Increased Prevalence of Eosinophilic Esophagitis in Patients With Chronic Rhinosinusitis.

BACKGROUND: Chronic rhinosinusitis (CRS) and eosinophilic esophagitis (EoE) are immune-mediated inflammatory conditions that share common histopathologic features. Once considered two separate pathologies, preliminary data has suggested that a higher prevalence of EoE may exist in patients with CRS. OBJECTIVES: We aimed to expand the base of evidence across geographic regions and investigate the association between EoE and CRS, including CRS with nasal polyposis (CRSwNP). METHODS: Quantitative data detailing the prevalence of CRS, CRSwNP, and EoE were pooled from 6 large academic institutions spread across the United States using Epic electronic medical record system. One-way analysis of variance was then used to analyze the data. RESULTS: The mean prevalence of EoE in our general population sample of over 26 million individual records was 0.058% (range, 0.013%-0.103%). The mean prevalence of EoE in our sub-populations of individual with diagnoses of CRS and CRSwNP was 0.43% (F(1,12) = [8.194], P = .01) and 0.84% (F(1,12) = [23.61], P < .01) respectively. CONCLUSION: This study reveals an 8-fold greater prevalence of concurrent EoE in patients with CRS. Importantly, this is the first study to describe the association of EoE and the CRSwNP subtype, and we demonstrate a 14-fold greater prevalence of EoE in patients with CRSwNP.

Nickel Cobaltite: A Positive Electrode Material for Hybrid Supercapacitors.

The increased demand of energy due to the recent technological advances in diverse fields such as portable electronics and electric vehicles is often hindered by the poor capability of energy-storage systems. Although supercapacitors (SCs) exhibit higher power density than state-of-the art batteries, their insufficient energy density remains a major challenge. An emerging concept of hybrid supercapacitors (HSCs) with the combination of one capacitive and one battery electrode in a single cell holds a great promise to deliver high energy density without sacrificing power density and cycling stability. This Minireview elaborates the recent advances of use of nickel cobaltite (NiCo2 O4 ) as a potential positive electrode (battery-like) for HSCs. A brief introduction on the structural benefits and charge storage mechanisms of NiCo2 O4 was provided. It further shed a light on composites of NiCo2 O4 with different materials like carbon, polymers, metal oxides, and others, which altogether helps in increasing the electrochemical performance of HSCs. Finally, the key scientific challenges and perspectives on building high-performance HSCs for future-generation applications were reviewed.

Novel vaccines: Technology and development.

The development and widespread use of vaccines, which are defined by the World Health Organization as "biological preparations that improve immunity to a particular disease," represents one of the most significant strides in medicine. Vaccination was first applied to reduce mortality and morbidity from infectious diseases. The World Health Organization estimates that vaccines prevent 2 to 3 million human deaths annually, and these numbers would increase by at least 6 million if all children received the recommended vaccination schedule. However, the origins of allergen immunotherapy share the same intellectual paradigm, and subsequent innovations in vaccine technology have been applied beyond the prevention of infection, including in the treatment of cancer and allergic diseases. This review will focus on how new and more rational approaches to vaccine development use novel biotechnology, target new mechanisms, and shape the immune system response, with an emphasis on discoveries that have direct translational relevance to the treatment of allergic diseases.

A chimeric IgE that mimics IgE from patients allergic to acid-hydrolyzed wheat proteins is a novel tool for in vitro allergenicity assessment of functionalized glutens.

BACKGROUND: Acid-hydrolyzed wheat proteins (acid-HWPs) have been shown to provoke severe allergic reactions in Europe and Japan that are distinct from classical wheat allergies. Acid-HWPs were shown to contain neo-epitopes induced by the deamidation of gluten proteins. However, products with variable rates of deamidation can be found. OBJECTIVES: In this work, we studied the effect of the extent of wheat proteins deamidation on its allergenicity. A recombinant chimeric IgE was produced and compared to patients' IgE for its capacity to assess the IgE-mediated triggering potential of acid-HWPs. METHODS: Sera from acid-HWP allergic patients were analyzed via ELISA and a functional basophil assay for their IgE reactivity to wheat proteins with different deamidation levels. A chimeric mouse/human IgE (chIgE-DG1) specific for the main neo-epitope, QPEEPFPE, involved in allergy to acid-HWPs was characterized with respect to its functionality and its reactivity compared to that of patients' IgE. RESULTS: Acid-HWPs with medium (30%) and high (50-60%) deamidation levels displayed a markedly stronger IgE binding and capacity to activate basophils than those of samples with weak (15%) deamidation levels. The monoclonal chIgE-DG1 allowed basophil degranulation in the presence of deamidated wheat proteins. ChIgE-DG1 was found to mimic patients' IgE reactivity and displayed the same ability to rank acid-HWP products in a degranulation assay. CONCLUSION: Increasing the deamidation level of products from 15% to 60% resulted in an approximately 2-fold increase in their antigenicity and a 100-fold increase in their eliciting potential. The chimeric ChIgE-DG1 may be a useful tool to evaluate functionalized glutens for their allergenic potential. By mimicking patient sera reactivity, chIgE-DG1 also provided data on the patients' IgE repertoire and on the functionality of certain repeated epitopes in gluten proteins.

Immediate Hypersensitivity Reaction to Chemotherapeutic Agents.

An increase by 70% in new cases of cancer is expected over the next 2 decades, with more than 8 million people dying each year from the disease, an estimated 13% of all deaths worldwide. Several new chemotherapeutic agents have been rapidly developed and many of them approved through a fast-track process. In parallel, adverse reactions to chemotherapy have increased dramatically worldwide, frequently preventing the use of first-line therapy for cancer and jeopardizing patients' treatment outcomes. The present review focuses on immediate hypersensitivity reactions (IHRs) induced by chemotherapeutic agents. We address general features of these reactions and specific characteristics of the most prevalent agents involved. On the basis of scientific evidence, we suggest classifying acute reactions to chemotherapy as toxic, systemic inflammatory response syndrome, and IHRs (anaphylactic-type reactions). IHRs to chemotherapeutic agents are unpredictable adverse reactions with potentially lethal consequences. Correct diagnosis and proper management of oncologic patients with IHRs are fundamental in order not to deprive them of the first-line treatment for their disease. In this scenario, rapid drug desensitization is a groundbreaking procedure that enables selected patients to receive the drug that induced an IHR in a safe way, minimizing the risks of anaphylaxis and treatment failure.

Oxaliplatin hypersensitivity: evaluation, implications of skin testing, and desensitization.

BACKGROUND: Oxaliplatin hypersensitivity (OXS) presents a challenge in the treatment of oxaliplatin-sensitive malignancies. OBJECTIVE: To analyze patient characteristics of patients with OXS, skin test results, and desensitization outcomes to optimize management. METHODS: Over 5 years, 48 patients with OXS were referred to the allergy/immunology unit at Massachusetts General Hospital. Their clinical reaction patterns were analyzed. Immediate hypersensitivity skin testing was used for risk stratification, and drug desensitizations were performed by using 3 related continuous intravenous protocols that were chosen based on clinical history, skin test reactivity, and the patients' previous desensitization outcomes. RESULTS: OXS occurred in both sexes, with mostly gastrointestinal-related tumors. Hypersensitivity reaction (HSR) onset had occurred during any course of therapy (course nos. 1-28), with a median onset at course no. 8. HSR to oxaliplatin was similar to those observed with cisplatin and carboplatin, including cutaneous, cardiovascular, pulmonary, and gastrointestinal symptoms. However, neurologic symptoms, including tingling, and systemic symptoms, including fever and chills, occurred more often in patients with OXS. Unique to OXS, 2 patients developed drug-induced thrombocytopenia; 1 patients also developed drug-induced hemolytic anemia. Skin testing was positive for the majority of patients with OXS (27/46 [59%]) and correlated with a greater likelihood of developing an HSR during subsequent desensitizations. We safely performed 200 desensitizations in 48 patients with OXS. CONCLUSION: OXS is common with much similarity to other platin agents but also have distinct differences in the onset of hypersensitivity, sex, tumor type, drug-induced hemolytic anemia, and drug-induced thrombocytopenia. Skin testing was helpful for risk stratification. All of the desensitizations were completed successfully.

The usefulness of biomarkers of airway inflammation in managing asthma.

The goal of managing asthma is to maintain disease control. Current approaches to assessment of control do not include measurement of airway inflammation. This study was designed to assess the usefulness of biomarkers of airway inflammation in guiding asthma management decisions. A literature review was performed. Bronchial biopsy is a direct measure of airway inflammation but not practical for routine use. Enumeration of sputum eosinophils is very useful in guiding changes in controller medication to decrease asthma exacerbations, whereas measurement of exhaled nitric oxide has not proven to be useful in this regard. Serial measurement of airway hyperreactivity as a guide to asthma management yields inconclusive results. Use of indirect stimuli for bronchial challenge offers both practical and theoretical advantages in the assessment of airway hyperreactivity. Data on the analysis of exhaled breath condensate have not yet been studied adequately in guiding management decisions. Enumeration of sputum cell counts appears to be the most useful biomarker of airway inflammation in guiding asthma management decisions. Combined approaches using simple methods of measuring airway hyperreactivity and obtaining sputum samples hold promise for the future, particularly if rapid analysis of cellular products in sputum can be developed.