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11.
Differences in reporting the ragweed pollen season using Google Trends across 15 countries
Jean Bousquet, Ioana Agache, Uwe Berger, Karl-Christian Bergmann, Jean-Pierre Besancenot, Philippe J. Bousquet, Thomas Casale, Gennaro d'Amato, Igor Kaidashev, Musa Khaitov, Ralph Mösges, Kristof Nekam, Gabrielle L. Onorato, Davor Plavec, Aziz Sheikh, Michel Thibaudon, Robert Vautard, Mihaela Zidarn, 2018, pregledni znanstveni članek

Povzetek: Background: Google Trends (GT) searches trends of specific queries in Google, which potentially reflect the real-life epidemiology of allergic rhinitis. We compared GT terms related to ragweed pollen allergy in American and European Union countries with a known ragweed pollen season. Our aim was to assess seasonality and the terms needed to perform the GT searches and to compare these during the spring and summer pollen seasons. Methods: We examined GT queries from January 1, 2011, to January 4, 2017. We included 15 countries with a known ragweed pollen season and used the standard 5-year GT graphs. We used the GT translation for all countries and the untranslated native terms for each country. Results: The results of "pollen," "ragweed," and "allergy" searches differed between countries, but "ragweed" was clearly identified in 12 of the 15 countries. There was considerable heterogeneity of findings when the GT translation was used. For Croatia, Hungary, Romania, Serbia, and Slovenia, the GT translation was inappropriate. The country patterns of "pollen," "hay fever," and "allergy" differed in 8 of the 11 countries with identified "ragweed" queries during the spring and the summer, indicating that the perception of tree and grass pollen allergy differs from that of ragweed pollen. Conclusions: To investigate ragweed pollen allergy using GT, the term "ragweed" as a plant is required and the translation of "ragweed" in the native language needed.
Ključne besede: allergy and immunology, allergens, seasonal allergic rhinitis, rhinitis, pollen, ambrosia, Google Trends, hay fever
Objavljeno v DiRROS: 20.11.2020; Ogledov: 1183; Prenosov: 257
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12.
Quantitative, absolute count-based T cell analysis of CD69 upregulation as a new methodology for in vitro diagnosis of delayed-type nickel hypersensitivity
Ana Koren, Mira Šilar, Helena Rupnik, Mihaela Zidarn, Peter Korošec, 2019, izvirni znanstveni članek

Povzetek: Background: T cells play a major role in delayed-type hypersensitivity reactions. Their reactivity can be assessed by measuring the upregulation of the activation marker CD69, followed by proliferation and cytokine production. The aim of our study was to develop a novel, whole blood-based, quantitative, absolute count activation index (AI) analysis of CD69 upregulation on different subsets of T cells in nickel hypersensitive patients and compare it with the previously reported approaches. Methods: Ten patients with nickel allergy and nine healthy controls were included. CD69 expression of CD3+, CD3+CD4+ and CD3+CD8+ T cells in heparinized blood was determined with flow cytometry after incubation with nickel sulfate for 48 h. The absolute cell count of CD69+ cells was determined with microbeads. The production of the cytokines IL-2, IL-5, IL-13, and IFN-[gamma] was determined after nickel sulfate stimulation of PBMNCs for 48 h. Results: We showed that the most sensitive methodology is the absolute AI, which was calculated as the ratio between the absolute count of CD69-positive T cells stimulated with nickel and the absolute count of CD69-positive T cells in non-stimulated blood. This novel quantitative approach was more discriminative than the previously reported approaches in which T cell CD69 percentage AI and cytokine production are measured. Conclusions: Our results demonstrated that measuring the absolute CD69 AI is an accurate new approach to quantify antigen-specific T cells in the blood of patients with hypersensitivity reactions to nickel. This approach may be useful for better in vitro assessment of patients with delayed-type hypersensitivity reactions.
Ključne besede: allergy and immunology, delayed hypresensitivity, nickel, blood, CD antigenes, CD69
Objavljeno v DiRROS: 18.11.2020; Ogledov: 1189; Prenosov: 308
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13.
Epitope mapping of major ragweed allergen Amb a 1
Abida Zahirović, Borut Štrukelj, Peter Korošec, Mojca Lunder, 2019, izvirni znanstveni članek

Povzetek: Ragweed is a prominent cause of seasonal allergies. Thus far, information on IgE-binding sites of major allergen in ragweed pollen, Amb a 1, is very limited. A powerful experimental method to gain insights on the allergen epitopes is the selection of peptides from biological libraries that bind to anti-allergen antibodies. In this work, we aimed to map IgE epitopes of Amb a 1 using epitope-mimicking short peptides % mimotopes that were affinity-selected from phage-displayed random peptide libraries. The peptides weakly aligned with the Amb a 1 primary sequence, thus suggesting that the epitopes are conformational. When the peptides were mapped onto the surface of Amb a 1 homology model, the EpiSearch analysis predicted the location of four potential epitopic sites on surface patches centred at residues K104, S110, H214, and W312. The peptides matching to the predicted epitopes bound selectively to the IgE from pool of ragweed-allergic patients% sera and therefore represent mimetics of Amb a 1 IgE epitopes. The knowledge of IgE epitopes is a prerequisite for the rational design of molecular-based approaches to diagnosis and immunotherapy of allergic diseases.
Ključne besede: allergens, ragweed allergy, Amb a 1, epitope mapping, phage display, mimotopes
Objavljeno v DiRROS: 09.11.2020; Ogledov: 1276; Prenosov: 884
.pdf Celotno besedilo (607,98 KB)
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15.
An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions
Lene Heise Garvey, Didier G. Ebo, Paul Michel Mertes, Pascale Dewachter, Tomaz Garcez, Peter Kopač, Jose Julio Laguna, Anca Chiriac, Ingrid Terreehorst, Susanna Voltolini, K Scherer, 2019, pregledni znanstveni članek

Povzetek: Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper are to provide recommendations for the investigation of immediate type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations.
Ključne besede: allergy and immunology -- diagnosis, drug hypersensitivity -- diagnosis, anaphylaxis, anesthesia, anesthetics, opioid analgesics, anti-bacterial agents, anti-inflammatory agents, non-steroidal opioids, antibiotics
Objavljeno v DiRROS: 16.10.2020; Ogledov: 1478; Prenosov: 363
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16.
Recombinant glycoproteins resembling carbohydrate-specific IgE epitopes from plants, venoms and mites
Pia Gattinger, Irene Mittermann, Christian Lupinek, Gerhard Hofer, Walter Keller, Urška Bidovec, Peter Korošec, Christine Koessler, Natalija Novak, Rudolf Valenta, 2019, izvirni znanstveni članek

Povzetek: Background: N-linked glycans present in venoms, pollen and mites are recognized by IgE antibodies from >20% of allergic patients but have low or no allergenic activity. Objectives: To engineer recombinant glycoproteins resembling carbohydrate-specific IgE epitopes from venoms, pollen and mites which can discriminate carbohydrate-specific IgE from allergenic, peptide-specific IgE. Methods: One or two N-glycosylation sites were engineered into the N-terminus of the non-allergenic protein horse heart myoglobin (HHM) using synthetic gene technology. HHM 1 and HHM 2 containing one or two N-glycosylation sites were expressed in baculovirus-infected High-FiveTM insect cells and a non-glycosylated version (HHM 0) was obtained by mutating the glycosylation motif. Recombinant HHM proteins were analyzed regarding fold and aggregation by circular dichroism and gel filtration, respectively. IgE reactivity was assessed by ELISA, immunoblotting and quantitative ImmunoCAP measurements. IgE inhibition assays were performed to study cross-reactivity with venom, plant and mite-derived carbohydrate IgE epitopes. Results: HHM-glycovariants were expressed and purified from insect cells as monomeric and folded proteins. The HHM-glycovariants exhibited strictly carbohydrate-specific IgE reactivity, designed to quantify carbohydrate specific IgE and resembled IgE epitopes of pollen, venom and mite-derived carbohydrates. IgE-reactivity and inhibition experiments established a hierarchy of plant glcyoallergens (nPhl p 4 > nCyn d 1 > nPla a 2 > nJug r 2 > nCup a 1 > nCry j 1) indicating a hitherto unknown heterogeneity of carbohydrate IgE epitopes in plants which were completely represented by HHM 2. Conclusion: Defined recombinant HHM-glycoproteins resembling carbohydrate-specific IgE epitopes from plants, venoms and mites were engineered which made it possible to discriminate carbohydrate- from peptide-specific IgE reactivity.
Ključne besede: allergy and immunology, allergens, glycoproteins, molecular diagnostic technique, recombinant glycoproteins, molecular allergology, component-resolved diagnosis
Objavljeno v DiRROS: 16.10.2020; Ogledov: 1493; Prenosov: 1083
.pdf Celotno besedilo (2,07 MB)
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17.
Management of a surgical patient with a label of penicillin allergy : narrative review and consensus recommendations
Louise C. Savic, David A. Khan, Peter Kopač, Russel C. Clarke, Peter J. Cooke, Pascale Dewachter, Didier G. Ebo, Tomaz Garcez, Lene Heise Garvey, Anne Berit Guttormsen, 2019, pregledni znanstveni članek

Povzetek: Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems, only a minority of surgical patients have the opportunity to undergo testing and de-labelling before surgery. Testing pathways can be modified and shortened in selected patients. A variety of healthcare professionals can, with appropriate training and in collaboration with allergists, provide testing for selected patients. We review how patients might be assessed, the appropriate testing strategies that can be used, and the minimum standards of safe testing.
Ključne besede: allergy and immunology, drug hypersensitivity, penicillins, antibiotic prophylaxis, surgery, operative surgical procedures, bacterial infections, surgical wound infection, drug provocation testing, surgical procedures
Objavljeno v DiRROS: 16.10.2020; Ogledov: 1389; Prenosov: 401
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18.
Anaesthetic management of patients with pre-existing allergic conditions : a narrative review
Pascale Dewachter, Peter Kopač, Jose Julio Laguna, Paul Michel Mertes, Vito Sabato, Gerald W. Volcheck, Peter J. Cooke, 2019, pregledni znanstveni članek

Povzetek: This narrative review seeks to distinguish the clinical patterns of pre-existing allergic conditions from other confounding non-allergic clinical entities, and to identify the potential related risks and facilitate their perioperative management. Follow-up investigation should be performed after a perioperative immediate hypersensitivity to establish a diagnosis and provide advice for subsequent anaesthetics, the main risk factor for perioperative immunoglobulin E (IgE)-mediated anaphylaxis being a previous uninvestigated perioperative immediate hypersensitivity reaction. The concept of cross-reactivity between drugs used in the perioperative setting and food is often quoted, but usually not supported by evidence. There is no reason to avoid propofol in egg, soy, or peanut allergy. The allergenic determinants have been characterised for fish, shellfish, and povidone iodine, but remain unknown for iodinated contrast agents. Iodinated drugs may be used in seafood allergy. Evidence supporting the risk for protamine allergy in fish allergy and in neutral protamine Hagedorn insulin use is lacking. Conversely, cross-reactivity to gelatin-based colloid may occur in agal syndrome. Atopy and allergic asthma along with other non-allergic conditions, such as NSAID-exacerbated respiratory disease, chronic urticaria, mastocytosis, and hereditary or acquired angioedema, are not risk factors for IgEmediated drug allergy, but there is a perioperative risk associated with the potential for exacerbation of the various conditions.
Ključne besede: allergy and immunology, drug hypersensitivity, food hypersensitivity, immediate hypersensitivity, anaphylaxis, anesthesia, drug-related side effects and adverse reactions, perioperative period, adverse effects
Objavljeno v DiRROS: 16.10.2020; Ogledov: 1378; Prenosov: 468
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19.
The use of drug provocation testing in the investigation of suspected immediate perioperative allergic reactions : current status
Lene Heise Garvey, Didier G. Ebo, Mogens Krøigaard, Sinisa Savic, Russel C. Clarke, Peter J. Cooke, Pascale Dewachter, Tomaz Garcez, Anne Berit Guttormsen, Philip M. Hopkins, Peter Kopač, 2019, pregledni znanstveni članek

Povzetek: Suspected perioperative allergic reactions are often severe. To avoid potentially life-threatening re-exposure to the culprit drug, establishing a firm diagnosis and identifying the culprit is crucial. Drug provocation tests are considered the gold standard in drug allergy investigation but have not been recommended in the investigation of perioperative allergy, mainly because of the pharmacological effects of drugs such as induction agents and neuromuscular blocking agents. Some specialised centres have reported benefits of provocation testing in perioperative allergy investigation, but the literature on the subject is limited. Here we provide a status update on the use of drug provocation testing in perioperative allergy, including its use in specific drug groups. This review is based on a literature search and experiences of the authors comprising anaesthesiologists and allergists with experience in perioperative allergy investigation. In addition, 19 participating centres in the International Suspected Perioperative Allergic Reaction Group were surveyed on the use of provocation testing in perioperative allergy investigation. A response was received from 13 centres in eight European countries, New Zealand, and the USA. Also, 21 centres from the Australian and New Zealand Anaesthetic Allergy Group were surveyed. Two centres performed provocation routinely and seven centres performed no provocations at all. Nearly half of the centres reported performing provocations with induction agents and neuromuscular blocking agents. Drug provocation testing is being used in perioperative allergy investigation in specialised centres, but collaborations between relevant specialties and multicentre studies are necessary to determine indications and establish common testing protocols.
Ključne besede: allergy and immunology, drug hypersensitivity, anesthesia, drug-related side effects and adverse reactions, anaphylaxis, perioperative period, allergic reactions, hypersensitivity reaction, perioperative anaphylaxis, allergy testing, challenge testing, drug provocation test
Objavljeno v DiRROS: 09.10.2020; Ogledov: 1295; Prenosov: 476
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20.
Management of suspected immediate perioperative allergic reactions : an international overview and consensus recommendations
Lene Heise Garvey, Pascale Dewachter, David L. Hepner, Paul Michel Mertes, Susanna Voltolini, Russel C. Clarke, Peter J. Cooke, Tomaz Garcez, Anne Berit Guttormsen, Didier G. Ebo, Philip M. Hopkins, Peter Kopač, 2019, pregledni znanstveni članek

Povzetek: Suspected perioperative allergic reactions are rare but can be life-threatening. The diagnosis is difficult to make in the perioperative setting, but prompt recognition and correct treatment is necessary to ensure a good outcome. A group of 26 international experts in perioperative allergy (anaesthesiologists, allergists, and immunologists) contributed to a modified Delphi consensus process, which covered areas such as differential diagnosis, management during and after anaphylaxis, allergy investigations, and plans for a subsequent anaesthetic. They were asked to rank the appropriateness of statements related to the immediate management of suspected perioperative allergic reactions. Statements were selected to represent areas where there is a lack of consensus in existing guidelines, such as dosing of epinephrine and fluids, the management of impending cardiac arrest, and reactions refractory to standard treatment. The results of the modified Delphi consensus process have been included in the recommendations on the management of suspected perioperative allergic reactions. This paper provides anaesthetists with an overview of relevant knowledge on the immediate and postoperative management of suspected perioperative allergic reactions based on current literature and expert opinion. In addition, it provides practical advice and recommendations in areas where consensus has been lacking in existing guidelines.
Ključne besede: allergy and immunology, drug hypersensitivity, anesthesia, drug-related side effects and adverse reactions, anaphylaxis, epinephrine, Delphi technique, perioperative period, allergic reactions, hypersensitivity reaction, adrenaline, perioperative anaphylaxis, allergy testing, guideline
Objavljeno v DiRROS: 09.10.2020; Ogledov: 1374; Prenosov: 421
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