Managing systemic reactions and venom immunotherapy in vespid-venom allergy: observations from a retrospective study of Portuguese patients.

Summary: Background. Vespula spp. and Polistes spp. are relevant species in South Europe, with Vespa velutina nigrithorax (VVN) being considered a public health problem. We aimed to characterize a cohort of Portuguese patients referred for large local reaction (LLR) and/or systemic reaction (SR) to vespids. In patients treated with venom immunotherapy (VIT), induction protocol and frequency of adverse reactions were evaluated. Methods. Retrospective study including patients with LLR and SR to vespids referred to our Immunoallergology Department (2008-2022). Results. A total of 129 patients were evaluated, the majority were male adults (n = 77, 59.7%), from rural areas. From these, 51 patients had SR (Mueller classification: 7.8% grade I, 19.6% grade II, 37.3% grade III, 35.3% grade IV). We found no differences regarding the levels of total serum IgE, basal serum tryptase value, sIgE levels to the eliciting venom or their molecular components, regarding the severity of the SR that motivated the referral to our clinic. In the SR group, previous LLR Hymenoptera sting were reported in 15.7%. Thirty-eight patients (74.5%) initiated VIT: 22 with wasp venom, 14 with paper wasp venom and 2 with Vespa velutina venom. There was one mild systemic reaction, not requiring adrenaline and 4 LLR. Re-stings after VIT occurred in 16 patients, without any systemic or local reactions. Currently, eleven patients remain under VIT. Conclusions. Most vespid-venom allergic patients are male adults from rural areas. Sensitization to wasp venom was present in 52.9%, paper wasp in 33.3% and Vespa velutina in 13.7%. The frequency of adverse reactions during both induction and maintenance phases appears to be low. Despite a reduced sample size, our experience with VVN VIT, suggests its safety.

Molecular sensitization profile to grass and olive pollens in Portugal.

Summary: Background. Grass and olive pollens have overlapping pollination periods and are common allergens in the Iberian Peninsula. The objective is to determine the sensitization pattern to major Phleum pratense and Olea europaea pollens in the Portuguese population with pollen allergic rhinitis (AR) using molecular allergen diagnosis (MAD). Methods. Seasonal AR patients (≥ 12 years), with positive skin prick tests (SPT) to Phleum and Olea were recruited from 16 centers. Using ALEX2, specific IgE to Phl p1, Phl p2, Phl p5, Phl p6, Phl p7, Phl p 12, Ole e1, Ole e7 and Ole e9 were determined. Immunoblotting of Olea allergic patients was performed. Results. Included 175 patients (55.4% female; mean age 31.6 ± 13.3 years; 85.7% adults; 40% asthmatic, Coast 28%/Inland 72% and North 29.1%/Centre 20.6%/South 50.3%). Considering Phleum MAD, 85.7% were sensitized to Phl p1, 45.7% to Phl p2, 50.3% to Phl p5, 45.7%, to Phl p6, 10.9% to Phl p7 and 22.9% to Phl p12. Sensitization to Ole e1 was found in 56.6%, to Ole e7 in 1.7% and Ole e9 in 3.4% patients. Sensitization to Phl p7 was more frequent in asthmatics (17.4% vs 6.6%; p = 0.044). Sensitization to Phl p5, Phl p6, Phl p12 and Ole e1 was more frequent in inland. Regarding sensitization patterns: 53.1% patients were sensitized to both species genuine´ sIgE, 38.3% to Phleum and 3.4% only to Olea species' sIgE. Immunoblotting of Olea allergic patients showed a high intensity band that may correspond to Ole e12. Conclusions. MAD showed "genuine" Grass and Olea sensitization in approximately 50% of our patients.

Successful removal of fluoride from aqueous environment using Al(OH)3@AC: column studies and breakthrough curve modeling.

In this study, we discuss the removal of fluoride from water through column adsorption methods using Al(OH)3@AC as a functional granular activated carbon. The height of the bed, fluoride concentration, and flow rate are the experimental factors used to obtain the breakthrough curves. As the flow rate increased, the breakthrough and saturation times decreased. The analysis of simplified column models, such as the Adams-Bohart, Thomas, and Yoon-Nelson models, revealed that the Clark model best described the adsorption process when fitting the experimental data. The obtained breakthrough curves agreed with the corresponding experimental data. The highest capacity for adsorption obtained during the column procedure was found to be 41.84 mg g-1 with a bed height of 3 cm, an initial fluoride concentration of 10 mg L-1 and a flow rate of 7.5 mL min-1.

Molecular Profile of Sensitization to Dermatophagoides pteronyssinus Dust Mite in Portugal

Objective: To analyze component-resolved diagnosis of sensitization to Dermatophagoides pteronyssinus (Der p) in patients with respiratory allergy and the association between diagnostic findings and clinical severity in different geographical areas.Methods: The study population comprised 217 patients (mean age, 25.85 [12.7] years; 51.16% female) selected from 13 centers in Portugal (5 from the North, n=65). All had allergic rhinitis with or without asthma and positive skin prick test results to at least 1 dust mite. Specific IgE (sIgE) to Der p, Dermatophagoides farinae, Lepidoglyphus destructor, Der p 1, Der p 2, Der p 10, and Der p 23 was determined using ImmunoCAP. The Mann-Whitney test was applied for the following comparisons: rhinitis vs rhinitis and asthma; mild vs moderate-to-severe rhinitis; North vs South.Results: The prevalence of sensitization was 98.2% for Der p, and 72.4%, 89.4%, 9.7%, and 77% for Der p 1, Der p 2, Der p 10, and Der p 23, respectively. The corresponding median sIgE levels were 8.56, 17.7, 0.01, and 3.95 kUA/L. sIgE to all allergens was higher in patients with moderate-to-severe rhinitis and rhinitis with asthma (nonsignficant). Concentrations of sIgE to Der p 2 were significantly higher in the South than in the North (P=.0496).Conclusions: The most common sensitization in Portugal was to Der p. The highest prevalence and median sIgE level were observed for Der p 2. All sIgE values for molecular components were higher in more symptomatic patients (nonsignificant). Concentrations of sIgE to Der p 2 were higher in the South, probably because of the warmer temperature and/or the larger sample size (AU)

Objetivo: Analizar el diagnóstico por componentes para Dermatophagoides pteronyssinus (Der p) en pacientes con alergia respiratoria ysu relación con la gravedad clínica en diferentes áreas geográficas.Métodos: Se incluyeron 217 pacientes (edad media 25,85±12,7 años; 51,16% mujeres), seleccionados de 13 centros en Portugal (5 delNorte, n = 65). Todos tenían rinitis alérgica, con o sin asma, y tenían pruebas positivas en prick a al menos un ácaro del polvo. La IgEespecífica (sIgE) para Der p, Dermatophagoides farinae, Lepidoglyphus destructor, Der p 1, Der p 2, Der p 10 y Der p 23 se determinaronpor ImmunoCAP. El análisis estadístico (prueba U de Mann Whitney) comparó pacientes con rinitis frente a rinitis y asma; rinitis leve frentea moderada-grave; Norte frente a Sur.Resultados: La prevalencia de sensibilización fue del 98,2% para Der p, y del 72,4%, 89,4%, 9,7% y 77% para Der p 1, Der p 2, Der p 10y Der p 23, respectivamente. Las medianas de sIgE fueron de 8,56, 17,7, 0,01 y 3,95 kUA/ L. Las medianas de sIgE de todos los alérgenosfue mayor en pacientes con rinitis de moderada a grave y rinitis con asma, pero no estadísticamente significativo (NSS). El valor de Der p2 fue significativamente mayor en el Sur en comparación con el Norte (p = 0,0496).Conclusiones: La sensibilización a Der p es la más común en Portugal. Der p 2 tuvo la prevalencia más alta y los niveles medios más altos.Todos los componentes moleculares fueron mayores en pacientes más sintomáticos (NSS). El valor de Der p 2 fue mayor en el Sur, lo quepuede estar relacionado con la temperatura más cálida y/o el tamaño de muestra más grande (AU)

Salmon roe as an emerging allergen in western countries

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