosa-Cortes, Mª.J. Tejedor-Sanz, J.C. Julia-Benito, T. Alvarez-de-Laviada-Mulero, Mª.V. Planelles-Cantarino, E. Apolinar-Valiente, M. Loriente-Tur, A.M. Abella-Bazataqui, I. Alvarez-Gonzalez, C. Morales-Carpi, Mª.E. Burches-Greus, A.B. Ferrer-Bautista, R. Felix-Toledo, D. Marmaneu-Laguia, V.E. Garcia-Martinez, Mª.A. Beltran-Marques, B. Rodriguez-Gracia
BackgroundThe long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD.MethodsA randomized controlled, multicentric, double-blind trial was conducted. Children (2–10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan–Meier estimates were calculated.ResultsFifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated.ConclusionThis long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.



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Loss of tolerance for fishes previously tolerated in children with fish food protein induced enterocolitis syndrome

Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): S. Miceli Sopo, C. Fantacci, G. Bersani, A. Romano, S. Monaco
We describe two case reports presenting some novel information on fish FPIES. Fish FPIES to one fish does not always start at the same time to other fish. Additionally, development of tolerance to the index fish do not necessarily imply tolerance to other reactive fish. This reflects on the best management of children with FPIES fish.



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Assessment of CTNNB1 gene mutations and β-catenin immunoexpression in salivary gland pleomorphic adenomas and adenoid cystic carcinomas

Abstract

β-Catenin exerts multiple functions in several neoplasms, playing a major role in cell signaling and tumor progression. This study analyzed possible CTNNB1 mutations in salivary gland pleomorphic adenomas (PAs) and adenoid cystic carcinomas (ACCs), and determined possible differences in β-catenin immunoexpression in relation to these mutations, as well as histopathological aspects of these tumors. Twenty-four PAs (15 cell-rich and 9 cell-poor tumors) and 24 ACCs (10 tubular, 8 cribriform, and 6 solid tumors) were selected for the analysis of β-catenin distribution and cellular localization. Furthermore, β-catenin expression was evaluated using the H-score scoring system. Mutations in CTNNB1 exon 3 were investigated by the single-strand conformational polymorphism test. Diffuse β-catenin expression was more frequently observed in ACCs compared to PAs (P = 0.008). No significant difference in β-catenin cellular localization was observed between these tumors (P = 0.098). Comparisons between PA and ACC cases revealed a higher median H-score in the latter (P = 0.036). Cell-rich PAs exhibited a trend for higher H-score than cell-poor tumors (P = 0.060), whereas lower H-scores were observed in cribriform ACCs when compared to tubular and solid ACCs (P = 0.042). Mutations in CTNNB1 were observed in 6 PAs and 7 ACCs, with no significant difference in H-scores for β-catenin according to mutation status (P = 0.135). β-Catenin is important in the pathogenesis of salivary gland PAs and ACCs. In addition, CTNNB1 exon 3 mutations do not seem to significantly influence β-catenin cytoplasmic/membranous expression or nuclear translocation in these tumors.

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Chemokines and cancer: new immune checkpoints for cancer therapy

Nathan Karin

https://ift.tt/2I6cbWD

Engineering T cells for adoptive therapy: outsmarting the tumor

Andre Kunert | Reno Debets

https://ift.tt/2IOpBYm

Helicobacter, Volume 23, Issue 2, April 2018.

Helicobacter, Volume 23, Issue 2, April 2018.


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Comparison of long-term functional results between standard supracricoid laryngectomy and modified technique with sternohyoid muscle

Publication date: Available online 24 March 2018
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Selçuk Güneş, Kadir Serkan Orhan, Bora Başaran, Mehmet Çelik, Erkan Kıyak
IntroductionLaryngeal cancer is the most common cancer of the upper respiratory tract. The main methods of treatment included surgery (partial laryngectomy and total laryngectomy) and radiation therapy. Laryngeal dysfunction is seen after both treatment modalities.ObjectiveThe aim of the study is to compare postoperative functional results of the standard supracricoid partial laryngectomy technique and a modified supracricoid partial laryngectomy technique using the sternohyoid suscle.MethodsIn total, 29 male patients (average years 58.20±9.00 years; range 41–79 years) with laryngeal squamous cell carcinoma who underwent supra cricoid partial laryngectomy were included. The patients were divided into two groups in terms of the surgical techniques. In Group A, all patients underwent standard supracricoid partial laryngectomy technique between January 2007 and November 2011. In Group B, all patients underwent modified supracricoid partial laryngectomy between August 2010 and November 2011. Fiberoptic endoscopic evaluation of swallowing test, short version of the voice handicap index scores, and the MD Anderson dysphagia inventory, the time of oral feeding and the decanulation of the patients after surgery of each groups were compared.ResultsThe mean maximum phonation time was 8.68±4.21s in Group A and 15.24±6.16s in Group B (p>0.05). The S/Z (s/s) ratio was 1.23±0.35 in Group A and 1.08±0.26 in Group B (p>0.05); the voice handicap index averages were 9.86±4.77 in Group A and 12.42±12.54 in Group B (p>0.05); the fiberoptic endoscopic evaluation of swallowing test averages were calculated as 12.73±3.08 in Group A and 13.64±1.49 in Group B (p>0.05). In the MD Anderson dysphagia inventory, evaluation of swallowing, the emotional, physical, and functional scores were 29.21±4.11, 32.21±6.85, and 20.14±2.17 in the Group B, and 29.20±2.54, 32.4±4.79, and 19±1.92 in Group A, respectively.ConclusionAlthough there is no statistical difference in functional outcome comparisons, if rules are adhered to in preoperative patient selection, modified supracricoid partial laryngectomy can be applied safely and meaningful gains can be achieved in functional outcomes.



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Preservation of residual hearing after cochlear implant surgery: an exploration of residual hearing function in a group of recipients at cochlear implant units

Publication date: Available online 24 March 2018
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Katherine Gautschi, Katijah Khoza-Shangase, Dhanashree Pillay
IntroductionThe preservation of residual hearing is becoming increasingly important in cochlear implant surgery. Conserving residual hearing is a positive prognostic indicator for improved hearing abilities.ObjectiveThe primary aim of the study was to explore the preservation of residual hearing following cochlear implantation in a group of recipients at two major cochlear implant centers.MethodsA quantitative paradigm was adopted and exploratory research conducted within a retrospective data review design. The sample consisted of 50 surgical records and 53 audiological records from 60 observations (53 patients, seven of whom were implanted bilaterally). The records were selected using purposive sampling and consisted of records from participants ranging from six to 59 years of age. The average time of when the postoperative audiograms were performed in the current study was 24.7 months (s.d.=±9.0). Data were analyzed through both qualitative and inferential statistics and a comparative analysis of unaided pre- and postoperative audiological test results was conducted.ResultsResults indicated a high success rate of 92% preservation of residual hearing with half of the sample exhibiting complete preservation in cochlear implant recipients across all frequencies postoperatively. A total postoperative hearing loss was found in only 8% of cochlear implantees across all frequencies. There was no relationship between preoperative hearing thresholds and preservation of hearing postoperatively. The two main surgical techniques used in the current study were the contour on stylet and the advance off-stylet techniques, with the majority of surgeons utilizing a cochleostomy approach. From the findings, it became apparent that the majority of cases did not have any reported intraoperative complications. This is a positive prognostic indicator for the preservation of residual hearing.ConclusionFindings suggest improved cochlear implant surgical outcomes when compared to previous studies implying progress in surgical techniques. The surgical skill and experience of the surgeon are evidenced by the minimal intraoperative complications and the high success rate of hearing preservation. This is a positive prognostic indicator for individuals with preoperative residual hearing as the preserved residual hearing allows for the potential of electro-acoustic stimulation, which in turn has its own hearing benefits.



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Metastasis to Paranasal Sinuses from Carcinoma of Prostate: Report of a Case and Review of the Literature

Metastasis from distant primary tumors is extremely rare in the paranasal sinuses with few hundred cases in the literature. Metastatic carcinoma of the prostate is even rarer, despite being one of the most common tumors, with only 24 cases published. In this article, we report a case of a 58-year-old male presenting with epistaxis and nasal obstruction as initial symptoms of a metastatic prostate carcinoma in the ethmoid cells and maxillary sinus.

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A hydatic cyst of the appendix mimicking a uterine lateral mass: a case report

Hydatic cyst is a zoonotic disease caused by Echinococcus granulosus. It is a public health problem in Tunisia and remains endemic. It occurs in intra-abdominal organs in 10–15% of the cases, particularly in t...

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Guidelines for the Content of Statistical Analysis Plans in Clinical Trials

Gamble, C; Krishan, A; Stocken, D; Lewis, S; Juszczak, E; Dore, C; Williamson, PR; ... Loder, E; + view all Gamble, C; Krishan, A; Stocken, D; Lewis, S; Juszczak, E; Dore, C; Williamson, PR; Altman, DG; Montgomery, A; Lim, P; Berlin, J; Senn, S; Day, S; Barbachano, Y; Loder, E; - view fewer (2017) Guidelines for the Content of Statistical Analysis Plans in Clinical Trials. JAMA - Journal of the American Medical Association , 318 (23) pp. 2337-2343. 10.1001/jama.2017.18556 .

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A rare case of drug-induced hypersensitivity syndrome by pirfenidone for idiopathic pulmonary fibrosis

Publication date: Available online 24 March 2018
Source:Allergology International
Author(s): Kumiko Suda, Koji Kamiya, Binluen Chiang, Hirofumi Okada, Naoko Mato, Takeo Maekawa, Mayumi Komine, Satoru Murata, Mamitaro Ohtsuki




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A Case of Congenital Syphilis Presenting with Unusual Skin Eruptions

Once believed to be a rare disease in developed countries, recent data suggest that there is a surge in incidence of congenital syphilis in many developed countries. Diagnosis of congenital syphilis can be difficult because more than two-thirds of affected infants are asymptomatic at birth, and signs of symptomatic infants may be nonspecific or subtle. On top of this, some affected infants may have atypical presentations. Familiarity with the diverse presentations is essential to diagnosis. We report a 2-week-old male infant with congenital syphilis whose cutaneous manifestations included diffuse, erythematous keratoderma with desquamation and fissures on his hands and feet, multiple linear scaly fissures at the angles of his mouth, and onychauxis of the fingernails and toenails To our knowledge, diffuse, erythematous keratoderma of the hands and feet and thick nails have not been reported previously in congenital syphilis.

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Parasite allergens

Publication date: Available online 24 March 2018
Source:Molecular Immunology
Author(s): Luis Caraballo, Sandra Coronado
Human IgE against helminths is a normal component of the whole protective response elicitesd during infection, when specific IgE to a great number of antigens is produced; however, few of those IgE binding components are actually allergens. In general, considering the strong Th2/IgE responses during helminth infections is intriguing that they are not usually associated with allergic symptoms, which probably (but not exclusively) depends on parasite-induced immunomodulation. However, allergic manifestations have been described during some helminth infections such as ascariasis, strongyloidiasis, anisakiasis and hydatidosis. In addition, there is evidence that helminthiases (e.g. ascariasis) can increase symptoms in allergic patients. Furthermore, allergic reactions during anti-helminth vaccination have been observed, a problem that also could be associated to the future use of parasite derived immunomodulators. Therefore, identification and characterization of helminth allergens is a matter of increasing research and a great number of IgE binding antigens have been found (www.allergen.org and www.allergome.org). Here we describe only a small group of them, for which allergenic activity (the ability to induce IgE mediated inflammation) have been clinical or experimentally demonstrated. Ascaris lumbricoides tropomyosin (Asc l 3) has strong allergenic activity; in the Tropics it has been associated with asthma and asthma severity, suggesting clinical relevance. In addition, due to its cross reactivity with mite tropomyosins this allergen could influence house dust mite (HDM) allergy diagnosis. Characterized Ascaris allergens also include the polyprotein As s 1 (ABA-1) and the Glutathione transferase As l 13. Other helminth allergens include Anisakis simplex Ani s 1, Ani s 4, Ani s 7 and Ani s 9; Necator americanus NaASP2q and Nacal1 and Schistosoma mansoni SmVAL4 and Sm22.6. Future work on helminth IgE binding antigens will help to understand several aspects of allergenicity and allergenic activity, among them the increasing finding of IgE binding molecules that not induce allergic symptoms.



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