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.
{"title":"Measures for food allergy emergency in nurseries.","authors":"Mitsunobu Kaneko, Tomoko Miyoshi, Yoshihiro Miyashita, Riku Hayashi, Takuji Hashimoto","doi":"10.5415/apallergy.2022.12.e34","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e34","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>We evaluated measures for food allergy emergency in nurseries.</p><p><strong>Methods: </strong>A questionnaire survey regarding emergency measures in all authorized nurseries (411 facilities including 20,586 children) was conducted in Kawasaki city, Japan.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 4","pages":"e34"},"PeriodicalIF":1.7,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/cf/apa-12-e34.PMC9669463.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40492761","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}
Pub Date : 2022-07-29eCollection Date: 2022-07-01DOI: 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.
{"title":"APAAACI's activities and this issue.","authors":"Yoon-Seok Chang","doi":"10.5415/apallergy.2022.12.e33","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e33","url":null,"abstract":"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.","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e33"},"PeriodicalIF":1.7,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/ea/apa-12-e33.PMC9353205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413402","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}
Pub Date : 2022-07-29eCollection Date: 2022-07-01DOI: 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。
{"title":"Association of upper airway bacterial microbiota and asthma: systematic review.","authors":"Purevsuren Losol, Hee-Sun Park, Woo-Jung Song, Yu-Kyoung Hwang, Sae-Hoon Kim, John W Holloway, Yoon-Seok Chang","doi":"10.5415/apallergy.2022.12.e32","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e32","url":null,"abstract":"<p><p>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 <i>Moraxella</i>, <i>Streptococcus</i>, and <i>Haemophilus</i> were predominant in the bacterial community. In pooled analysis, nasal <i>Streptococcus</i> colonization was associated with the presence of wheezing at age 5 (<i>p</i> = 0.04). In adult patients with asthma, the abundance of Proteobacteria was elevated in the upper respiratory tract (3 studies). Nasal colonization of <i>Corynebacterium</i> 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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e32"},"PeriodicalIF":1.7,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/55/apa-12-e32.PMC9353206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697383","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}
Pub Date : 2022-07-26eCollection Date: 2022-07-01DOI: 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.
{"title":"Prevalence of IgE-mediated cow milk, egg, and peanut allergy in young Singapore children.","authors":"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","doi":"10.5415/apallergy.2022.12.e31","DOIUrl":"10.5415/apallergy.2022.12.e31","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e31"},"PeriodicalIF":1.6,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/56/apa-12-e31.PMC9353200.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697386","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}
Pub Date : 2022-07-22eCollection Date: 2022-07-01DOI: 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.
{"title":"Stevens-Johnson syndrome related with Comirnaty® coronavirus disease 2019 vaccine.","authors":"João Marcelino, João Vieira, Fátima Ferreira, Irina Didenko, Rute Reis, Rita Silva, Regina Viseu, 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}
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.
{"title":"Systemic autoinflammatory diseases in pediatric population.","authors":"Maria Luís Marques, Inês Machado Cunha, Sérgio Alves, Margarida Guedes, Carla Zilhão","doi":"10.5415/apallergy.2022.12.e29","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e29","url":null,"abstract":"<p><strong>Background: </strong>Systemic autoinflammatory diseases (SAID) are monogenic and polygenic inherited conditions characterized by dysregulation of the innate immune system.</p><p><strong>Objective: </strong>We aimed to characterize the clinical features of patients with SAID.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e29"},"PeriodicalIF":1.7,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/2b/apa-12-e29.PMC9353204.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697384","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}
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.
{"title":"Delayed urticaria after BNT162b2 booster vaccination at previous intradermal test site with severe acute respiratory syndrome-coronavirus-2 spike protein.","authors":"Jidapa Triwatcharikorn, Jettanong Klaewsongkram, Pawinee Rerknimitr","doi":"10.5415/apallergy.2022.12.e27","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e27","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e27"},"PeriodicalIF":1.7,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/c5/apa-12-e27.PMC9353207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40413399","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}
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.
{"title":"Major basic protein deposited at intra mucosal epithelium with probable eosinophilic chronic rhinosinusitis.","authors":"Satoshi Suzuki, Naomi Kudo, Daisuke Matsushita, Ryutaro Hara, Tomoya Miura, Atsushi Matsubara","doi":"10.5415/apallergy.2022.12.e28","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e28","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i> < 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 (<i>p</i> < 0.05), despite of smaller tissue eosinophil counts.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e28"},"PeriodicalIF":1.7,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/58/apa-12-e28.PMC9353210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697388","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}
Pub Date : 2022-07-13eCollection Date: 2022-07-01DOI: 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.
{"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, 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}
Pub Date : 2022-07-13eCollection Date: 2022-07-01DOI: 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.
{"title":"Increase in eosinophil-derived neurotoxin level in school children with allergic disease.","authors":"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","doi":"10.5415/apallergy.2022.12.e25","DOIUrl":"https://doi.org/10.5415/apallergy.2022.12.e25","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>This study aimed to investigate an alternate marker of eosinophilic inflammation, eosinophil-derived neurotoxin (EDN), in a number of allergic diseases.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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]) (<i>p</i> < 0.0001). These elevated levels were consistent throughout the age range (6-12 years) of the healthy study subjects (<i>p</i> = 0.0679). EDN levels also correlated well with total immunoglobulin E (Rs = 0.5599, <i>p</i> < 0.0001). Looking at all individuals with an allergic disease, the area under the curve was 0.790.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":8488,"journal":{"name":"Asia Pacific Allergy","volume":"12 3","pages":"e25"},"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/8d/f4/apa-12-e25.PMC9353201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697387","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}