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Measures for food allergy emergency in nurseries. 托儿所食物过敏应急措施。
IF 1.7 Q3 ALLERGY Pub Date : 2022-10-17 eCollection Date: 2022-10-01 DOI: 10.5415/apallergy.2022.12.e34
Mitsunobu Kaneko, Tomoko Miyoshi, Yoshihiro Miyashita, Riku Hayashi, Takuji Hashimoto

Background: As food allergy potentially can induce life-threatening anaphylaxis, measures for food allergy are required at nurseries caring for food allergy children, but a large-scale factual investigation has not been carried out.

Objective: We evaluated measures for food allergy emergency in nurseries.

Methods: A questionnaire survey regarding emergency measures in all authorized nurseries (411 facilities including 20,586 children) was conducted in Kawasaki city, Japan.

Results: The recovery rate of the questionnaire was 46.5%, which include 14,343 children of 191 facilities in total. A total of 637 children (4.4%) in 157 facilities (82.2%) requires elimination diets that were suggested by physicians. Among them, 22 children had been suggested to undergo the use of epinephrine auto-injection kit for emergency. 161 facilities (84.3%) had set a specific manual for emergency of food allergy. Emergency cases over the past one year were 4 cases and there was no case that had been suggested to use epinephrine auto-injection kit. All were anaphylaxis and the causes of these included 2 accidental digestion of culprit foods and the causes of other 2 cases were unknown. A case who required no elimination diet showed first episode of anaphylaxis. All cases were recovered.

Conclusion: High percentage of nurseries in Kawasaki city has cared for food allergy children. While many children with food allergy have been in nurseries, only several cases of anaphylaxis have been reported for a 1 year. Among 4 cases of anaphylaxis, no specific cause has been recognized in 2 cases and 1 case has been the first episode of anaphylaxis. While most of nurseries have set specific measures for emergency of food allergy, there is certain possibility that nursery staffs can encounter the first episode of anaphylaxis even if there is no food allergy child. For all nurseries, emergency measures for food allergy are vital.

背景:由于食物过敏可能诱发危及生命的过敏反应,托儿所需要对食物过敏儿童采取措施,但尚未开展大规模的事实调查。目的:探讨幼儿园食物过敏应急措施。方法:对日本川崎市所有授权托儿所(411家机构,20,586名儿童)的应急措施进行问卷调查。结果:问卷回收率为46.5%,共涉及191家机构14343名儿童。157个机构(82.2%)共有637名儿童(4.4%)需要医生建议的消除饮食。其中22例患儿建议急诊使用肾上腺素自动注射包。161个设施(84.3%)制定了专门的食物过敏应急手册。1年内急诊病例4例,未见建议使用肾上腺素自动注射试剂盒的病例。所有病例均为过敏反应,原因包括2例意外消化不良食物,其他2例原因不明。1例不需要消除饮食的患者首次出现过敏反应。所有病例均已痊愈。结论:川崎市幼儿园对食物过敏儿童的护理比例较高。虽然许多食物过敏的儿童都在托儿所,但只有几例过敏反应报告了1年。4例过敏反应中,2例病因不明,1例首次发生过敏反应。虽然大多数托儿所都有具体的食物过敏应急措施,但即使没有食物过敏的儿童,托儿所工作人员也有可能遇到首次过敏反应。对所有托儿所来说,食物过敏的紧急措施都是至关重要的。
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引用次数: 1
APAAACI's activities and this issue. APAAACI的活动和这个问题。
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-29 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e33
Yoon-Seok Chang
https://apallergy.org Recent activities of the Asia Pacific Association of Allergy, Asthma, and Clinical Immunology (APAAACI) are very successful including APAAACI Allergy Week 2022 (16–22 May) with the theme of ‘Climate change a global challenge: impact on allergic diseases.’ APAAACI TV is very active. Especially APAAACI MasterClass/The Junior APAAACI Allergy Leadership Forum Café is really successful and became one of APAAACI’s flagship programs. Motivational conversations with global leaders provide a great motivation and inspiration for our younger generation and all. The latest interview was done with professor You-Young Kim, past president of APAAACI (1998 & 2002–2004), from Korea. Please note and save the date that World Allergy Congress 2022 will be held in Istanbul 13–15 Oct 2022, and that ‘APAAACI 2022 Congress PSAAI@50’ will be held in Manila 5-8 Dec 2022.
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引用次数: 0
Association of upper airway bacterial microbiota and asthma: systematic review. 上呼吸道细菌微生物群与哮喘的关系:系统综述。
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-29 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e32
Purevsuren Losol, Hee-Sun Park, Woo-Jung Song, Yu-Kyoung Hwang, Sae-Hoon Kim, John W Holloway, Yoon-Seok Chang

Individual studies have suggested that upper airway dysbiosis may be associated with asthma or its severity. We aimed to systematically review studies that evaluated upper airway bacterial microbiota in relation to asthma, compared to nonasthmatic controls. Searches used MEDLINE, Embase, and Web of Science Core Collection. Eligible studies included association between asthma and upper airway dysbiosis; assessment of composition and diversity of upper airway microbiota using 16S rRNA or metagenomic sequencing; upper airway samples from nose, nasopharynx, oropharynx or hypopharynx. Study quality was assessed and rated using the Newcastle-Ottawa scale. A total of 249 publications were identified; 17 in the final analysis (13 childhood asthma and 4 adult asthma). Microbiome richness was measured in 6 studies, species diversity in 12, and bacterial composition in 17. The quality of evidence was good and fair. The alpha-diversity was found to be higher in younger children with wheezing and asthma, while it was lower when asthmatic children had rhinitis or mite sensitization. In children, Proteobacteria and Firmicutes were higher in asthmatics compared to controls (7 studies), and Moraxella, Streptococcus, and Haemophilus were predominant in the bacterial community. In pooled analysis, nasal Streptococcus colonization was associated with the presence of wheezing at age 5 (p = 0.04). In adult patients with asthma, the abundance of Proteobacteria was elevated in the upper respiratory tract (3 studies). Nasal colonization of Corynebacterium was lower in asthmatics (2 studies). This study demonstrates the potential relationships between asthma and specific bacterial colonization in the upper airway in adult and children with asthma.

个别研究表明,上呼吸道生态失调可能与哮喘或其严重程度有关。我们的目的是系统地回顾评估与哮喘相关的上呼吸道细菌微生物群的研究,并将其与非哮喘对照进行比较。搜索使用MEDLINE, Embase和Web of Science Core Collection。符合条件的研究包括哮喘与上呼吸道生态失调之间的关系;使用16S rRNA或宏基因组测序评估上呼吸道微生物群的组成和多样性;鼻、鼻咽部、口咽部或下咽的上呼吸道样本。使用纽卡斯尔-渥太华量表对研究质量进行评估和评级。共确定了249种出版物;最终分析为17例(儿童哮喘13例,成人哮喘4例)。6项研究测量了微生物群落丰富度,12项研究测量了物种多样性,17项研究测量了细菌组成。证据质量良好、公正。α -多样性在患有喘息和哮喘的低龄儿童中较高,而在患有鼻炎或螨虫致敏的哮喘儿童中较低。在儿童中,与对照组相比,变形菌门和厚壁菌门在哮喘患者中较高(7项研究),莫拉菌、链球菌和嗜血杆菌在细菌群落中占主导地位。在汇总分析中,鼻腔链球菌定植与5岁时出现喘息有关(p = 0.04)。在成人哮喘患者中,上呼吸道变形杆菌的丰度升高(3项研究)。哮喘患者鼻部棒状杆菌的定植较低(2项研究)。本研究表明哮喘与成人和儿童哮喘患者上呼吸道特异性细菌定植之间的潜在关系。
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引用次数: 10
Prevalence of IgE-mediated cow milk, egg, and peanut allergy in young Singapore children. IgE 介导的新加坡幼儿牛奶、鸡蛋和花生过敏症的发病率。
IF 1.6 Q3 ALLERGY Pub Date : 2022-07-26 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e31
Alison Joanne Lee, Elizabeth Huiwen Tham, Anne Eng-Neo Goh, Wern-Ee Tang, Yew-Cheong Tung, Yehudi Yeo, Keith Tsou, Le-Ye Lee, Jian-Yi Soh, Cesar Brence Labastida, Ping-Ping Wang, Michelle Mei-Ling Tan, Hsin Yue Cheng, Yiong-Huak Chan, Hugo Van Bever, Lynette Pei-Chi Shek, Bee-Wah Lee

Background: The rising prevalence of food allergy reported in the United States, UK, and Australia may be attributable to the rise in peanut allergy prevalence. The food allergy prevalence in other parts of the world such as Asia is, however, less well documented.

Objective: This study aimed to evaluate the prevalence of cow's milk, egg, and peanut allergies in a general population of Singaporean children below 30 months of age.

Methods: A total of 4,115 children from the general population who attended well-baby visits between 2011 and 2015 completed standardized questionnaires to elicit a convincing history of food allergy to estimate the population prevalence of food allergies.

Results: The prevalence of a convincing history of cow's milk allergy was 0.51% (95% confidence interval [CI], 0.3-0.7), hen's egg allergy 1.43% (95% CI, 1.1-1.8), and peanut allergy 0.27% (95% CI, 0.12-0.42). Of the 15 of 59 children with a convincing history of hen's egg allergy who consented, 12 (80%) had corroborative positive skin prick tests.

Conclusion: The prevalence of food allergy, in particular peanut allergy, in children below 2 years of age is lower in this South East Asian population than reported in Western cohorts. Further research should focus on deciphering differential risk factors for food allergy across different geographical locations.

背景:据报道,美国、英国和澳大利亚的食物过敏患病率不断上升,这可能与花生过敏患病率上升有关。然而,世界其他地区(如亚洲)的食物过敏发病率却鲜有文献记载:本研究旨在评估新加坡 30 个月以下儿童中牛奶、鸡蛋和花生过敏的发病率:2011年至2015年期间,共有4115名普通人群中的儿童接受了婴儿健康检查,他们填写了标准问卷,以获得令人信服的食物过敏史,从而估算出食物过敏的人群患病率:令人信服的牛奶过敏史发生率为 0.51%(95% 置信区间 [CI],0.3-0.7),鸡蛋过敏发生率为 1.43%(95% 置信区间 [CI],1.1-1.8),花生过敏发生率为 0.27%(95% 置信区间 [CI],0.12-0.42)。59名儿童中有15名同意接受鸡心蛋过敏治疗,其中12名(80%)的皮肤点刺试验结果呈阳性:结论:在东南亚人群中,2 岁以下儿童的食物过敏(尤其是花生过敏)发病率低于西方人群。进一步的研究应侧重于解读不同地区食物过敏的不同风险因素。
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引用次数: 0
Stevens-Johnson syndrome related with Comirnaty® coronavirus disease 2019 vaccine. 与2019冠状病毒病疫苗相关的史蒂文斯-约翰逊综合征
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-22 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e30
João Marcelino, João Vieira, Fátima Ferreira, Irina Didenko, Rute Reis, Rita Silva, Regina Viseu, Elza Tomaz

Stevens-Johnson syndrome is a rare severe delayed-type hypersensitivity reaction. Even though not initially described as a side-effect of the Comirnaty® coronavirus disease 2019 (COVID-19) Vaccine, the worldwide public COVID-19 vaccination programs are uncovering this serious adverse event. We present the case of a 44-year-old woman, vaccinated with the 1st dose in July 2021, and the 2nd dose 4 weeks later. Five days after the 2nd dose, a 10 cm, circular, painful, violet/red lesion appeared on the injection site. From then on, multiple, generalized purpuric painful lesions appeared, associated with ulcers on the lips, oral cavity, nasal cavity, vulva, and vagina, oedema of the hands and feet, conjunctival erythema, blurred vision, and malaise. The patient was being treated with lamotrigine and sodium valproate (for 2 years, without interruptions or dose change) which were stopped, and the patient started treatment with systemic corticosteroids. Lymphocyte transformation test were performed and were positive for PEG2000 1 µg/mL (stimulation index [SI], 30.9), and the undiluted Comirnaty® vaccine (SI, 32.2). These tests were negative on several vaccinated controls. We can definitively show that sensitization to the vaccine and PEG2000 can occur. A more extensive evaluation and reporting is needed to know the true incidence of this life-threatening condition and possible risk factors; as not only further booster shots of this vaccine will be administered, but also new vaccines with the mRNA technology are likely to be more prevalent in the future.

史蒂文斯-约翰逊综合征是一种罕见的严重迟发性超敏反应。尽管最初并未被描述为2019冠状病毒病(COVID-19)疫苗的副作用,但全球公共COVID-19疫苗接种计划正在发现这一严重不良事件。我们报告了一名44岁妇女的病例,她于2021年7月接种了第一剂疫苗,4周后接种了第二剂疫苗。第2次给药后5天,注射部位出现10厘米圆形、疼痛、紫色/红色病灶。此后出现多发、全身性紫癜性疼痛病变,伴唇部、口腔、鼻腔、外阴、阴道溃疡,手足水肿,结膜红斑,视力模糊,全身乏力。患者正在接受拉莫三嗪和丙戊酸钠治疗(2年,没有中断或剂量变化),并停止治疗,患者开始全身皮质类固醇治疗。进行淋巴细胞转化试验,PEG2000 1µg/mL(刺激指数[SI], 30.9)和未稀释的Comirnaty®疫苗(SI, 32.2)阳性。在几个接种过疫苗的对照组中,这些试验呈阴性。我们可以明确地表明,可以发生对疫苗和PEG2000的致敏。需要进行更广泛的评估和报告,以了解这种危及生命的疾病的真实发病率和可能的风险因素;因为不仅该疫苗的进一步加强注射将被实施,而且采用mRNA技术的新疫苗可能在未来更加普遍。
{"title":"Stevens-Johnson syndrome related with Comirnaty® coronavirus disease 2019 vaccine.","authors":"João Marcelino,&nbsp;João Vieira,&nbsp;Fátima Ferreira,&nbsp;Irina Didenko,&nbsp;Rute Reis,&nbsp;Rita Silva,&nbsp;Regina Viseu,&nbsp;Elza Tomaz","doi":"10.5415/apallergy.2022.12.e30","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e30","url":null,"abstract":"<p><p>Stevens-Johnson syndrome is a rare severe delayed-type hypersensitivity reaction. Even though not initially described as a side-effect of the Comirnaty® coronavirus disease 2019 (COVID-19) Vaccine, the worldwide public COVID-19 vaccination programs are uncovering this serious adverse event. We present the case of a 44-year-old woman, vaccinated with the 1st dose in July 2021, and the 2nd dose 4 weeks later. Five days after the 2nd dose, a 10 cm, circular, painful, violet/red lesion appeared on the injection site. From then on, multiple, generalized purpuric painful lesions appeared, associated with ulcers on the lips, oral cavity, nasal cavity, vulva, and vagina, oedema of the hands and feet, conjunctival erythema, blurred vision, and malaise. The patient was being treated with lamotrigine and sodium valproate (for 2 years, without interruptions or dose change) which were stopped, and the patient started treatment with systemic corticosteroids. Lymphocyte transformation test were performed and were positive for PEG2000 1 µg/mL (stimulation index [SI], 30.9), and the undiluted Comirnaty® vaccine (SI, 32.2). These tests were negative on several vaccinated controls. We can definitively show that sensitization to the vaccine and PEG2000 can occur. A more extensive evaluation and reporting is needed to know the true incidence of this life-threatening condition and possible risk factors; as not only further booster shots of this vaccine will be administered, but also new vaccines with the mRNA technology are likely to be more prevalent in the future.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e30"},"PeriodicalIF":1.7,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/34/apa-12-e30.PMC9353208.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Systemic autoinflammatory diseases in pediatric population. 小儿全身性自身炎症性疾病。
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-18 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e29
Maria Luís Marques, Inês Machado Cunha, Sérgio Alves, Margarida Guedes, Carla Zilhão

Background: Systemic autoinflammatory diseases (SAID) are monogenic and polygenic inherited conditions characterized by dysregulation of the innate immune system.

Objective: We aimed to characterize the clinical features of patients with SAID.

Methods: This study was a retrospective chart review on the clinical and genetic features of the pediatric population with SAID observed from 1998 to 2020 in our center.

Results: A total of 54 patients were evaluated: 18 with periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome; 16 with Behçet disease; 13 with systemic juvenile idiopathic arthritis; 4 with syndrome of undifferentiated recurrent fever; 1 with cryopyrin associated periodic syndrome; 1 with chronic nonbacterial osteomyelitis; and 1 with Muckle-Wells syndrome.

Conclusion: The analysis of clinical features of our patients are similar to other studies. Our goal was to aware the medical community to early recognize and treat SAID to improve quality of life of pediatric patients.

背景:系统性自身炎症性疾病(SAID)是单基因和多基因遗传性疾病,其特征是先天免疫系统失调。目的:我们旨在描述SAID患者的临床特征。方法:本研究对1998年至2020年在我中心观察到的儿童SAID人群的临床和遗传特征进行回顾性分析。结果:共评估54例患者:18例出现周期性发热、口疮性口炎、咽炎、腺炎综合征;behaperet病16例;13例系统性幼年特发性关节炎;4例为无分化反复发热综合征;1例低温肾上腺素相关周期综合征;1例慢性非细菌性骨髓炎;1人患有粘液-威尔斯综合症。结论:本组患者的临床特征分析与其他研究相似。我们的目标是让医学界尽早认识和治疗SAID,以提高儿科患者的生活质量。
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引用次数: 4
Delayed urticaria after BNT162b2 booster vaccination at previous intradermal test site with severe acute respiratory syndrome-coronavirus-2 spike protein. 严重急性呼吸综合征-冠状病毒-2刺突蛋白在先前皮内试验点接种BNT162b2加强疫苗后出现延迟性荨麻疹。
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-18 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e27
Jidapa Triwatcharikorn, Jettanong Klaewsongkram, Pawinee Rerknimitr

Urticaria is a common cutaneous adverse event from coronavirus disease 2019 vaccination. Previous studies hypothesized that excipients as polyethylene glycol in BNT162b2 vaccine and polysorbate in ChAdOx1 nCoV-19 vaccine are allergens. A 28-year-old woman had urticaria after a booster vaccination with BNT162b2 at the site of previous intradermal injection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) spike protein. This reaction emphasized that delayed urticaria may not be an allergic reaction to excipient but rather to the immunogen as such as SARS-CoV-2 spike protein.

荨麻疹是2019冠状病毒病疫苗接种后常见的皮肤不良事件。先前的研究假设赋形剂如BNT162b2疫苗中的聚乙二醇和ChAdOx1 nCoV-19疫苗中的聚山梨酯是过敏原。一名28岁妇女在先前皮内注射严重急性呼吸综合征-冠状病毒-2 (SARS-CoV-2)刺突蛋白的部位加强接种BNT162b2后出现荨麻疹。这一反应强调了延迟性荨麻疹可能不是对赋形剂的过敏反应,而是对SARS-CoV-2刺突蛋白等免疫原的过敏反应。
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引用次数: 1
Major basic protein deposited at intra mucosal epithelium with probable eosinophilic chronic rhinosinusitis. 主要碱性蛋白沉积于粘膜上皮内,可能为嗜酸性慢性鼻窦炎。
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-18 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e28
Satoshi Suzuki, Naomi Kudo, Daisuke Matsushita, Ryutaro Hara, Tomoya Miura, Atsushi Matsubara

Background: Eosinophilic chronic rhinosinusitis (ECRS) is diagnosed by Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) scoring system and histopathological eosinophil counts of dissected nasal polyps. Patients with low JESREC score and small number of tissue eosinophils are diagnosed with non-ECRS (NECRS). Due to the 2 parameters of this diagnostic system, chronic rhinosinusitis is to be divided to 4 groups and some patients fall into the 2 groups other than ECRS and NECRS: probable ECRS (pECRS) and probable non-ECRS (pNECRS). We attempted to clarify clinical and histopathological similarities and differences, especially concerning major basic protein (MBP), among those groups.

Methods: One hundred twenty-eight patients treated by endoscopic sinus surgery was included. Clinical characteristics were compared among each group, and immunohistological analysis for MBP was performed to 35 randomly selected patients. MBP deposition at intra mucosal epithelium was evaluated by semiquantificational approach.

Results: ECRS patients showed significantly higher comorbidity rate with allergic rhinitis (36 patients, 78.3%), asthma (36 patients, 78.3%) compared with other groups. Also, percentage of the patients complaining olfactory dysfunction (42 patients, 91.3%) was significantly higher (p < 0.001). Lund-Mackay score (mean, 14.5; 6-24) and recurrence rate (27 patients, 61.4%) was the highest in ECRS patients. Regarding pECRS, the number of patients with olfactory dysfunction (5 patients, 55.6%) was higher than pNECRS and NECRS groups. Also, comorbidity of asthma and percentage of blood eosinophils tended to be higher than those 2 groups. MBP score of pECRS group was significantly higher than NECRS (p < 0.05), despite of smaller tissue eosinophil counts.

Conclusion: pECRS might share some characteristics with ECRS although tissue eosinophil count was significantly smaller compared with ECRS. The results of this study have shown that MBP score in pECRS nasal polyps was significantly higher than NECRS patients and close to ECRS. That might suggest that eosinophils have existed in the nasal polyps of pPECRS patients at some point before surgery.

背景:日本难治性嗜酸性慢性鼻窦炎流行病学调查(JESREC)评分系统和解剖鼻息肉组织病理学嗜酸性粒细胞计数诊断为嗜酸性慢性鼻窦炎(ECRS)。JESREC评分低且组织嗜酸性粒细胞数量少的患者被诊断为非ecrs (NECRS)。根据该诊断系统的2个参数,将慢性鼻窦炎分为4组,部分患者属于ECRS和NECRS之外的2组:可能的ECRS (pECRS)和可能的非ECRS (pNECRS)。我们试图澄清这些组之间的临床和组织病理学的异同,特别是关于主要基础蛋白(MBP)。方法:回顾性分析经鼻内镜手术治疗的128例患者。比较各组患者的临床特征,随机选取35例患者进行MBP免疫组织学分析。采用半定量方法评价粘膜上皮内MBP沉积。结果:ECRS患者与变应性鼻炎(36例,78.3%)、哮喘(36例,78.3%)的合并率明显高于其他组。同时,抱怨嗅觉功能障碍的患者比例(42例,91.3%)显著高于对照组(p < 0.001)。Lund-Mackay评分(平均14.5分;ECRS患者复发率最高(27例,61.4%)。pECRS组嗅觉功能障碍患者(5例,55.6%)高于pNECRS组和NECRS组。哮喘合并症和血嗜酸性粒细胞比例均高于两组。pECRS组MBP评分显著高于NECRS组(p < 0.05),但组织嗜酸性粒细胞计数较NECRS组低。结论:pECRS可能与ECRS有一些共同的特征,但组织嗜酸性粒细胞计数明显少于ECRS。本研究结果显示,pECRS鼻息肉患者的MBP评分明显高于NECRS患者,接近ECRS。这可能表明pPECRS患者的鼻息肉在手术前的某个时刻存在嗜酸性粒细胞。
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引用次数: 2
The association of CD4 lymphocyte count with drug hypersensitivity reaction to highly active antiretroviral therapy, trimethoprim sulfamethoxazole, and antitubercular agents in human immunodeficiency virus patients. CD4淋巴细胞计数与人类免疫缺陷病毒患者对高活性抗逆转录病毒治疗、甲氧苄氨苄磺胺甲恶唑和抗结核药物过敏反应的关系
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-13 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e26
Jannah Lee S Tarranza, Maria Carmen D Ang

Background: The introduction of highly active antiretroviral therapy (HAART) and antibiotic regimens for the treatment of human immunodeficiency virus (HIV) and its concomitant opportunistic infections, respectively, significantly improve the morbidity and mortality of the infected patients. However, these drugs commonly cause drug hypersensitivity reactions (DHRs) in patients with acquired immunodeficiency syndrome. The reason proposed are multifactorial, which includes immune hyperactivation, changes in drug metabolism, patient cytokine profiles, oxidative stress, genetic predisposition, and the principal target in HIV patients, the CD4+ lymphocytes.

Objective: This study determined the association of CD4 count and DHRs to first-line HAART, trimethoprim sulfamethoxazole, and antitubercular agents among HIV patients.

Methods: This is a retrospective analytical study. Review of charts were done. The demographic and clinical profile used a descriptive statistics such as mean and standard deviation for quantitative data and frequency and percent for categorical data. Chi-square and Fisher exact tests were used to measure the degree of the relationship of CD4 count and DHRs.

Results: A total of 337 eligible patients were included. There was a 25% incidence of hypersensitivity reactions. However, the prevalence of DHRs across the different CD4 groups was not statistically significant (p = 0.167). Likewise, the study found no significant association between the CD4 count and DHRs to first-line HAART, trimethoprim sulfamethoxazole, and antitubercular agents (p = 0.311). The most common DHR was morbilliform rash, and nevirapine was the most reported antiretroviral drug causing DHR.

Conclusion: There was no association in the CD4 count and DHRs to first-line HAART, trimethoprim sulfamethoxazole, and antitubercular agents. Hence, regardless of the baseline CD4 lymphocyte count, the physician should be vigilant in monitoring hypersensitivity reactions. Patient education on common DHRs is very important upon diagnosis of HIV and/or initiation of treatment.

背景:高活性抗逆转录病毒疗法(HAART)和抗生素治疗方案分别用于治疗人类免疫缺陷病毒(HIV)及其伴随的机会性感染,显著提高了感染患者的发病率和死亡率。然而,这些药物通常会引起获得性免疫缺陷综合征患者的药物超敏反应(DHRs)。提出的原因是多因素的,包括免疫过度激活、药物代谢变化、患者细胞因子谱、氧化应激、遗传易感性以及HIV患者的主要靶点CD4+淋巴细胞。目的:研究HIV患者CD4计数和dhr与一线HAART、甲氧苄氨苄磺胺甲恶唑和抗结核药物的关系。方法:回顾性分析研究。对图表进行了审查。人口统计学和临床概况使用描述性统计,如定量数据的平均值和标准差,分类数据的频率和百分比。采用卡方检验和Fisher精确检验来衡量CD4计数与dhr的关系程度。结果:共纳入337例符合条件的患者。过敏反应发生率为25%。然而,不同CD4组的dhr患病率无统计学意义(p = 0.167)。同样,该研究发现CD4计数和dhr与一线HAART、甲氧苄氨苄磺胺甲恶唑和抗结核药物之间没有显著关联(p = 0.311)。最常见的DHR是麻疹型皮疹,奈韦拉平是报道最多的引起DHR的抗逆转录病毒药物。结论:一线HAART、甲氧苄氨苄磺胺甲恶唑及抗结核药物与CD4计数和dhr无相关性。因此,无论基线CD4淋巴细胞计数如何,医生都应警惕监测过敏反应。在诊断艾滋病毒和/或开始治疗时,对患者进行常见DHRs的教育非常重要。
{"title":"The association of CD4 lymphocyte count with drug hypersensitivity reaction to highly active antiretroviral therapy, trimethoprim sulfamethoxazole, and antitubercular agents in human immunodeficiency virus patients.","authors":"Jannah Lee S Tarranza,&nbsp;Maria Carmen D Ang","doi":"10.5415/apallergy.2022.12.e26","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e26","url":null,"abstract":"<p><strong>Background: </strong>The introduction of highly active antiretroviral therapy (HAART) and antibiotic regimens for the treatment of human immunodeficiency virus (HIV) and its concomitant opportunistic infections, respectively, significantly improve the morbidity and mortality of the infected patients. However, these drugs commonly cause drug hypersensitivity reactions (DHRs) in patients with acquired immunodeficiency syndrome. The reason proposed are multifactorial, which includes immune hyperactivation, changes in drug metabolism, patient cytokine profiles, oxidative stress, genetic predisposition, and the principal target in HIV patients, the CD4+ lymphocytes.</p><p><strong>Objective: </strong>This study determined the association of CD4 count and DHRs to first-line HAART, trimethoprim sulfamethoxazole, and antitubercular agents among HIV patients.</p><p><strong>Methods: </strong>This is a retrospective analytical study. Review of charts were done. The demographic and clinical profile used a descriptive statistics such as mean and standard deviation for quantitative data and frequency and percent for categorical data. Chi-square and Fisher exact tests were used to measure the degree of the relationship of CD4 count and DHRs.</p><p><strong>Results: </strong>A total of 337 eligible patients were included. There was a 25% incidence of hypersensitivity reactions. However, the prevalence of DHRs across the different CD4 groups was not statistically significant (<i>p</i> = 0.167). Likewise, the study found no significant association between the CD4 count and DHRs to first-line HAART, trimethoprim sulfamethoxazole, and antitubercular agents (<i>p</i> = 0.311). The most common DHR was morbilliform rash, and nevirapine was the most reported antiretroviral drug causing DHR.</p><p><strong>Conclusion: </strong>There was no association in the CD4 count and DHRs to first-line HAART, trimethoprim sulfamethoxazole, and antitubercular agents. Hence, regardless of the baseline CD4 lymphocyte count, the physician should be vigilant in monitoring hypersensitivity reactions. Patient education on common DHRs is very important upon diagnosis of HIV and/or initiation of treatment.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e26"},"PeriodicalIF":1.7,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/2f/apa-12-e26.PMC9353209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Increase in eosinophil-derived neurotoxin level in school children with allergic disease. 过敏性疾病学龄儿童嗜酸性粒细胞衍生神经毒素水平升高。
IF 1.7 Q3 ALLERGY Pub Date : 2022-07-13 eCollection Date: 2022-07-01 DOI: 10.5415/apallergy.2022.12.e25
Chang-Keun Kim, Dong Yoon Kang, Zak Callaway, Kyoung Soo Kim, Eun Mi Kwon, Fumiya Yamaide, Taiji Nakano, Yoichi Suzuki, Yoichi Mashimo, Akira Hata, Yoshitaka Okamoto, Naoki Shimojo

Background: Eosinophils are major effector cells of allergic disease and excellent markers of eosinophilic inflammation. Accurate and reliable biomarkers are helpful in the diagnosis, treatment, and control of allergic disease.

Objective: This study aimed to investigate an alternate marker of eosinophilic inflammation, eosinophil-derived neurotoxin (EDN), in a number of allergic diseases.

Methods: Three hundred ninety-six elementary school-age children with various allergic conditions were recruited for this study. Subgroups included food allergies (FAs), atopic dermatitis (AD), bronchial asthma (BA), and allergic rhinitis (AR). EDN levels in these groups were compared to those in 93 healthy controls (HC).

Results: All subjects with allergic disease had elevated levels of serum EDN (median [interquartile range]: FA, 124.2 ng/mL [59.13-160.5 ng/mL]; AD, 110.8 ng/mL [57.52-167.9 ng/mL]; BA, 131.5 ng/mL [60.60-171.0 ng/mL]; AR, 91.32 ng/mL [46.16-145.0 ng/mL]) compared to HC (38.38 ng/mL [32.40-55.62 ng/mL]) (p < 0.0001). These elevated levels were consistent throughout the age range (6-12 years) of the healthy study subjects (p = 0.0679). EDN levels also correlated well with total immunoglobulin E (Rs = 0.5599, p < 0.0001). Looking at all individuals with an allergic disease, the area under the curve was 0.790.

Conclusions: Direct measures of eosinophilic inflammation are needed for accurate diagnosis, treatment, and monitoring of allergic diseases. EDN may be a worthy biomarker of eosinophil activity and a useful screening tool for allergic diseases including FA, AD, BA, and AR.

背景:嗜酸性粒细胞是过敏性疾病的主要效应细胞,也是嗜酸性粒细胞炎症的优良标志物。准确可靠的生物标志物有助于变态反应性疾病的诊断、治疗和控制。目的:本研究旨在探讨嗜酸性粒细胞炎症的另一种标志物,嗜酸性粒细胞衍生神经毒素(EDN)在许多过敏性疾病中的作用。方法:对396名患有不同过敏症状的小学学龄儿童进行研究。亚组包括食物过敏(FAs)、特应性皮炎(AD)、支气管哮喘(BA)和过敏性鼻炎(AR)。将这些组的EDN水平与93名健康对照(HC)进行比较。结果:所有变应性疾病患者血清EDN水平均升高(中位数[四分位数范围]:FA, 124.2 ng/mL [59.13-160.5 ng/mL];AD, 110.8 ng/mL [57.52 ~ 167.9 ng/mL];BA, 131.5 ng/mL [60.60-171.0 ng/mL];AR为91.32 ng/mL [46.16 ~ 145.0 ng/mL]), HC为38.38 ng/mL [32.40 ~ 55.62 ng/mL] (p < 0.0001)。这些升高的水平在健康研究对象的整个年龄范围(6-12岁)是一致的(p = 0.0679)。EDN水平与总免疫球蛋白E也有良好的相关性(Rs = 0.5599, p < 0.0001)。观察所有患有过敏性疾病的个体,曲线下的面积为0.790。结论:对变态反应性疾病的准确诊断、治疗和监测需要直接测量嗜酸性粒细胞炎症。EDN可能是一种有价值的嗜酸性粒细胞活性生物标志物,也是一种有用的过敏性疾病筛查工具,包括FA、AD、BA和AR。
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引用次数: 6
期刊
Asia Pacific Allergy
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