BAT in the Diagnosis of Drug Allergy: a Novel Tool in Clinical Daily Practice?

PURPOSE OF REVIEW: The aim of this study is to critically review the relevant literature published on basophil activation test, presenting the current knowledge and future perspectives. RECENT FINDINGS: Basophil activation test (BAT) results varied accordingly to the class of the drug studied, and have promising results in immediate hypersensitivity reactions to pyrazolone (selective reactors), neuromuscular blockers, beta-lactams, and platinum compounds, all examples of classical IgE-mediated hypersensitivity drug reactions. Currently, BAT is applied in research settings, but based in the results of our review, the test can be considered as a diagnostic tool for daily practice for selected patients and selected drugs, when the test is available, particularly for patients who experienced severe reactions and when diagnosis cannot be stablished by serum-specific IgE and skin testing, in order to avoid unnecessary drug provocations tests.

Increased gene expression of inflammatory markers in nasal turbinate of patients with persistent allergic rhinitis and chronic obstruction.

PURPOSE: The pathogenesis of persistent allergic rhinitis with chronic and refractory nasal obstruction is still unknown. Inflammation and tissue remodeling are known to play a role, but this has not been studied thoroughly. The purpose of this study is to identify the profile of gene expression of inflammatory and remodeling markers in nasal mucosa of patients with PAR and chronic obstruction. METHODS: After informed consent, we obtained nasal mucosa tissue from five aeroallergen-sensitized PAR patients undergoing anterior turbinectomy, and control non-sensitized individuals undergoing cerebrospinal fluid fistula repair or rhinoplasty. We assessed the expression of 34 genes related to inflammation and tissue remodeling using the real-time polymerase chain reaction (qPCR) to quantify each mRNA. RESULTS: IL-4 mRNA was upregulated in nasal mucosa of all five patients; CCR3, CCR8 and Eotaxin-2 were upregulated in four out of five patient samples; while IL-5 and IL-13 were upregulated in two of them. TGF-ß1 was not upregulated in PAR samples. mRNA from metalloproteinases MMP-7, MMP13 and MMP15 were upregulated in three out of five samples. Our results indicate a typical mRNA expression profile of the infiltrating inflammatory Th2 cells and eosinophils, combined with altered gene expression of remodeling-related proteins in stromal cells from the mucosa. CONCLUSION: Prolonged allergen challenge can lead to persistent upregulation of genes for inflammatory mediators such as IL-4 Th2/eosinophil cytokines, chemokines and receptors, which may play an important role in maintaining PAR with chronic nasal obstruction. Our findings may have therapeutic implications, including the use of anti-IL4, -CCR3 or -MMP therapy to ameliorate the condition.

A systemic review for measuring circular economy with multi-criteria methods.

Determining the circularity of a system through a criteria and indicators approach has been the focus of research in many branches of science. In this way, this work aims to review multiple criteria decision-making (MCDM) methods employed for measuring circular economy (CE) indicators and CE aspects at different levels (micro, meso, and macro). For this purpose, a systematic literature review (SLR) was conducted in ISI Web of Science and Scopus databases. Further, the results summarized 22 MCDM techniques, 27 CE aspects, and 36 CE indicators The SLR provides a concept map highlighting the relation of the level of circularity implementation (subdivided into micro-, meso-, and macro-levels) and MCDM techniques and demonstrates the interaction between CE aspects and indicators. The review provides an outline as to how MCDM techniques can solve problems related to CE aspects and marks the relevance in the use of CE indicators to support circularity aspects and to construct criteria in the methodologies applied.

Basophil Activation Test as a Biomarker for Taxanes Anaphylaxis.

Introduction: Taxanes are widely used chemotherapy agents, and their administration, despite premedication, is associated with hypersensitivity reactions (HR) in up to 9% of patients, 1% of which are severe. The mechanisms of these reactions are not fully understood. Finding biomarkers for early diagnosis and better understanding the underlying mechanisms of these reactions are key to defining the best treatment strategy for patients. Methods: The purpose of this study was to evaluate the effectiveness of the basophil activation test (BAT) to diagnose patients with anaphylactic reactions to taxanes. Patients with anaphylaxis to taxane compounds (n = 15) were assessed through clinical history, skin testing (when possible), and BAT. BAT was performed immediately before rapid drug desensitization or before skin testing using anti-CD123 conjugated (APC-Biolegend), anti-HLADR conjugated (FITC-Biolegend) to gate Basophils and anti-CD63 conjugated (PE-Biolegend), and anti-CD203c conjugated (BV-Biolegend) to assess CD203c and CD63 expression on basophils under taxane stimulation. BAT was also performed in eight healthy volunteers. Results: BAT was positive for CD203c in eight out of 15 patients and for CD63 in four out of 15 patients and in two out of eight controls. The sensitivity for CD203c was 53%, the specificity was 87%, and the area under the curve was 0.66 (p = 0.19%). For CD63, these rates were 33%, 87%, and 0.6 (p = 0.4). In a subgroup analysis of patients with positive skin tests (11 patients), CD203c was positive in six patients (sensitivity of 54.5% and specificity of 87.5%), and CD63 was positive in five patients (sensitivity of 45% and specificity of 75%). Conclusions: BAT as a diagnostic tool for immediate hypersensitivity reactions to taxanes may be relevant in patients with selected phenotypes and endotypes, especially those with severe reactions or when the diagnosis cannot be established by the skin test. Increased expression of CD203c was more frequent than of CD63 in patients with positive results, and the sensitivity of this biomarker was higher in patient sub-group with positive skin tests, i.e., patients with IgE-mediated endotypes.

Environmental management performance for Brazilian industrials: measuring with the item response theory.

Growing challenges with respect to preserving the environment have forced changes in company operational structures. Thus, the objective of this article is to measure the evidence of Environmental Management using the Item Response Theory, based on website analysis from Brazilian industrial companies from sectors defined through the scope of the research. This is a qualitative, exploratory, and descriptive study related to an information collection and analysis instrument. The general view of the research problem with respect to the phenomenon under study in based on multi-case studies, with the methodological outline based on the theoretical reference used. Primary data was gathered from 270 company websites from 7 different Brazilian sectors and led to the creation of 26 items approved by environmental specialists. The results were attained with the measuring of Environmental Management evidence via the Item Response Theory, providing a clear order of the items involved based on each item's level of difficulty, quality, and propriety. This permitted the measurement of each item's quality and propriety, as well as that of the respondents, placing them on the same analysis scale. Increasing the number of items and companies involved is suggested fEor future research in order to permit broader sector analysis.

Avaliação de projetos sociais em ONGs da Grande Florianópolis: um estudo sobre modelos relacionados ao foco de atuação / An evaluation of social projects in Greater Florianópolis NGOs: a study on models that relate to the work focus

Este artigo tem como objetivo compreender como os modelos de avaliação de projetos sociais em cinco ONGs da Grande Florianópolis são influenciados em decorrência de sua matriz ideológica e natureza do foco de sua atuação. Com experiência e aplicabilidade no campo educacional, tais modelos estão sendo adaptados e utilizados em avaliações de projetos sociais. Assim, para se atingir este objetivo, buscou-se inicialmente identificar o campo reconhecido como terceiro setor e sua realidade formal, para depois apresentar os conceitos de ONGs e a evolução das avaliações em projetos sociais. Os diversos modelos de avaliações foram agrupados em abordagens similares em decorrência de sua atribuição de valor, fontes filosóficas e ideológicas, bem como predileções metodológicas. A presente pesquisa caracteriza-se como qualitativa, utilizando como estratégia de campo o estudo de caso, do tipo interpretativo que utilizou categorias conceituais, do tipo fechadas, e a análise de conteúdo como técnica de análise dos dados. Os resultados apontam para a constatação de que os modelos avaliativos são influenciados pela natureza de atuação das ONGs estudadas, por crenças filosóficas e ideológicas e predileções metodológicas.

Avaliação da produção e qualidade do gás de aterro para energia no aterro sanitário dos Bandeirantes - SP / Evaluation of the production and quality of the landfill gas to energy at Bandeirantes landfill - SP

O presente trabalho apresenta os primeiros resultados da avaliação da produção e qualidade do gás para a geração de energia em um aterro sanitário. Foram monitorados parâmetros de qualidade do biogás, pressão exercida pelo sistema e volume de gás extraído. A partir do acompanhamento desses parâmetros, foram feitas três análises em diferentes situações que pudessem explicar o comportamento dos parâmetros: uma análise com poços em diferentes profundidades e duas análises a caráter de comparação: (a) poços conectados ao sistema de captação por extração ativa; e (b) poços não conectados ao sistema de captação, com extração passiva. Os resultados demonstraram que poços em profundidade intermediária apresentam as maiores produções e qualidade do gás e poços com extração passiva em relação à ativa tiveram diferenças significativas dos parâmetros acompanhados.

The present work shows the initial results of the evaluation of production and quality of the landfill gas to energy. Parameters of quality, pressure exerted by the system and volume of extracted landfill gas had been monitored. From the accompaniment of these parameters, three different analyses in different situations could explain the behavior of the wells: one analysis of wells in different depths, and two comparison analyses: (a) wells hardwired to the system of collection for active extraction; and (b) wells not hardwired to the collection system, with passive extraction. The results demonstrated that wells at intermediate deep have the highest yields and quality of gas and wells with passive extraction in relation to the active ones had significant differences of the monitored parameters.

Antileucotrienos em asmáticos corticodependentes – relato de seis casos / Antileukotriene in steroid dependent asthma – report of six cases

Objetivo: Descrever a experiência com o uso de antileucotrienos em seis pacientes com asma grave corticodependente, acompanhados no Serviço de Alergia e Imunopatologia do Hospital do Servidor Público Estadual de São Paulo. Pacientes e métodos: Por um período de três meses os pacientes maiores de doze anos receberam aleatoriamente zafirlucaste 20mg de 12/12h ou montelucaste 10mg/dia e os menores de 12 anos montelucaste 5mg/dia. Os parâmetros avaliados foram: necessidade do uso diário de corticosteróides sistêmicos (oral), escore clínico de sintomas, prova de função pulmonar realizada antes da introdução da medicação e após três meses de acompanhamento. Resultados: Houve melhora do escore clínico em todos os pacientes (exceto um), melhora da prova de função pulmonar em apenas três dos pacientes, porém todos reduziram de forma significativa o uso diário de corticosteróides sistêmicos. Conclusão: Concluímos que na população avaliada, os pacientes em muito se beneficiaram com o uso de antileucotrienos, sugerindo que esta medicação tenha um papel no tratamento da asma grave corticodependente, para tanto, novos estudos serão necessários.