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Qualitative analysis of protein antigen in bird exposed asthma patients by high-performance liquid chromatography method 禽暴露哮喘患者蛋白抗原的高效液相色谱定性分析
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_16_22
Raj Kumar, A. Mavi, S. Spalgais, M. Kumar, Kamal Singh, Priya
BACKGROUND: Asthma is a chronic disease that affects large number of people worldwide. In urban areas, asthmatic people are getting exposed to pigeon antigen (droppings and feathers) around the workplace and domestic areas. The present study was conducted to the determination of MUC1 protein in the blood of pigeon-exposed asthmatic patients by the high-performance liquid chromatography (HPLC) method. MATERIALS AND METHODS: This was a prospective study of 108 pigeon-exposed asthma patients. We enrolled 17 asthmatic patients for detection of MUC1 expression in their serum sample who were atopic and skin prick testing positive for pigeon antigens (droppings and feathers). The MUC1 analysis was done with HPLC method. RESULTS: A total of 17 asthmatic patients were enrolled on the basis of the history of pigeon exposure and positive skin prick test for pigeon's feather and dropping allergens including 9 males and 8 females, the average age of the study candidates was 28.8 ± 10.1 years. MUC1 concentration was raised in all of the asthmatic patients exposed to pigeons. The MUC1 was upregulated in 15 and downregulated in 2 patients. A higher concentration of MUC1 was seen in younger patients. CONCLUSION: Pigeon droppings and feathers allergen exposed and sensitivity showed the higher MUC1 expression in serum in asthma patients. The concentration of MUC1 was higher in the younger age group. The HPLC method was easier and economical for the detection of MUC1.
背景:哮喘是一种影响全世界大量人群的慢性疾病。在城市地区,哮喘患者在工作场所和家庭周围接触到鸽子抗原(粪便和羽毛)。本研究采用高效液相色谱法(HPLC)测定了鸽子暴露哮喘患者血液中MUC1蛋白的含量。材料与方法:这是一项108例鸽子暴露哮喘患者的前瞻性研究。我们招募了17例哮喘患者,检测其血清中MUC1的表达,这些患者均为鸽抗原(粪便和羽毛)的特应性和皮肤点刺试验阳性。MUC1分析采用高效液相色谱法。结果:共有17例哮喘患者,均有鸽接触史,鸽羽及落毛过敏原皮肤点刺试验阳性,其中男9例,女8例,平均年龄28.8±10.1岁。所有暴露于鸽子的哮喘患者MUC1浓度均升高。15例MUC1表达上调,2例MUC1表达下调。年轻患者MUC1浓度较高。结论:暴露及敏感的鸽粪及羽毛变应原在哮喘患者血清中MUC1表达较高。MUC1浓度在低龄组较高。高效液相色谱法检测MUC1简便、经济。
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引用次数: 0
Successful treatment with a combination of bee venom immunotherapy and omalizumab for recurrent anaphylaxis after honey bee sting 蜂毒免疫疗法和奥玛珠单抗联合成功治疗蜜蜂蜇伤后复发性过敏反应
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_28_21
P. Kathuria, M. Rai, G. Hassan
Hymenoptera venom hypersensitivity reaction affects about 3% of the general population and a higher percentage (14%–43%) in beekeepers. Bee venom immunotherapy (bVIT) is effective in reducing subsequent severe systemic reactions and has a significant beneficial effect on disease-specific quality of life in both children and adults. In patients with a history of recurrent systemic anaphylactic reaction with bee venom, successful bVIT is difficult to achieve and can often lead to withdrawal of treatment. The combination of bVIT and omalizumab is a good option for these patients. Omalizumab is a humanized nonanaphylactogenic monoclonal anti-immunoglobulin (Ig) E antibody against the Cε3 domain of IgE to reduce the allergenicity, if combined with bVIT. We describe a successful treatment with combined omalizumab and bVIT in a case of recurrent anaphylaxis by honey bee sting hypersensitivity. Herein, subcutaneous omalizumab 150 mg was started 15 days before the initiation of bVIT and subsequently once a month for 30 months along with cluster doses of bVIT till the cumulative dose of 100 μg was achieved successfully.
膜翅目毒液过敏反应影响约3%的普通人群,养蜂人的比例更高(14%-43%)。蜂毒免疫疗法(bVIT)在减少随后的严重全身反应方面是有效的,对儿童和成人的疾病特异性生活质量都有显著的有益影响。对于有蜂毒复发性全身性过敏反应史的患者,成功的bVIT很难实现,通常会导致停止治疗。bVIT联合omalizumab对这些患者来说是一个很好的选择。Omalizumab是一种人源化的非过敏性单克隆抗免疫球蛋白(Ig) E抗体,如果与bVIT联合使用,可针对IgE的Cε3结构域降低致敏性。我们描述了一个成功的治疗与联合奥玛珠单抗和bVIT的情况下复发性过敏反应由蜜蜂蜇伤过敏。在本研究中,在bVIT开始前15天开始皮下注射omalizumab 150 mg,随后每月一次,持续30个月,同时给予bVIT集群剂量,直到成功达到100 μg的累积剂量。
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引用次数: 1
Purpuric autologous serum skin test in urticaria: Is it mere a chance occurrence or a marker of strong autoimmunity 荨麻疹的紫癜性自体血清皮肤试验:这仅仅是偶然发生还是强自身免疫的标志
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_67_20
S. Rani, Aastha Agarwal
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引用次数: 0
In silico prediction of B-cell and T-cell epitope of Ves g 5 and Vesp m 5 allergens vesp5和vesp5变应原b细胞和t细胞表位的计算机预测
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_3_22
Kuldeepkumar Singh, T. Khandagale, Akshit Puri, Sangeeta Sinha
BACKGROUND: Hymenoptera venom allergy is one of the leading insect allergies in which allergens that promote IgE-mediated immune responses cause mild-to-severe reactions. Vespula germanica has a high spread rate and invades many regions of the world, while Vespa mandarinia has caused many fatalities in Asian countries including India. Ves g 5 and Vesp m 5 are important allergens of V. germanica and V. mandarinia, respectively, which cause allergenic reactions. AIM: This study aimed to predict the B- and T-cell epitopes of allergens Ves g 5 and Vesp m 5 using computational tools. MATERIALS AND METHODS: ProtParam, Jalview, and Swiss-Model analyzed the physiochemical, allergen sequence and 3D model. BepiPred-2.0, ABCPred, and ElliPro predicted B-cell epitopes, while Immune Epitope Database major histocompatibility complex-II binding prediction tool and CD4+ T-cell immunogenicity prediction tool were used to predict and confirm immunogenic T-cell epitopes RESULTS: Nine linear and four discontinuous B-cell epitopes were predicted for the Ves g 5 allergen and ten linear and five discontinuous B-cell epitopes were predicted for the Vesp m 5 allergen. Four and three T-cell epitopes were predicted for the allergens Ves g 5 and Vesp m 5, showing efficient binding and immunogenicity, respectively. CONCLUSION: Venom immunotherapy used as a treatment for HVA shows few fatal reactions and side effects, hence epitope-based vaccines or therapies are necessary. These results can be further used in the process of better immunotherapy and peptide-based vaccine design as well as to understand the etiology of Ves g 5 and Vesp m 5 allergens.
背景:膜翅目毒液过敏是一种主要的昆虫过敏,其中过敏原促进ige介导的免疫反应引起轻到严重的反应。德国Vespa传播率高,入侵世界许多地区,而中国Vespa mandarinia在包括印度在内的亚洲国家造成了许多死亡。Vesp 5和Vesp 5分别是德国弧菌和mandarinia弧菌的重要过敏原,引起过敏反应。目的:本研究旨在利用计算工具预测过敏原vespm5和vespm5的B细胞和t细胞表位。材料与方法:ProtParam、Jalview和Swiss-Model分析理化、过敏原序列和三维模型。使用免疫表位数据库主要组织相容性复合体- ii结合预测工具和CD4+ t细胞免疫原性预测工具预测和确认免疫原性t细胞表位。结果:预测到9个线性和4个不连续的b细胞表位,预测到10个线性和5个不连续的b细胞表位。预测了4个和3个t细胞表位,分别显示了有效的结合和免疫原性。结论:用于HVA治疗的蛇毒免疫疗法几乎没有致命反应和副作用,因此基于表位的疫苗或疗法是必要的。这些结果可以进一步用于更好的免疫治疗和基于肽的疫苗设计过程,以及了解vesp5和vesp5过敏原的病因。
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引用次数: 0
A rare and interesting case of wandering unilateral edema like a wave 一个罕见而有趣的病例,游离的单侧水肿像波浪
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_2_21
Navgeet Mathur, M. Mathur
This case report is about a 55-year-old female who presented with wandering unilateral edema in the sequence of the left breast (for 7 days) followed by left upper limb (for 1 month), followed by the left nape of the neck (for 1 day), followed by left scalp (for 1 day), followed by left-sided face (for 3 days), followed by right-sided face (for 2 days). Edema progressed from one site to another site in the above sequence with the overlapping period of only 12–24 h and later subsided completely from its previous site. In the patient's language edema was moving from site to site like a slow wave moving forward. The patient took multiple consultations but could not get any relief. The patient was evaluated according. Serum total eosinophil count found 3100/cumm (30.1% of total leucocyte count) and diagnosed with angioedema. The patient was completely recovered by steroid and antihistaminic. To the best of our knowledge, this is the first case reporting wandering unilateral edema like a wave.
本病例报告是一名55岁女性患者,出现游离性单侧水肿,顺序为左乳房(7天)、左上肢(1个月)、左颈背(1天)、左头皮(1天)、左侧面部(3天)、右侧面部(2天)。水肿按上述顺序从一个部位向另一个部位进展,重叠周期仅为12-24 h,随后从前一个部位完全消退。患者的语言水肿从一个部位移动到另一个部位,就像一个缓慢向前移动的波。病人进行了多次咨询,但没有得到任何缓解。对患者进行评估。血清嗜酸性粒细胞总数为3100/cumm(占白细胞总数的30.1%),诊断为血管性水肿。患者经类固醇及抗组胺药治疗后完全康复。据我们所知,这是第一例报告像波浪一样徘徊的单侧水肿。
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引用次数: 0
An open-labeled, single-centered, interventional, prospective study to determine the efficacy of autologous serum therapy in chronic spontaneous urticaria 一项开放标记、单中心、介入性、前瞻性研究,旨在确定自体血清治疗慢性自发性荨麻疹的疗效
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_9_21
K. Minni, G. Tharini
BACKGROUND: Chronic spontaneous urticaria (CSU) poses a therapeutic challenge by dermatologists and patients alike. OBJECTIVES: This study aimed to find the prevalence of functional autoantibodies among patients using autologous serum skin test (ASST) and to evaluate the efficacy of autologous serum therapy (AST) as an adjuvant in CSU. MATERIALS AND METHODS: An open-labeled, single-centered, prospective, interventional study of 1 year was performed after institutional ethical approval among 55 consenting patients of CSU. ASST was performed to find the prevalence of functional autoantibodies and those positive were given weekly intramuscular AST for the next 9 weeks. For clinical outcome, weekly urticaria activity score (UAS7) was recorded at baseline and at week 10. Any adverse effects were recorded. Wilcoxon sign-ranked test and Fisher's exact test were used to demonstrate equal variance. Results: Fifty-five CSU patients consented to participate in the study; 41 were ASST+ and six were dropped out; hence, the prevalence of autoreactivity was 74.54%. Four of seven who presented with angioedema were ASST+. Thus, the prevalence of angioedema in ASST+ patients of CSU was 11.4%. At the end of 10th week, on comparing individual components of UAS7, there was a statistical significant difference (P < 0.05) in the number of wheals (P = 0.00001), pruritus (P = 0.00001), frequency of wheals (P = 0.00001), as well as the overall UAS7 (P = 0.0001) scores. The effect size is 1.23 (Cohen's d). On grading the improvement at week 10, marked (>75%), good (50%–74%), satisfactory (25%–49%), and poor (<25%) improvement were observed in 8 (22.9%), 12 (34.3%), 11 (31.4%), and 4 (11.4%) patients, respectively. CONCLUSION: AST is effective in significantly reducing wheals and pruritus and improves quality of life. It can be tried as an adjuvant before switching patient to other immunosuppressants or expensive biologicals in this current COVID-19 pandemic. Large long-term prospective randomized controlled trials with follow-up are required to conclusively ascertain the efficacy of AST as an adjuvant in CSU.
背景:慢性自发性荨麻疹(CSU)对皮肤科医生和患者都提出了治疗挑战。目的:本研究旨在通过自体血清皮肤试验(自体血清皮肤试验)发现功能性自身抗体在CSU患者中的流行情况,并评估自体血清治疗(AST)作为辅助治疗的疗效。材料和方法:在机构伦理批准后,在55名同意的CSU患者中进行了一项为期1年的开放标签、单中心、前瞻性、干预性研究。在接下来的9周内,每周一次肌内注射AST检测功能性自身抗体的流行情况。对于临床结果,在基线和第10周记录每周荨麻疹活动评分(UAS7)。记录任何不良反应。采用Wilcoxon符号排序检验和Fisher精确检验证明方差相等。结果:55例CSU患者同意参与研究;41例为阳性,6例退出;因此,自身反应性的患病率为74.54%。7例出现血管性水肿的患者中有4例为助理皮肤抗原阳性。因此,CSU患者中血管水肿的发生率为11.4%。第10周结束时,比较UAS7单项成分,两组患者的皮疹数量(P = 0.00001)、瘙痒(P = 0.00001)、皮疹出现频率(P = 0.00001)及UAS7总分(P = 0.0001),差异均有统计学意义(P < 0.05)。效应值为1.23 (Cohen’s d)。在第10周对改善进行评分时,分别有8例(22.9%)、12例(34.3%)、11例(31.4%)和4例(11.4%)患者出现显著(>75%)、良好(50%-74%)、满意(25% - 49%)和不良(<25%)改善。结论:AST能明显减轻皮肤瘙痒,改善患者生活质量。在当前的COVID-19大流行中,在将患者转向其他免疫抑制剂或昂贵的生物制剂之前,可以尝试将其作为辅助剂。需要有随访的大型长期前瞻性随机对照试验来最终确定AST作为CSU辅助治疗的有效性。
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引用次数: 0
Expert opinion on montelukast and acebrophylline combination in the management of asthma 孟鲁司特联合乙酰茶碱治疗哮喘的专家意见
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_4_22
N. Krishna, Amita Nene, Mahavir Modi, Tanvir Reza, Ashwin Songara, V. Deshmukh
Asthma control is highly inadequate in India, with worse outcomes and poor adherence to inhaled corticosteroids (ICSs). As per the Global Initiative for Asthma guidelines, leukotriene receptor antagonist (LTRA) can be added when a low-to-moderate dose of ICS does not provide sufficient disease control. The combination of montelukast with its anti-inflammatory action and acebrophylline with its mild bronchodilator, anti-inflammatory, and mucolytic actions may be beneficial in patients with asthma. This manuscript aims to present an expert opinion to discuss the role of montelukast and acebrophylline combination in the management of asthma. An expert panel comprising nine specialists in respiratory medicine took part in a roundtable discussion to review the role of montelukast–acebrophylline combination in the management of asthma. A qualitative question-and-answer-based format was used to help facilitate the discussion. It was concurred that the montelukast and acebrophylline combination may be used if asthma symptoms remain uncontrolled with ICS and long-acting β2-agonists. This combination can also be preferred in patients with severe pulmonary obstruction along with allergic bronchopulmonary aspergillosis, in patients with asthma–chronic obstructive pulmonary disease overlap syndrome, and in patients with a history of smoking. There is adequate evidence for the role of montelukast and acebrophylline as individual drugs in asthma. However, evidence related to their combination therapy is lacking. The panel has reiterated the need for studies to evaluate the safety and efficacy of montelukast and acebrophylline combination in patients with asthma and its variants.
在印度,哮喘控制非常不充分,结果更差,吸入皮质类固醇(ICSs)的依从性较差。根据全球哮喘倡议指南,当低至中等剂量的ICS不能提供足够的疾病控制时,可以添加白三烯受体拮抗剂(LTRA)。孟鲁司特具有抗炎作用,乙酰茶碱具有轻度支气管扩张、抗炎和溶黏液作用,联合应用可能对哮喘患者有益。本文旨在提出专家意见,讨论孟鲁司特和乙酰茶碱联合治疗哮喘的作用。一个由九名呼吸医学专家组成的专家小组参加了圆桌讨论,以审查孟鲁司特-乙酰茶碱联合用药在哮喘治疗中的作用。采用了一种定性的问答形式来帮助促进讨论。如果使用ICS和长效β2激动剂哮喘症状仍不受控制,则同意孟鲁司特和乙酰茶碱联合使用。严重肺阻塞合并过敏性支气管肺曲霉病患者、哮喘-慢性阻塞性肺疾病重叠综合征患者和有吸烟史的患者也可优先使用该组合。有足够的证据表明孟鲁司特和乙酰茶碱作为单独的药物在哮喘中的作用。然而,缺乏与它们联合治疗相关的证据。专家组重申有必要开展研究,评估孟鲁司特和乙酰茶碱联合治疗哮喘及其变异型患者的安全性和有效性。
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引用次数: 0
Sulphites in food & drinks in asthmatic adults & children: What we need to know 哮喘成人和儿童的食物和饮料中的亚硫酸盐:我们需要知道的
Pub Date : 2021-07-01 DOI: 10.4103/ijaai.ijaai_33_21
Mukesh Gupta, G. Basavaraj
Sulfites are commonly used preservatives and additives in the food and pharmaceutical industries. Many people develop adverse reactions to them which may vary from mild skin rash to life-threatening anaphylactic reactions. However, asthma exacerbation is the most commonly linked problem. The possibility of sulfite sensitivity should be considered when individuals demonstrate asthma symptoms following the consumption of sulfite-containing foods (such as dried fruits and wines in adults and packaged food in children such as biscuits, chips, and packaged drinks) or adverse skin reactions following the use of cosmetics or medicated creams. In fact, many of the mild-to-moderate asthma cases in children can be cured by just avoiding the packaged/preserved/processed food and beverages. Food that has no additives at all is to be preferred particularly if it is to be consumed by children. It is best to eat a preservative-free diet if at all possible by adults as well if required natural food preservatives should be used.
亚硫酸盐是食品和制药工业中常用的防腐剂和添加剂。许多人对它们产生不良反应,从轻微的皮疹到危及生命的过敏反应。然而,哮喘恶化是最常见的相关问题。当个体在食用含亚硫酸盐的食物(如成人食用干果和葡萄酒,儿童食用饼干、薯片和包装饮料等包装食品)或在使用化妆品或药膏后出现皮肤不良反应后出现哮喘症状时,应考虑亚硫酸盐敏感性的可能性。事实上,许多轻度至中度儿童哮喘病例可以通过避免包装/腌制/加工食品和饮料来治愈。不含任何添加剂的食物是最好的特别是儿童食用的食物。如果可能的话,成年人最好吃无防腐剂的食物,如果需要的话,也应该使用天然食品防腐剂。
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引用次数: 3
Allergy testing amidst COVID pandemic COVID大流行期间的过敏测试
Pub Date : 2021-01-01 DOI: 10.4103/ijaai.ijaai_42_21
N. Goel, Raj Kumar
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引用次数: 1
Estimation of prevalence of bronchial asthma in preschool and prepubertal children using international study of asthma and allergies in childhood criteria in Raipur Chhattisgarh 利用国际哮喘和过敏儿童标准研究估算赖布尔恰蒂斯加尔邦学龄前和青春期前儿童支气管哮喘患病率
Pub Date : 2021-01-01 DOI: 10.4103/ijaai.ijaai_15_21
R. Kale, Raghavendra Khachhawaha
OBJECTIVE: Bronchial asthma is the most common chronic disease affecting children and young adults. The prevalence of asthma is on the rise worldwide with increasing levels of pollution. The epidemiology of asthma is a growing area of research. There is a paucity of data from central India, especially from Raipur, which has become the capital of Chattishgarh since the year 2000. This community-based study was conducted to estimate the prevalence of bronchial asthma in school going children aged between 6–7 years and 13–14 years. MATERIALS AND METHODS: A cross-sectional study using ISSAC questionnaires was conducted across 12 schools in Raipur, selected on a random basis. The required sample size of 1000/age group was needed according to International Study of Asthma and Allergies in Childhood criteria, so a total of 2029 children were recruited in both age groups. Data were managed in Microsoft Office Excel and were analyzed using tests of proportion. RESULT: Out of 2029 children evaluated, 153 (7.54%) had a positive history of wheezing throughout their lives and the relative number of wheezy girls was 7.56% as compared to boys 7.52%. Comparison between two age groups 6–7 and 13–14 years, wheezing incidence of 7.37% and 7.71% was similar with no significant difference. Confirmed asthma was detected in 2.32% of cases. No significant difference was noted in both age groups, i.e. 1.97% in 6–7 and 2.67% in 13–14 years. Higher incidence of exercise-induced wheeze was noted in older age group (13–14 years) children 5.04% versus 4.23%. CONCLUSION: The prevalence of bronchial asthma was 2.32% in children in Raipur. Increasing trends in prevalence due to increasing pollution needs environmental measure to control pollution.
目的:支气管哮喘是儿童和青少年最常见的慢性疾病。随着污染程度的增加,哮喘的患病率在世界范围内呈上升趋势。哮喘流行病学是一个不断发展的研究领域。来自印度中部的数据很少,尤其是来自赖布尔的数据,自2000年以来,赖布尔已成为恰蒂斯加尔邦的首府。这项以社区为基础的研究旨在估计6-7岁至13-14岁学龄儿童支气管哮喘的患病率。材料和方法:在随机选择的基础上,使用ISSAC问卷在Raipur的12所学校进行横断面研究。根据国际儿童哮喘和过敏研究的标准,需要1000/年龄组的样本量,因此两个年龄组共招募2029名儿童。数据在Microsoft Office Excel中进行管理,并使用比例检验进行分析。结果:在2029名儿童中,153名(7.54%)有终生喘息病史,女孩的相对比例为7.56%,男孩为7.52%。6-7岁和13-14岁两个年龄组的喘息发生率比较,分别为7.37%和7.71%,差异无统计学意义。确诊哮喘占2.32%。两组间差异无统计学意义,6-7岁为1.97%,13-14岁为2.67%。在年龄较大的年龄组(13-14岁)中,运动引起的喘息的发生率较高,分别为5.04%和4.23%。结论:赖布尔市儿童支气管哮喘患病率为2.32%。由于污染增加,发病率呈上升趋势,需要采取环境措施来控制污染。
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引用次数: 0
期刊
Indian Journal of Allergy Asthma and Immunology
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