Tolerance to baked and fermented cow's milk in children with IgE-mediated and non-IgE-mediated cow's milk allergy in patients under two years of age

Publication date: Available online 15 July 2017
Source:Allergologia et Immunopathologia
Author(s): A. Uncuoglu, N. Yologlu, I.E. Simsek, Z.S. Uyan, M. Aydogan
BackgroundIgE-mediated cow's milk allergy (CMA) has been shown consistent in milder heated-milk tolerant and severe heated-milk reactant groups in patients older than two years. Little is known whether fermentation of milk gives rise to similar clinical phenotypes.We aimed to determine the influence of extensively heated and fermented cow's milk on the IgE-mediated and non-IgE-mediated CMA in children younger than two years.MethodsSubjects followed with the diagnosis of IgE-mediated and non-IgE-mediated CMA for at least six months underwent unheated milk challenge. IgE-mediated and non-IgE-mediated groups were categorised as unheated milk-reactive and tolerant, separately. Unheated milk-reactive groups were further challenged sequentially with fermented milk (yoghurt) and baked milk, 15 days apart. Allergy evaluation with skin tests, prick-to-prick tests and atopy patch tests were performed.ResultsFifty-seven children (median age: 14 months; range: 7–24 months) underwent unheated milk challenge. Eleven of 27 children with IgE-mediated CMA and 14 of 30 children with non-IgE-mediated CMA tolerated unheated milk. Among subjects who reacted to unheated milk; 15 of 16 subjects (93%) with IgE-mediated CMA also reacted to yoghurt, whereas 11 of 16 subjects (68%) with non-IgE-mediated CMA tolerated fermented milk. Thirteen subjects (81%) of the unheated milk-reactive IgE-mediated group tolerated to heated milk. None of 16 subjects of unheated milk-reactive non-IgE-mediated group reacted to baked milk.ConclusionThe majority of children under the age of two years with both IgE-mediated and non-IgE-mediated CMA tolerated baked-milk products. Yoghurt was tolerated in two thirds of unheated milk reactive patients suffering from non-IgE-mediated CMA.



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Expression of MyHC isoforms mRNA transcripts in different regions of the masseter and medial pterygoid muscles in chimpanzees

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Neus Ciurana, Rosa Artells, Carmen Muñoz, Júlia Arias-Martorell, Gaëlle Bello-Hellegouarch, Alejandro Pérez-Pérez, Juan Francisco Pastor, Josep Maria Potau
ObjectiveThe aim of this study is to examine the expression pattern of the different myosin heavy chain (MyHC) isoforms in the masseter and medial pterygoid muscles by real time quantitative polymerase chain reaction (RT-qPCR) to obtain information at molecular level which can be related to the functional characteristics of these two muscles.DesignThe masseter, deep and superficial portion, and medial pterygoid muscles of five adult Pan troglodytes were dissected in order to obtain samples of the anterior and posterior regions of each portion of the masseter and of the medial pterygoid. The expression of MyHC isoforms mRNA transcripts was analyzed by RT-qPCR.ResultsNo significant differences in expression of MyHC isoforms between the masseter and the medial pterygoid were found. In contrast, when comparing the superficial and the deep portion of the masseter, we found that the MyHC-IIM isoform was expressed at a significantly higher level in the superficial portion.ConclusionsThe superficial portion of the masseter and the medial pterygoid muscle have the same expression pattern regarding the different MyHC isoforms. On the other hand, the deep portion of the masseter, which is activated mainly during lateral and repositioning movements of the mandible, has a lower MyHC-IIM isoform expression than the superficial portion. Our findings provide new data on functional aspects of the masseter and medial pterygoid that can complement results obtained by other techniques.



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In silico search of inhibitors of Streptococcus mutans for the control of dental plaque

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Rodrigo Ochoa, María Cecilia Martínez-Pabón, María Adelaida Arismendi-Echeverri, Willer Leandro Rendón-Osorio, Carlos Enrique Muskus-López
Biofilm is an extremely complex microbial community arranged in a matrix of polysaccharides and attached to a substrate. Its development is crucial in the pathophysiology of oral infections like dental caries, as well as in periodontal, pulp, and periapical diseases. Streptococcus mutans is one of the most effective microorganisms in lactic acid production of the dental biofilm. Identifying essential Streptococcus mutans proteins using bioinformatics methods helps to search for alternative therapies. To this end, the bacterial genomes of several Streptococcus mutans strains and representative strains of other cariogenic and non-cariogenic bacteria were analysed by identifying pathogenicity islands and alignments with other bacteria, and by detecting the exclusive genes of cariogenic species in comparison to the non-pathogenic ones. This study used tools for orthology prediction such as BLAST and OrthoMCL, as well as the server IslandViewer for the detection of pathogenicity islands. In addition, the potential interactome of Streptococcus mutans was rebuilt by comparing it to interologues of other species phylogenetically close to or associated with cariogenicity. This protocol yielded a final list of 20 proteins related to potentially virulent factors that can be used as therapeutic targets in future analyses. The EIIA and EIIC enzymatic subunits of the phosphotransferase system (PTS) were prioritized, as well as the pyruvate kinase enzyme, which are directly involved in the metabolism of carbohydrates and in obtaining the necessary energy for the microorganism's survival. These results will guide a subsequent experimental trial to develop new, safe, and effective molecules in the treatment of dental caries.



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Respiratory Virus prior to Hematopoietic Cell Transplantation is associated with allo-immune mediated lung syndromes

Publication date: Available online 15 July 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Birgitta Versluys, Marc Bierings, Jean Luc Murk, Tom Wolfs, Caroline Lindemans, Kors vd Ent, Jaap Jan Boelens
BackgroundAllo-immune mediated lung syndromes (allo-LS) are life-threatening complications after hematopoietic cell transplantation (HCT). Respiratory virus (RV) has been suggested to play a role in the pathogenesis.ObjectiveWe studied the relation between RV-DNA/RNA detection in upper/lower airway before HCT and the occurrence of allo-LS.MethodsWe retrospectively analyzed all HCT recipients between 2004 and 2014, in whom Real-Time PCR for RV was done from Nasal-Pharyngeal-Aspirates (NPA) and Broncho-Alveolar- Lavage (BAL) before HCT. Main outcome of interest was allo-LS, defined as Idiopathic Pneumonia Syndrome or Bronchiolitis Obliterans Syndrome. Other outcomes were overall survival and treatment related mortality (TRM). We used Cox proportional hazard models, logistic regression models and Fine-Gray competing risk regression for analyses.Results179 children (median age 6.8 years) were included. RV was found in 61% (41% in BAL/NPA, 20% in NPA-only). Rhinovirus was the most frequently detected RV (42%). Allo-LS occurred in 13 %. RV-positivity in BAL was a predictor for allo-LS (HR 3·8, 95% CI 1·4 – 10·7; p=0·01), while RV-positivity in NPA-only was not. No other predictors were found. Acute Graft-Versus-Host-Disease grade 2-4, related with steroid treatment, shows a trend towards a protective effect (OR 0·16, 95%CI 0·0–1·3; p=0·08). Allo-LS significantly increased TRM (52 ± 10% in allo-LS, 20 ± 4% in non-allo-LS, p= 0·007).ConclusionsThese results show that pre-HCT BAL RV-positivity was a predictor for allo-LS. Screening for RV before HCT may identify patients at risk for allo-LS. This may have implications for prevention and treatment and may subsequently influence the outcomes of HCT.

Graphical abstract

Teaser

This study shows a strong relation between Respiratory Virus prior to transplant, and alloimmune lungsyndromes, which may have therapeutic implications. Our hypothesis, based on biological and pathophysiological factors, can guide reflections on immunemediated disease in general.


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A brief psychological intervention for mothers of children with food allergy can change risk perception and reduce anxiety: outcomes of a randomised controlled trial

Abstract

Background

Mothers of children with food allergy have increased anxiety, which may be influenced by healthcare professionals' communication of risk.

Objective

To evaluate a brief psychological intervention for reducing anxiety in mothers of children with food allergy.

Methods

Two hundred mothers of children with food allergy were recruited from allergy clinics. A computer-generated randomization list was used to allocate participants to a single-session Cognitive Behavioural Therapy intervention including a risk communication module, or standard care. Anxiety and risk perception were assessed at 6 weeks and 1 year. Primary outcome was state anxiety at 6 weeks. Secondary outcomes included state anxiety at 1 year, risk perception at 6 weeks and 1 year, and salivary cortisol response to a simulated anaphylaxis scenario at 1 year.

Results

We found no significant difference in the primary outcome state anxiety at 6 weeks, with mean 31.9 (sd 10.2) intervention, 34.0 (10.2) control; mean difference 2.1 (95%CI -0.9, 5.0; P=0.17). There was significantly reduced state anxiety at 6 weeks in the intervention group, in the subgroup of participants with moderate/high anxiety at enrolment (103/200, 52%), with mean 33.0 (sd 9.3) intervention, 37.8 (sd 10.0) control; mean difference 4.8 (95% CI 0.9, 8.7; P=0.016; Cohen's d effect size 0.50). The psychological intervention also reduced risk perception and salivary cortisol response (P=0.032; effect size 0.36).

Conclusion

We found evidence that a brief psychological intervention which incorporates accurate risk information may impact on anxiety, risk perception and physiological stress response in mothers of children with food allergy.

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Food allergy phenotypes: the key to personalized therapy

Abstract

Food allergies (FAs) are of increasing public health concern and are characterized by a large spectrum of diseases. Their diversity is well known for immunologic pathways (IgE, non-IgE mediated FAs), and natural history. Many other factors and patient characteristics are involved including type of food, exposure route, allergic comorbidities, gender, racial and ethnic backgrounds, co-factors and health conditions. Food allergen components and sensitization profiles are also involved in FA phenotypes. A new approach to chronic disorders based on the identification of phenotypes through extensive knowledge of all the complex components is also applicable to FAs and could lead towards integrative care management. Diagnostic biomarkers for FAs are emerging which also contribute to better care modalities. The aim of this article is to highlight current knowledge regarding the phenotypic diversity of FA. This review will focus on IgE-mediated FAs and how identifying phenotypes may help to better understand the pathophysiological complexity, improve diagnosis and lead to personalized treatment strategies.

This article is protected by copyright. All rights reserved.

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Assessment of BRAF V600E mutation in pulmonary Langerhans cell histiocytosis in tissue biopsies and bronchoalveolar lavages by droplet digital polymerase chain reaction

Abstract

The neoplastic nature of pulmonary Langerhans cell histiocytosis (PLCH) is still debated. As the detection of BRAF ^V600E and MAP2K1 mutations in patients with PCLH is now considered for such assessment, the aim of our study was to evaluate digital droplet polymerase chain reaction (ddPCR) in PCLH diagnosis. We retrospectively analyzed BRAF^V600E detection in a cohort of 42 PCLH tissues and 18 bronchoalveolar lavages (BALs) by ddPCR, immunohistochemistry, high-resolution melting PCR (HRM), and next-generation sequencing (NGS). The presence of BRAF^V600E mutation was assessed by at least two concordant techniques to further evaluate specificity and sensitivity of each method. The BRAF ^V600E mutation prevalence was detected in 18 out of 41 cases by ddPCR, 10 out of 36 cases by HRM PCR, and 16 out of 31 cases by NGS. BRAF^V600E immunohistochemistry sensitivity was 94%, and specificity was 79%. HRM PCR sensitivity was only 59%, and specificity was 100%. NGS sensitivity and specificity were 100% for interpretable cases (n = 31), but in 11 cases, this technique was non-contributive. The analysis of BAL samples by ddPCR revealed a BRAF^V600E mutation both in tissue and in BAL samples in one patient, a wild-type status both in tissue and in BAL samples in two patients, and a wild-type BRAF status in BAL and a BRAF^V600E mutation in tissue samples in four patients. The study supports the usefulness of ddPCR for BRAF status assessment in either tissue or BAL samples to increase the accuracy of PLCH diagnosis.

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