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Study on the Association between Cesarean Section Birth and Asthma Risk in the Pediatric Population of the Health Area of Palencia between 1993 and 2020. 关于 1993 年至 2020 年帕伦西亚卫生区儿童剖腹产与哮喘风险之间关系的研究。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i4.1084
Jesús Rodríguez Calleja, Eva María Jiménez Hernández, Alba Macías Panedas, José Fernando Soltero Carracedo, Carla González García, María Paz Barrio Alonso, María Teresa Cantero Tejedor, José Elviro Fernández Alonso

Introduction and objectives: Both asthma prevalence and the percentage of cesarean sections have increased in parallel in recent years. Research studies suggest an increased risk of developing atopic diseases and asthma after cesarean section birth compared to vaginal delivery. The main objective of this study is to analyze the risk of asthma admission after cesarean section birth compared to vaginal delivery in the pediatric population.

Population and methods: Retrospective observational analytical case-control study from 1993 to 2020. The cases include all admitted patients to our health area hospital, for patients aged 7 to 16 diagnosed with asthma. For each case, a control without a diagnosis of asthma is selected with the same age, and that has also caused an episode of admission.

Results: A total of 290 admission episodes with a diagnosis of asthma were obtained, caused by 155 patients. Out of these, 145 cases with documented delivery types were selected. For cases, 155 controls were selected. The historical proportion of cesarean sections in the asthmatic group is 18.6%, compared to 14.2% in the non-asthmatic group. There is a statistically non-significant difference of 4.4% more cesarean sections in the asthmatic group compared to the control group.

Discussion: We have not demonstrated a statistically significant association between being born by cesarean section and an increased risk of asthma admission. Based on this finding, we cannot conclude that there is an association between being born by cesarean section and a higher risk of suffering from asthma, unlike what has been postulated in other research studies.

导言和目标:近年来,哮喘的发病率和剖腹产的比例都在同步上升。研究表明,与阴道分娩相比,剖腹产后患特应性疾病和哮喘的风险更高。本研究的主要目的是分析在儿科人群中,剖宫产与阴道分娩后患哮喘的风险:1993年至2020年的回顾性观察分析病例对照研究。病例包括本卫生保健区医院收治的所有被诊断为哮喘的 7 至 16 岁患者。每个病例均选择一名年龄相同、未被诊断为哮喘且也曾入院的患者作为对照:结果:共获得 290 例诊断为哮喘的入院病例,由 155 名患者引起。结果:共获得 290 次诊断为哮喘的入院病例,由 155 名患者引起。对于病例,则选择了 155 例对照。哮喘组剖腹产的历史比例为 18.6%,而非哮喘组为 14.2%。与对照组相比,哮喘组的剖宫产率高 4.4%,差异无统计学意义:讨论:我们没有证明剖腹产与哮喘入院风险增加之间存在统计学意义上的显著关联。基于这一发现,我们不能得出剖宫产与罹患哮喘的风险增加之间存在关联的结论,这与其他研究推测的情况不同。
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引用次数: 0
Knockdown of GNL3 inhibits LUAD cell growth by regulating Wnt-β-catenin pathway. 敲除 GNL3 可通过调节 Wnt-β-catenin 通路抑制 LUAD 细胞的生长。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i4.1117
Guihong Dai, Yuejun Sun

Background: Lung adenocarcinoma (LUAD) is a leading cause of tumor-associated mortality, and it is needed to find new target to combat this disease. Guanine nucleotide-binding -protein-like 3 (GNL3) mediates cell proliferation and apoptosis in several cancers, but its role in LUAD remains unclear.

Objective: To explore the expression and function of Guanine nucleotide-binding protein-like 3 (GNL3) in lung adenocarcinoma (LUAD) and its potential mechanism in inhibiting the growth of LUAD cells.

Methods: We evaluated the expression of GNL3 in LUAD tissues and its association with patient prognosis using databases and immunohistochemistry. Cell proliferation was assessed by CCK-8 assay as well as colony formation, while apoptosis was evaluated by FCM. The effect of GNL3 knockdown on the Wnt/β-catenin axis was investigated by Immunoblot analysis.

Results: GNL3 is overexpressed in LUAD tissues and is correlated with poor prognosis. Knockdown of GNL3 significantly inhibited the growth as well as induced apoptosis in A549 as well as H1299 cells. Furthermore, we found that the inhibitory effect of GNL3 knockdown on LUAD cell growth is associated with the downregulation of the Wnt/β-catenin axis.

Conclusion: GNL3 is key in the progression of LUAD by metiating Wnt/β-catenin axis. Targeting GNL3 may represent a novel therapeutic method for LUAD treatment.

背景:肺腺癌(LUAD)是导致肿瘤相关死亡的主要原因之一,因此需要找到新的靶点来对抗这种疾病。鸟嘌呤核苷酸结合蛋白样 3(GNL3)在多种癌症中介导细胞增殖和凋亡,但其在肺腺癌中的作用仍不清楚:目的:探讨类鸟嘌呤核苷酸结合蛋白 3(GNL3)在肺腺癌(LUAD)中的表达和功能及其抑制 LUAD 细胞生长的潜在机制:我们使用数据库和免疫组化方法评估了 GNL3 在 LUAD 组织中的表达及其与患者预后的关系。细胞增殖通过 CCK-8 试验和集落形成进行评估,细胞凋亡通过 FCM 进行评估。免疫印迹分析研究了GNL3基因敲除对Wnt/β-catenin轴的影响:结果:GNL3在LUAD组织中过表达,并与不良预后相关。敲除 GNL3 能显著抑制 A549 和 H1299 细胞的生长并诱导其凋亡。此外,我们还发现敲除 GNL3 对 LUAD 细胞生长的抑制作用与 Wnt/β-catenin 轴的下调有关:结论:通过调控Wnt/β-catenin轴,GNL3是LUAD进展的关键。靶向 GNL3 可能是治疗 LUAD 的一种新方法。
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引用次数: 0
Chloroquine regulates the lipopolysaccharide-induced inflammatory response in RAW264.7 cells. 氯喹调节脂多糖诱导的 RAW264.7 细胞炎症反应。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i4.1083
Natsuki Ota, Shoya Endo, Kouki Honma, Kuninori Iwayama, Hiroshi Yamashita, Ryosuke Tatsunami, Keisuke Sato

Introduction and objectives: Macrophage-induced inflammation plays a key role in defense against injury and harmful pathogens. Autophagy and the inflammatory response are associated; however, the relationship between the autophagy pathway and lipopolysaccharide (LPS)- induced inflammatory responses remains unknown. We aimed to determine the effect of autophagy on the LPS-induced myeloid differentiation factor 88 (MyD88)/nuclear transcription factor kB (NF-kB) pathway-mediated inflammatory response in RAW264.7 cells.

Materials and methods: To determine the effect of autophagy on the LPS-induced inflammatory response, using various in vitro assays, we determined the effect of autophagy inhibitors and inducers on the inflammatory response in RAW264.7 cells.

Results: Chloroquine (CQ), an autophagy inhibitor, suppressed pro-inflammatory cytokines, including interleukin (IL)-1β, IL-6, and tumor necrosis factor α (TNFα) in LPS-stimulated RAW264.7 cells. CQ also affected inflammatory mediators such as myeloid differentiation factor 88 and NF-kB in LPS-stimulated RAW264.7 cells.

Conclusion: This study demonstrated that CQ regulates the LPS-induced inflammatory response in RAW264.7 cells. We propose that targeting the regulation of pro-inflammatory cytokine levels and inflammatory mediators using CQ is a promising therapeutic approach for preventing inflammatory injury. CQ serves as a potential therapeutic target for treating various inflammatory diseases.

引言和目的:巨噬细胞诱导的炎症在抵御损伤和有害病原体方面发挥着关键作用。自噬与炎症反应相关;然而,自噬途径与脂多糖(LPS)诱导的炎症反应之间的关系仍然未知。我们旨在确定自噬对 RAW264.7 细胞中 LPS 诱导的髓系分化因子 88(MyD88)/核转录因子 kB(NF-kB)通路介导的炎症反应的影响:为了确定自噬对LPS诱导的炎症反应的影响,我们利用各种体外试验,确定了自噬抑制剂和诱导剂对RAW264.7细胞炎症反应的影响:结果:自噬抑制剂氯喹(CQ)抑制了 LPS 刺激的 RAW264.7 细胞中的促炎细胞因子,包括白细胞介素(IL)-1β、IL-6 和肿瘤坏死因子α(TNFα)。CQ还影响了LPS刺激的RAW264.7细胞中的炎症介质,如髓系分化因子88和NF-kB:本研究表明,CQ 可调节 LPS 诱导的 RAW264.7 细胞炎症反应。我们认为,利用 CQ 靶向调节促炎细胞因子水平和炎症介质是一种很有前景的预防炎症损伤的治疗方法。CQ 是治疗各种炎症性疾病的潜在治疗靶点。
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引用次数: 0
Deciphering the mechanism of cimifugin in mitigating LPS-induced neuroinflammation in BV-2 cells. 解密 cimifugin 在减轻 LPS 诱导的 BV-2 细胞神经炎症中的作用机制。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i4.1107
Zhang Bu, Shan Xu, Feng Xu

Purpose: Sepsis often triggers a systemic inflammatory response leading to multi-organ dysfunction, with complex and not fully understood pathogenesis. This study investigates the therapeutic effects of cimifugin on BV-2 cells under sepsis-induced stress conditions.

Methods: We utilized a BV-2 microglial cell model treated with lipopolysaccharide (LPS) to mimic sepsis. Assessments included cellular vitality, inflammatory cytokine quantification (6 interleukin [6IL]-1β, interleukin 6 [IL-6], and tumor necrosis factor-α [TNF-α]) via enzyme-linked-immunosorbent serologic assay, and analysis of mRNA expression using real-time polymerase chain reaction. Oxidative stress and mitochondrial function were also evaluated to understand the cellular effects of cimifugin.

Results: Cimifugin significantly attenuated LPS-induced inflammatory responses, oxidative stress, and mitochondrial dysfunction. It enhanced cell viability and modulated the secretion and gene expression of inflammatory cytokines IL-1β, IL-6, and TNF-α. Notably, cimifugin activated the deacetylase sirtuin 1-nuclear factor erythroid 2-related factor 2 pathway, contributing to its protective effects against mitochondrial damage.

Conclusion: Cimifugin demonstrates the potential of being an effective treatment for sepsis--induced neuroinflammation, warranting further investigation.

目的:败血症通常会引发全身炎症反应,导致多器官功能障碍,其发病机制复杂且尚未完全明了。本研究探讨了 cimifugin 在败血症诱导的应激条件下对 BV-2 细胞的治疗作用:方法:我们利用经脂多糖(LPS)处理的 BV-2 小神经胶质细胞模型来模拟败血症。方法:我们利用脂多糖(LPS)处理的 BV-2 小胶质细胞模型模拟败血症,评估内容包括细胞活力、通过酶联免疫吸附血清测定的炎性细胞因子定量(6 白细胞介素 [6IL]-1β、白细胞介素 6 [IL-6] 和肿瘤坏死因子-α [TNF-α]),以及使用实时聚合酶链反应分析 mRNA 表达。此外,还对氧化应激和线粒体功能进行了评估,以了解西米福星对细胞的影响:结果:Cimifugin 能明显减轻 LPS 诱导的炎症反应、氧化应激和线粒体功能障碍。它提高了细胞活力,调节了炎症细胞因子 IL-1β、IL-6 和 TNF-α 的分泌和基因表达。值得注意的是,cimifugin激活了去乙酰化酶sirtuin 1-核因子红细胞2相关因子2通路,有助于其对线粒体损伤的保护作用:Cimifugin具有有效治疗脓毒症诱发的神经炎症的潜力,值得进一步研究。
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引用次数: 0
Jolkinolide B attenuates allergic airway inflammation and airway remodeling in asthmatic mice. Jolkinolide B 可减轻哮喘小鼠的过敏性气道炎症和气道重塑。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i4.1126
Haiyan Lin, Chao Xu, Jintong Ge, Hua Wu, Qi Wang

Asthma is a widely prevalent chronic disease that brings great suffering to patients and may result in death if it turns severe. Jolkinolide B (JB) is one diterpenoid component separated from the dried roots of Euphorbia fischeriana Steud (Euphorbiaceae), and has anti--inflammatory, antioxidative, and antitumor properties. However, the detailed regulatory role and associated regulatory mechanism in the progression of asthma remain elusive. In this work, it was demonstrated that the extensive infiltration of bronchial inflammatory cells and the thickening of airway wall were observed in ovalbumin (OVA)-induced mice, but these impacts were reversed by JB (10 mg/kg) treatment, indicating that JB relieved the provocative symptoms in OVA-induced asthma mice. In addition, JB can control OVA-triggered lung function and pulmonary resistance. Moreover, JB attenuated OVA-evoked inflammation by lowering the levels of interleukin (IL)-4, IL-5, and IL-13. Besides, the activated nuclear factor kappa B (NF-κB) and transforming growth factor-beta-mothers against decapentaplegic homolog 3 (TGFβ/smad3) pathways in OVA-induced mice are rescued by JB treatment. In conclusion, it was disclosed that JB reduced allergic airway inflammation and airway remodeling in asthmatic mice by modulating the NF-κB and TGFβ/smad3 pathways. This work could offer new opinions on JB for lessening progression of asthma.

哮喘是一种广泛流行的慢性疾病,给患者带来极大痛苦,严重时可能导致死亡。Jolkinolide B(JB)是从大戟科植物Euphorbia fischeriana Steud的干燥根中分离出来的一种二萜类成分,具有抗炎、抗氧化和抗肿瘤的作用。然而,哮喘进展过程中的详细调控作用和相关调控机制仍未确定。本研究表明,卵清蛋白(OVA)诱导的小鼠支气管炎性细胞广泛浸润,气道壁增厚,但这些影响在JB(10 mg/kg)治疗后被逆转,表明JB能缓解OVA诱导的哮喘小鼠的诱发症状。此外,JB 还能控制 OVA 引发的肺功能和肺阻力。此外,JB 还能降低白细胞介素(IL)-4、IL-5 和 IL-13 的水平,从而减轻 OVA 诱发的炎症反应。此外,OVA 诱导的小鼠体内活化的核因子卡巴 B(NF-κB)和转化生长因子-β-母亲抗截瘫同源物 3(TGFβ/smad3)通路也能通过 JB 治疗得到缓解。综上所述,JB通过调节NF-κB和TGFβ/smad3通路,减轻了哮喘小鼠的过敏性气道炎症和气道重塑。这项研究为 JB 减少哮喘的恶化提供了新的观点。
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引用次数: 0
The prognostic value of platelet aggregation in patients with sepsis. 脓毒症患者血小板聚集的预后价值。
IF 1.8 4区 医学 Q3 Medicine Pub Date : 2024-05-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i3.1039
Ting Chen, Haohao Yang, Zheren Zhao, Hui Wang, Song Zhong

Background: This study aims to investigate the relevance of platelet aggregation markers, specifically arachidonic acid (AA) and adenosine diphosphate (ADP), in relation to the prognosis of sepsis patients.

Methods: A cohort of 40 sepsis patients was included and stratified, based on their 28-day post-treatment prognosis, into two groups: a survival group (n = 31) and a severe sepsis group (n = 9. Then, their various clinical parameters, including patient demographics, platelet counts (PLT), inflammatory markers, and platelet aggregation rates (PAR) induced by AA and ADP between the two groups, were compared. Long-term health implications of sepsis were assessed using the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score, and logistic regression analysis was conducted to evaluate the prognostic significance of PAR in sepsis patients.

Results: Patients with severe sepsis exhibited significantly elevated levels of procalcitonin (PCT), platelet adhesion rates, and PAR induced by ADP (P < 0.05), but having lower PLT (P < 0.05), compared to those in the survival group. Logistic regression analysis demonstrated that PAR induced by ADP was a protective factor in predicting prognosis in sepsis patients (P < 0.01).

Conclusions: Activation of platelets in sepsis intensifies inflammatory response. Patients with sepsis whose ADP-induced PAR was < 60% displayed significant impairment in platelet aggregation function, and had higher mortality rate. Monitoring ADP-induced PAR is crucial for management of sepsis.

背景:本研究旨在探讨血小板聚集标志物(特别是花生四烯酸(AA)和二磷酸腺苷(ADP))与脓毒症患者预后的相关性:方法:纳入 40 名脓毒症患者,并根据治疗后 28 天的预后将其分为两组:生存组(31 人)和严重脓毒症组(9 人)。然后,比较了两组患者的各种临床参数,包括患者的人口统计学特征、血小板计数(PLT)、炎症指标以及 AA 和 ADP 诱导的血小板聚集率(PAR)。使用急性生理评估和慢性健康评估 II(APACHE II)评分评估了脓毒症对健康的长期影响,并进行了逻辑回归分析以评估 PAR 在脓毒症患者中的预后意义:结果:与生存组相比,严重脓毒症患者的降钙素原(PCT)、血小板粘附率和 ADP 诱导的 PAR 水平明显升高(P < 0.05),但 PLT 水平较低(P < 0.05)。逻辑回归分析表明,ADP诱导的PAR是预测脓毒症患者预后的保护性因素(P<0.01):结论:脓毒症中血小板的激活会加剧炎症反应。结论:脓毒症时血小板的活化会加剧炎症反应,ADP诱导的PAR低于60%的脓毒症患者血小板聚集功能明显受损,死亡率较高。监测 ADP 诱导的 PAR 对脓毒症的治疗至关重要。
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引用次数: 0
A modified schedule of multiple aeroallergen ultra-rush immunotherapy in perennial allergic rhinitis: safety, efficacy, and T lymphocyte cell population studies. 针对常年性过敏性鼻炎的多种空气致敏原超速免疫疗法:安全性、有效性和 T 淋巴细胞群研究。
IF 1.8 4区 医学 Q3 Medicine Pub Date : 2024-05-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i3.1043
Nazila Ariaee, Ali Fouladvand, Mojgan Mohammadi, Reza Farid-Hosseini, Amin Reza Nikpoor, Maryam Khoshkhui, Jalil Tavakkol-Afshari, Farahzad Jabbari-Azad

Background: This study assessed whether a modified immunotherapy schedule for allergic rhinitis could be safe and efficient. Ultra-rush immunotherapy (URIT) rapidly desensitizes patients to aeroallergens.

Objective: We aimed to develop a modified URIT protocol in 3 days to achieve the target dose while observing whether it could improve this situation and decrease the time to achieve the maintenance dose.

Methods: The URIT was exercised in 21 patients with perennial allergic rhinitis. Premeditations were given to the patients 3 days prior to the immunotherapy and during the 3 days injections immunotherapy: pred nisolone, ranitidine, and Airokast/montelukast. Finally, the T cell population frequencies of patients prior to and after immunotherapy, including T helper 1, T helper 2, cytotoxic T lymphocytes, and regulatory T cells, were studied using flow cytometry. During the URIT protocol, 21 patients received 291 injections.

Result: Six patients (28.6%) showed systemic reactions in our study. All systemic reactions occurred on the third day by the 1:1 dilution of the maintenance dose. These systemic reactions occurred in three patients after 13 injections, and the three remaining patients showed systemic reactions following the last injection. No systemic reaction was observed on the first and second day of the therapy, and the risk of systemic reaction with every injection was about 2%. Among the T cell populations, CD3+ and CD8+ cells decreased significantly.

Conclusion: The findings emphasized that URIT, alongside premedication with a high dose of antihistamine, helped to achieve the maintenance dose and control clinical manifestations.

研究背景这项研究评估了针对过敏性鼻炎的改良免疫疗法是否安全有效。超快速免疫疗法(URIT)可迅速使患者对空气过敏原脱敏:我们的目标是制定一种改进的超急促免疫疗法方案,在 3 天内达到目标剂量,同时观察它是否能改善这种情况并缩短达到维持剂量的时间:对 21 名常年过敏性鼻炎患者进行了 URIT 试验。在免疫疗法前 3 天和注射免疫疗法的 3 天内,对患者进行了预处理:尼索龙、雷尼替丁和艾洛卡斯特/孟鲁司特。最后,使用流式细胞术研究了免疫疗法前后患者的T细胞群频率,包括T辅助细胞1、T辅助细胞2、细胞毒性T淋巴细胞和调节性T细胞。在URIT方案中,21名患者接受了291次注射:结果:在我们的研究中,6 名患者(28.6%)出现了全身反应。所有全身反应都发生在 1:1 稀释维持剂量的第三天。三名患者在注射 13 次后出现全身反应,其余三名患者在最后一次注射后出现全身反应。治疗第一天和第二天未观察到全身反应,每次注射发生全身反应的风险约为 2%。在 T 细胞群中,CD3+ 和 CD8+ 细胞明显减少:研究结果表明,在使用大剂量抗组胺药进行预处理的同时使用 URIT,有助于达到维持剂量并控制临床表现。
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引用次数: 0
A real-world cross-sectional study evaluating the role of an oral amino acid-based supplement in nutrient intake by preschoolers on a cow's milk elimination diet. 一项真实世界横断面研究,评估了口服氨基酸补充剂在学龄前儿童排除牛奶饮食中营养摄入量中的作用。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-05-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i3.1053
Vanessa Cristina de Castro Rodrigues, Thaysa Maués Cezar, Camila Leonel Mendes de Abreu, Adriana Sanudo, Mauro Batista de Morais

Introduction and objectives: Food allergy has several negative nutritional consequences and may persist beyond the first year of lives. This study aimed to assess the role of a complete oral amino acid-based supplement in the diet of children on cow's milk protein elimination diet because of food allergy.

Materials and methods: This study included two groups of children aged 1-5 years paired by age and socioeconomic status: (1) study group, on cow's milk protein elimination diet plus an oral amino acid-based supplement, and (2) control group, on cow's milk protein elimination diet. Sociodemographic, clinical, anthropometric, and dietary data were obtained through online interviews. Two 24-h dietary recalls were collected on nonconsecutive days. Both groups comprised mostly boys.

Results: The study group presented lower values of body mass index. The frequency of feeding difficulties was similar between groups. The study group had a higher intake of energy, protein, carbohydrates, calcium, iron, zinc, phosphorus, magnesium, copper, selenium, vitamins D, E, B1, B2, B6, and B12, niacin, and folic acid compared to the control group. A higher proportion of children in the study group had adequate intake according to the recommendations made for energy, carbohydrates, iron, phosphorus, selenium, vitamins A, D, E, B1, B2, and B6, and folic acid.

Conclusions: The use of a complete oral amino acid-based supplement has a positive effect on the diet quality of preschoolers on cow's milk elimination diet because of food allergy, promoting higher intake of energy, calcium, vitamin D, and other essential nutrients.

导言和目标:食物过敏会对营养产生多种负面影响,并可能持续到婴儿出生后的第一年。本研究旨在评估以氨基酸为基础的全口服补充剂在因食物过敏而接受牛奶蛋白排除饮食的儿童饮食中的作用:本研究包括两组 1-5 岁的儿童,按年龄和社会经济地位配对:(1) 研究组,采用排除牛奶蛋白饮食加口服氨基酸补充剂;(2) 对照组,采用排除牛奶蛋白饮食。通过在线访谈获取社会人口学、临床、人体测量和饮食数据。在非连续日收集两次 24 小时饮食回顾。两组均以男孩居多:研究组的体重指数值较低。两组患喂养困难的频率相似。与对照组相比,研究组的能量、蛋白质、碳水化合物、钙、铁、锌、磷、镁、铜、硒、维生素 D、E、B1、B2、B6 和 B12、烟酸和叶酸的摄入量更高。研究组中有更高比例的儿童按照建议摄入了足够的能量、碳水化合物、铁、磷、硒、维生素 A、D、E、B1、B2 和 B6 以及叶酸:结论:对因食物过敏而改用牛奶饮食的学龄前儿童来说,口服氨基酸全营养补充剂对其饮食质量有积极影响,可促进能量、钙、维生素 D 和其他必需营养素的摄入。
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引用次数: 0
Evaluation of treatment and long-term management of anaphylaxis in pediatric departments of Greece: a 2-year nationwide survey. 希腊儿科过敏性休克的治疗和长期管理评估:一项为期两年的全国性调查。
IF 1.8 4区 医学 Q3 Medicine Pub Date : 2024-05-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i3.1032
Evanthia Chiampou, Konstantinos Douros, Dafni Moriki, Mitrogiorgou Marina, Anastasia Anastasiou-Katsiardani, Kalliopi Tanou, Vasilis Grammeniatis, Anna Zisi, Evanthia Perikleous, Emmanouil Galanakis, Marilia Lioudaki, Fotini Vrouvaki, Soultana Kolyva, Antigoni Mavroudi, Maria Nivatsi, Stergianna Ntouma, Evangelia Stefanaki, Maria Triga, Panagiota Kakava, Olga Lagiou, Kostas N Priftis, Nikolaos Chaliasos, Sophia Tsabouri

Background: Anaphylaxis proportions of incidence are increasing globally. However, limited data are available regarding anaphylaxis in the pediatric population of Greece.

Purpose: The aim of the study was to evaluate management of anaphylaxis in Greek pediatric departments.

Methods: We performed a questionnaire-based study of children aged less than 16 years presenting with anaphylaxis in 10 national pediatric hospitals over a period of 2 years. Management of anaphylaxis was assessed prior to and after an informative intervention.

Results: In all, 127 cases of anaphylaxis were identified. Epinephrine was administered in almost half of all cases (51.2%), predominantly through intramuscular route (88.5%), while the majority of anaphylaxis patients were treated with antihistamines (92.9%) and corticosteroids (70.1%). Epinephrine was more likely administered by physicians if the elicitor was a drug (P < 0.003). Regarding long-term management, an epinephrine auto-injector was prescribed in 66.9% of patients. Follow-up information was available for most of the patients (92.9%), the majority of whom (76.3%) were referred to an allergist. More than half of these patients (63.6%) had a documented allergy follow-up, which identified a causative allergen in 53.3% of cases. No statistically significant differences were recorded prior to and after the intervention regarding management of anaphylaxis.

Conclusions: This nationwide study highlighted the necessity of further improvement in terms of anaphylaxis treatment and secondary prevention measures. This presupposes appropriate education and training of healthcare professionals, thus contributing to proper and comprehensive care of the pediatric population.

背景:过敏性休克的发病率在全球范围内呈上升趋势。目的:本研究旨在评估希腊儿科对过敏性休克的处理情况:我们对 10 家国立儿科医院 16 岁以下的过敏性休克患儿进行了为期两年的问卷调查。在进行信息干预之前和之后,对过敏性休克的处理情况进行了评估:结果:共发现 127 例过敏性休克病例。几乎一半的病例(51.2%)使用了肾上腺素,主要是通过肌肉注射途径(88.5%),而大多数过敏性休克患者使用了抗组胺药(92.9%)和皮质类固醇(70.1%)。如果诱发因素是一种药物,医生更有可能使用肾上腺素(P < 0.003)。在长期治疗方面,66.9%的患者使用了肾上腺素自动注射器。大多数患者(92.9%)都有随访信息,其中大多数(76.3%)被转诊至过敏专科医生。半数以上的患者(63.6%)有过敏随访记录,其中 53.3% 的病例确定了致敏原。在对过敏性休克的处理方面,干预前后没有统计学上的明显差异:这项全国性研究强调了进一步改进过敏性休克治疗和二级预防措施的必要性。这需要对医疗保健专业人员进行适当的教育和培训,从而为儿科人群提供适当而全面的护理。
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引用次数: 0
Tablet allergen immunotherapy: the anaphylaxis issue. 片剂过敏原免疫疗法:过敏性休克问题。
IF 2.5 4区 医学 Q3 ALLERGY Pub Date : 2024-05-01 eCollection Date: 2024-01-01 DOI: 10.15586/aei.v52i3.990
Giorgio Ciprandi, Matteo Naso, Maria Angela Tosca

For the first time 15 years ago, tablet allergen immunotherapy (T-AIT) formulations were approved by regulatory agencies for treating allergic rhinitis caused by grass pollen in adults and children aged >5 years. Extensive evidences existed about effectiveness and safety of AIT. However, the safety profile is particularly compelling in children. Generally, T-AIT causes local reactions, mostly in the oral cavity, that are usually mild-to-moderate and often self-resolving. However, systemic allergic reactions are also observed with T-AIT, anaphylaxis representing the most fearsome adverse event, considering that it occurs in subjects treated for allergic rhinitis. Therefore, we conducted a literature search of patients reporting anaphylaxis because of T-AIT. Nine cases of anaphylactic reactions were reported in literature. Notably, no death was reported using T-AIT. This outcome was very important as it underscored the substantial safety of T-AIT. However, T-AIT deserves careful attention, mainly in the pediatric population. In this regard, after the first report of anaphylactic reaction at the first administration of T-AIT, manufacturers recommended that the first dose should be administered in a medical facility in the presence of staff with experience in managing anaphylaxis and the patient should be observed for at least 30 min. Interestingly, reported anaphylactic reactions were due to grass pollen extracts, with no report concerning other allergen extracts. However, it is relevant to note that anaphylactic reactions because of T-AIT are not reported in recent years.

15 年前,片剂过敏原免疫疗法(T-AIT)制剂首次获得监管机构批准,用于治疗成人和 5 岁以上儿童由草花粉引起的过敏性鼻炎。关于过敏原免疫疗法的有效性和安全性已有大量证据。然而,儿童的安全性尤其令人担忧。一般来说,T-AIT 会引起局部反应,主要发生在口腔,通常为轻度至中度反应,且通常可自行缓解。然而,T-AIT 也会引起全身性过敏反应,其中过敏性休克是最可怕的不良反应,因为过敏性休克发生在接受过敏性鼻炎治疗的受试者身上。因此,我们对报告因使用 T-AIT 而发生过敏性休克的患者进行了文献检索。文献中报告了 9 例过敏性反应。值得注意的是,没有使用 T-AIT 导致死亡的报道。这一结果非常重要,因为它强调了 T-AIT 的高度安全性。然而,T-AIT 值得仔细关注,主要是在儿童群体中。在这方面,在首次报告首次使用 T-AIT 时出现过敏反应后,生产商建议首次给药应在医疗机构中进行,并由具有处理过敏性休克经验的工作人员在场,同时应观察患者至少 30 分钟。有趣的是,报告的过敏性反应都是由草花粉提取物引起的,没有关于其他过敏原提取物的报告。不过,值得注意的是,近年来并没有因使用 T-AIT 而导致过敏反应的报道。
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引用次数: 0
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Allergologia et immunopathologia
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