Diagnostic capacity of commercial extracts vs prick-by-prick in the study of sensitization to peanut: which technique should we use?

No disponible

IgE-Mediated Sensitization to Galactose-α-1,3- Galactose (α-Gal) in Urticaria and Anaphylaxis in Spain: Geographical Variations and Risk Factors.

BACKGROUND: The objectives of this study were to investigate the prevalence of sIgE to galactose-α-1,3-galactose (α-gal) in individuals with acute urticaria or anaphylaxis from different geographical areas of Spain and to evaluate the relevance of demographics and lifestyle as risk factors for this immune response. METHODS: Participants were recruited from allergy departments at 14 Spanish hospitals. Patients aged 18 years or older presenting with urticaria or anaphylaxis were enrolled into one of 2 arms: cases and controls. An interviewer-administered questionnaire collecting demographic data, lifestyle habits, and the presence of cofactors was obtained from each participant. sIgE to α-gal and total IgE were determined using ImmunoCAP. sIgE levels ≥0.35 kU/L were considered a positive result. RESULTS: The study population comprised 160 cases and 126 controls. The median age was 44 years. The overall prevalence of a positive result of sIgE to α-gal was 15.7%; this was higher in cases (26.3%) than in controls (2.4%). The sIgE anti-α-gal positivity rate ranged from 37.68% (rural) to 15.38% (semiurban), and 7.85% (urban). The rates of positivity were 46.32%, (Northern), 0.72% (Center), and 0% (Mediterranean). A positive result for sIgE to α-gal was associated with a history of tick bites, participation in outdoor activities, pet ownership, and ingestion of mammalian meats or innards before the onset of symptoms. Only alcohol consumption could be implicated as a cofactor. CONCLUSION: Sensitization to α-gal in patients with urticaria or anaphylaxis differs considerably between the 3 geographical areas studied and is related to tick bites.

IgE-mediated sensitization to galactose-alfa-1.3-galactose (alfa-Gal) in urticaria and anaphylaxis in Spain: geographical variations and risk factors

BACKGROUND: The objectives of this study were to investigate the prevalence of sIgE to galactose-alfa-1,3-galactose (alfa-gal) in individuals with acute urticaria or anaphylaxis from different geographical areas of Spain and to evaluate the relevance of demographics and lifestyle as risk factors for this immune response. METHODS: Participants were recruited from allergy departments at 14 Spanish hospitals. Patients aged 18 years or older presenting with urticaria or anaphylaxis were enrolled into one of 2 arms: cases and controls. An interviewer-administered questionnaire collecting demographic data, lifestyle habits, and the presence of cofactors was obtained from each participant. sIgE to alfa-gal and total IgE were determined using ImmunoCAP. sIgE levels ≥0.35 kU/L were considered a positive result. RESULTS: The study population comprised 160 cases and 126 controls. The median age was 44 years. The overall prevalence of a positive result of sIgE to alfa-gal was 15.7%; this was higher in cases (26.3%) than in controls (2.4%). The sIgE anti-alfa-gal positivity rate ranged from 37.68% (rural) to 15.38% (semiurban), and 7.85% (urban). The rates of positivity were 46.32%, (Northern), 0.72% (Center), and 0% (Mediterranean). A positive result for sIgE to alfa-gal was associated with a history of tick bites, participation in outdoor activities, pet ownership, and ingestion of mammalian meats or innards before the onset of symptoms. Only alcohol consumption could be implicated as a cofactor. CONCLUSION: Sensitization to alfa-gal in patients with urticaria or anaphylaxis differs considerably between the 3 geographical areas studied and is related to tick bites

ANTECEDENTES: Investigar la prevalencia de IgE específica a galactosa-alfa-1,3-galactosa (alfa-gal) en sujetos con urticaria aguda o anafilaxia de diferentes zonas geográficas de España y evaluar la relevancia de factores demográficos y de estilo de vida como factores de riesgo para esta respuesta inmunológica. MÉTODOS: Pacientes de 18 años o mayores con urticaria o anafilaxia fueron reclutados en los Departamentos de Alergia de 14 hospitales españoles e incluidos en uno de dos grupos; casos o controles. Se recogieron datos demográficos, de estilo de vida y la presencia de cofactores. La IgE total e IgE especifica a alfa-gal se determinaron mediante ImmunoCAP. Niveles de IgE específica ≥0,35 kU/L fueron considerados como positivos. RESULTADOS: Se reclutaron 160 casos y 126 controles. La mediana de edad fue 44 años. La prevalencia global de positividad de IgE específica a alfa-gal fue 15,7%; siendo mayor en casos (26,3%) que en controles (2,4%) y oscilando entre 37,68% (rural) a 15,38% (semiurbano) y 7,85% (urbano). Las frecuencias de positividad fueron 46,32%, (Norte), 0,72% (Centro), y 0% (Mediterráneo). La positividad de IgE específica a alfa-gal se asoció a haber experimentado picadura de garrapata, participación en actividades de exterior, tenencia de mascotas e ingestion de carne de mamíferos o visceras previo al inicio de los síntomas. Solo el consumo de alcohol podía ser implicado como cofactor. CONCLUSIÓN: La sensibilización a alfa-gal en pacientes con urticaria o anafilaxia difiere considerablemente entre las tres zonas estudiadas y está relacionada con picadura de garrapata

Immediate Reactions to More Than 1 NSAID Must Not Be Considered Cross-Hypersensitivity Unless Tolerance to ASA Is Verified.

BACKGROUND AND OBJECTIVES: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Objective: To identify patients with SRs to 2 or more NSAIDs including strong COX-1 inhibitors. METHODS: Patients who attended the Allergy Service of Hospital Infanta Leonor, Madrid, Spain with DHRs to NSAIDs between January 2011 and December 2014 were evaluated. Those with 2 or more immediate reactions occurring in less than 1 hour after intake were included. After confirming tolerance to ASA, the selectivity of the response to 2 or more NSAIDs was demonstrated by in vivo and/or in vitro testing or by controlled administration. RESULTS: From a total of 203 patients with immediate DHRs to NSAIDs, 16 (7.9%) met the inclusion criteria. The patients presented a total of 68 anaphylactic or cutaneous reactions (mean [SD], 4.2 [2.1]). Most reactions were to ibuprofen and other arylpropionic acid derivatives and to metamizole. Two different NSAIDs were involved in 11 patients and 3 in 5 patients. CONCLUSIONS: Patients with NSAID-induced anaphylaxis or urticaria/angioedema should not be considered cross-hypersensitive unless tolerance to ASA is verified.

Food allergy in Catalonia: Clinical manifestations and its association with airborne allergens

BACKGROUND: Food allergy affects around 6% of the European population and its prevalence worldwide has been increasing in the last decades, but studies focused on investigating food allergy epidemiology in Europe are lacking. OBJECTIVE: The Cibus project was created to register the main culprit foods and their clinical manifestations in food allergic patients in Catalonia. METHODS: A specific online database was designed. Allergists from eight different Catalan hospitals registered the new diagnoses of food allergy. RESULTS: 618 food allergic patients were included. Egg and milk were the main elicitors in the early ages, while fruits and nuts were the most frequent in patients >14 years old. Fish was more frequent in children, while seafood and Anisakis allergy were more frequent in the >14-year-old group. Overall, peach was the most prevalent food eliciting an allergic reaction (10%). Food allergy diagnosis was reached using compatible clinical history and positive skin prick test to the involved food in 98% of cases. Globally, urticaria was the most frequently reported manifestation in our population (48.2%), followed by oral allergy syndrome (25.6%) and anaphylaxis (24.8%). CONCLUSIONS: The Cibus project gives a full overview of the profile of food allergic patients in Catalonia and reinforces the predominance of plant food allergies in the Mediterranean area

No disponible

Food allergy in Catalonia: Clinical manifestations and its association with airborne allergens.

BACKGROUND: Food allergy affects around 6% of the European population and its prevalence worldwide has been increasing in the last decades, but studies focused on investigating food allergy epidemiology in Europe are lacking. OBJECTIVE: The Cibus project was created to register the main culprit foods and their clinical manifestations in food allergic patients in Catalonia. METHODS: A specific online database was designed. Allergists from eight different Catalan hospitals registered the new diagnoses of food allergy. RESULTS: 618 food allergic patients were included. Egg and milk were the main elicitors in the early ages, while fruits and nuts were the most frequent in patients >14 years old. Fish was more frequent in children, while seafood and Anisakis allergy were more frequent in the >14-year-old group. Overall, peach was the most prevalent food eliciting an allergic reaction (10%). Food allergy diagnosis was reached using compatible clinical history and positive skin prick test to the involved food in 98% of cases. Globally, urticaria was the most frequently reported manifestation in our population (48.2%), followed by oral allergy syndrome (25.6%) and anaphylaxis (24.8%). CONCLUSIONS: The Cibus project gives a full overview of the profile of food allergic patients in Catalonia and reinforces the predominance of plant food allergies in the Mediterranean area.

Immediate reactions to more than 1 NSAID must not be considered cross-hypersensitivity unless tolerance to ASA is verified

Background: Individuals who develop drug hypersensitivity reactions (DHRs) to chemically unrelated nonsteroidal anti-inflammatory drugs (NSAIDs) are considered cross-hypersensitive. The hallmark for this classification is that the patient presents a reaction after intake of or challenge with acetylsalicylic acid (ASA). Whether patients react to 2 or more NSAIDs while tolerating ASA remains to be studied (selective reactions, SRs). Objective: To identify patients with SRs to 2 or more NSAIDs including strong COX-1 inhibitors. Methods: Patients who attended the Allergy Service of Hospital Infanta Leonor, Madrid, Spain with DHRs to NSAIDs between January 2011 and December 2014 were evaluated. Those with 2 or more immediate reactions occurring in less than 1 hour after intake were included. After confirming tolerance to ASA, the selectivity of the response to 2 or more NSAIDs was demonstrated by in vivo and/or in itro testing or by controlled administration. Results: From a total of 203 patients with immediate DHRs to NSAIDs, 16 (7.9%) met the inclusion criteria. The patients presented a total of 68 anaphylactic or cutaneous reactions (mean [SD], 4.2 [2.1]). Most reactions were to ibuprofen and other arylpropionic acid derivatives and to metamizole. Two different NSAIDs were involved in 11 patients and 3 in 5 patients. Conclusions: Patients with NSAID-induced anaphylaxis or urticaria/angioedema should not be considered cross-hypersensitive unless tolerance to ASA is verified (AU)

Introducción: Los individuos que desarrollan reacciones de hipersensibilidad a antiinflamatorios no esteroideos (AINE) no relacionados químicamente se consideran intolerantes cruzados. La característica esencial para ser incluidos en esta categoría es que presenten un resultado positivo tras la administración de AAS. La cuestión de si estos pacientes responden a dos o más AINE y toleran AAS no ha sido estudiada (reacciones selectivas a múltiples AINE, RS). Objetivos: Identificar pacientes con RS a dos o más AINE, incluidos inhibidores potentes de COX-1. Métodos: Se evaluaron los pacientes que acudieron al servicio de alergia del Hospital Infanta Leonor con una historia de hipersensibilidad a AINE desde enero de 2011 a diciembre de 2014. Únicamente se consideraron los casos con dos o más reacciones a AINE diferentes y que se produjeron durante la primera hora tras la ingesta del fármaco (reacciones inmediatas). Tras confirmar la tolerancia a AAS, se evaluó la selectividad de la reacción mediante pruebas in vivo/in vitro o administración controlada del medicamento. Resultados: De un total de 203 pacientes con reacciones inmediatas a AINE 16 (7,9%) se ajustaron a los criterios establecidos. Los pacientes presentaron 68 reacciones anafilácticas o urticaria/angioedema (media de 4,2±2,1). El ibuprofeno y otros derivados arilpropiónicos y el metamizol fueron los fármacos más frecuentemente implicados. En 11 pacientes las reacciones fueron inducidas por dos AINE diferentes, mientras que en otros 5 fueron tres los medicamentos implicados. Conclusiones: Los pacientes con anafilaxia o urticaria/angioedema a diferentes AINE no deben ser incluidos dentro del grupo de intolerancia cruzada hasta verificar su tolerancia a AAS (AU)

Relevance of Allergenic Sensitization to Cynodon dactylon and Phragmites communis: Cross-reactivity With Pooideae Grasses.

BACKGROUND AND OBJECTIVES: The homologous group of sweet grasses belongs to the Pooideae subfamily, but grass pollen species from other subfamilies can also cause allergy, such as Cynodon dactylon (Chloridoideae) and Phragmites communis (Arundinoideae). C dactylon and P communis have not been included in the sweet grasses homologous group because of their low cross-reactivity with other grasses. The aims of this study were to investigate the profile of sensitization to C dactylon and P communis in patients sensitized to grasses and to analyze cross-reactivity between these 2 species and temperate grasses. METHODS: Patients were skin prick tested with a grass mixture (GM). Specific IgE to GM, C dactylon, P communis, Cyn d 1, and Phl p 1 was measured by ImmunoCAP. A pool of sera was used for the immunoblot assays. Cross-reactivity was studied by ELISA and immunoblot inhibition. RESULTS: Thirty patients had sIgE to GM. Twenty-four (80%) had positive results for C dactylon, 27 (90%) for P communis, 22 (73.3%) for nCyn d 1, and 92.9% for rPhl p 1. Bands were detected in the 3 extracts by immunoblot. Inhibition of GM was not observed with C dactylon or P communis by immunoblot or ELISA inhibition. When C dactylon or P communis were used in the solid phase, GM produced almost complete inhibition. CONCLUSIONS: Eighty percent of patients sensitized to grasses were also sensitized to C dactylon and 90% were sensitized to P communis. Sensitization to these species seems to be induced by allergens different to those in sweet grasses.

Nonsteroidal anti-inflammatory drugs enhance IgE-mediated activation of human basophils in patients with food anaphylaxis dependent on and independent of nonsteroidal anti-inflammatory drugs.

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) act as cofactors worsening the allergic reactions induced by food allergens. AIM: The aim of this study was to evaluate the effect of both lysine acetylsalicylate (L-ASA) (non-selective cyclooxygenase (COX) inhibitor) and valdecoxib (selective COX-2 inhibitor) in basophils activated by peach lipid transfer protein (Pru p 3) in patients with food-dependent NSAID-induced anaphylaxis (FDNIA). METHODS: Twenty Pru p 3-allergic patients with FDNIA group, eleven peach anaphylaxis not exacerbated by NSAIDs (no-NSAID group) and 5 healthy volunteers were recruited. Basophil activation (BA) was measured as expression of CD63 (Flow(2) CAST(™) ; Bühlmann(®) ), after stimulation with Pru p 3, both alone and in combination with L-ASA (1.13, 3.38 and 6.78 mm) or valdecoxib (0.87, 7.8 and 31.25 µm). RESULTS: Basophils from no-NSAID group were significantly more reactive and sensitive to Pru p 3 than those from the FDNIA group. In both groups, an increase in BA was observed when basophils were exposed to Pru p 3 and L-ASA. In the FDNIA group, valdecoxib partially terminates the BA induced by Pru p 3, whereas in the no-NSAID group, a dual effect was observed depending on the concentration tested. CONCLUSIONS: This study indicates that subjects with food-induced anaphylaxis differ from FDNIA subjects in the higher reactivity and sensitivity of their basophils to allergen challenge. We have shown a direct effect of NSAIDs on basophils using a human model of FDNIA. Our results also suggest that selective COX2 inhibitors might be a safe alternative. BA test may be a useful tool in the study of the pathogenic mechanism of the cofactor phenomenon.

Molecular cloning of plane pollen allergen Pla a 3 and its utility as diagnostic marker for peach associated plane pollen allergy.

BACKGROUND: Non-specific lipid transfer proteins (nsLTP) are considered to provoke allergic symptoms to plane tree pollen, which are frequently associated with peach allergy. OBJECTIVE: The objective was to clone the cDNA of plane pollen nsLTP Pla a 3, to characterize IgE-binding and allergenic potency of recombinant Pla a 3 in comparison to its natural counterpart and peach nsLTP Pru p 3. METHODS: Natural Pla a 3 was purified from plane pollen and analysed by mass spectrometry (MS). Recombinant Pla a 3 was characterized by SDS-PAGE and CD spectroscopy. Specific IgE to extract, components of plane pollen and Pru p 3 was measured by ImmunoCAP in sera of patients allergic to either plane pollen (n = 10), peach (n = 15) or both (n = 15). Biological potency of the proteins was investigated by in vitro mediator release assays and IgE cross-reactivity by competitive ELISA. RESULTS: Two Pla a 3 isoforms were identified. Recombinant Pla a 3 showed high purity, structural integrity, IgE-binding capacity comparable to nPla a 3 and biological potency. Sensitization to plane pollen extract was confirmed in 24/25 plane pollen allergics. The frequency of sensitization to Pla a 3 was 53% among patients allergic to both plane pollen and peach and 10% among plane pollen allergics tolerating peach where most patients were sensitized to Pla a 1. Pla a 3 and Pru p 3 showed strong bi-directional IgE cross-reactivity in patients allergic to peach and plane pollen, but not in peach allergics tolerating plane pollen. Levels of IgE-binding were generally higher to Pru p 3 than to Pla a 3. CONCLUSION: Sensitization to Pla a 3 is relevant in a subgroup of plane pollen allergics with concomitant peach allergy. IgE testing with Pla a 3 may serve as a marker to identify plane pollen allergic patients at risk of LTP-mediated food reactions and thereby improve in vitro diagnostic procedures.

Potentially inappropriate prescription in patients with a history of allergy to Beta-lactam antibiotics: a health care challenge

No disponible

Relevance of allergenic sensitization to cynodon dactylon and Phragmites communis: cross-reactivity with pooideae grasses

Background and Objectives: The homologous group of sweet grasses belongs to the Pooideae subfamily, but grass pollen species from other subfamilies can also cause allergy, such as Cynodon dactylon (Chloridoideae) and Phragmites communi (Arundinoideae). C dactylon and P communis have not been included in the sweet grasses homologous group because of their low cross-reactivity with other grasses. The aims of this study were to investigate the profile of sensitization to C dactylon and P communis in patients sensitized to grasses and to analyze cross-reactivity between these 2 species and temperate grasses. Methods: Patients were skin prick tested with a grass mixture (GM). Specific IgE to GM, C dactylon, P communis, Cyn d 1, and Phl p 1 was measured by ImmunoCAP. A pool of sera was used for the immunoblot assays. Cross-reactivity was studied by ELISA and immunoblot inhibition. Results: Thirty patients had sIgE to GM. Twenty-four (80%) had positive results for C dactylon, 27 (90%) for P communis, 22 (73.3%) or nCyn d 1, and 92.9% for rPhl p 1. Bands were detected in the 3 extracts by immunoblot. Inhibition of GM was not observed with C dactylon or P communis by immunoblot or ELISA inhibition. When C dactylon or P communis were used in the solid phase, GM produced almost complete inhibition. Conclusions: Eighty percent of patients sensitized to grasses were also sensitized to C dactylon and 90% were sensitized to P communis. Sensitization to these species seems to be induced by allergens different to those in sweet grasses (AU)

Antecedentes y Objetivos: Desde un punto de vista taxonómico, el grupo homólogo de las gramíneas pertenece a la sub-familia Pooideae. Sin embargo, existen también otras especies de gramíneas alergénicas que pertenecen a sub-familias diferentes como son Cynodon dactylon (Chloridoideae) o Phragmites communis (Arundinoideae). C. dactylon y P. communis no están incluidas en este grupo homólogo debido a que la reactividad cruzada con otras gramíneas es limitada. Los objetivos del estudio fueron investigar el perfil de sensibilización a C. dactylon y P. communis en pacientes sensibilizados a gramíneas y analizar la reactividad cruzada entre estas dos especies y las gramíneas más comunes. Métodos: A los pacientes se les realizó una prueba cutánea con una mezcla de gramíneas (MG). Mediante ImmunoCAP se midió la IgE específica para MG, C. dactylon P. communis , Cyn d 1 y Phl p 1. Un pool de sueros se utilizó para ensayos de inmunoblot. La reactividad cruzada se estudió mediante ELISA e inmunoblot inhibición Resultados: Treinta pacientes tuvieron IgE específica para MG. Veinticuatro (80%) fueron positivos a C. dactylon, 27 (90%) a P. communis, 22 (73,3%) a nCyn d 1 y 92,9% fueron positivos a rPhl p 1. Se detectaron bandas en los tres extractos mediante inmunoblot. No se observó inhibición de MG con las otras dos especies mediante inmunoblot o ELISA inhibición. Cuando C. dactylon o P. communis se usaron en fase sólida, MG produjo una inhibición casi completa. Conclusiones: El 80% de los pacientes sensibilizados a gramíneas estaban también sensibilizados a C. dactylon y el 90% a P. communis. La sensibilización a estas especies parece estar inducida por diferentes alérgenos que en el caso de gramíneas (AU)

Analyzing phonetic confusions using formal concept analysis.

Confusion matrices have been used as a tool for the analysis of speech perception or human speech recognition (HSR) for decades. However, they are rarely employed in automatic speech recognition (ASR) mainly due to the lack of a systematic procedure for their exploration. The generalization of formal concept analysis employed in this paper provides a conceptual interpretation of confusion matrices that enables the analysis of the structure of confusions for both human and machine performances. Generalized formal concept analysis transforms confusion matrices into ordered lattices of confusion events, supporting classic results in HSR that identify a hierarchy of virtual articulatory-acoustic channels. Translating this technique into ASR, a detailed map of the relationships among the speech units employed in the system can be traced to make different sources of confusions apparent: the influence of the lexicon, segmentation errors, dialectal variations or limitations of the feature extraction procedures, among others.