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Schwarz C, Bend J, Hebestreit H, Hogardt M, Hügel C, Illing S, Mainz JG, Rietschel E, Schmidt S, Schulte-Hubbert B, Sitter H, Wielpütz MO, Hammermann J, Baumann I, Brunsmann F, Dieninghoff D, Eber E, Ellemunter H, Eschenhagen P, Evers C, Gruber S, Koitschev A, Ley-Zaporozhan J, Düesberg U, Mentzel HJ, Nüßlein T, Ringshausen FC, Sedlacek L, Smaczny C, Sommerburg O, Sutharsan S, Vonberg RP, Weber AK, Zerlik J. [CF Lung Disease - a German S3 Guideline: Pseudomonas aeruginosa]. Pneumologie 2024. [PMID: 38423036 DOI: 10.1055/a-2278-6685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Carsten Schwarz
- Klinikum Westbrandenburg GmbH, Standort Potsdam, Deutschland
| | - Jutta Bend
- Mukoviszidose Institut gGmbH, Bonn, Deutschland
| | | | - Michael Hogardt
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Frankfurt, Deutschland
| | - Christian Hügel
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
| | | | - Jochen G Mainz
- Klinikum Westbrandenburg, Standort Brandenburg an der Havel, Universitätsklinikum der Medizinischen Hochschule Brandenburg (MHB), Brandenburg an der Havel, Deutschland
| | - Ernst Rietschel
- Medizinische Fakultät der Universität zu Köln, Mukoviszidose-Zentrum, Klinik und Poliklinik für Kinder- und Jugendmedizin, Köln, Deutschland
| | - Sebastian Schmidt
- Ernst-Moritz-Arndt Universität Greifswald, Kinderpoliklinik, Allgemeine Pädiatrie, Greifswald, Deutschland
| | | | - Helmut Sitter
- Philipps-Universität Marburg, Institut für theoretische Medizin, Marburg, Deutschland
| | - Marc Oliver Wielpütz
- Universitätsklinikum Heidelberg, Klinik für Diagnostische und Interventionelle Radiologie, Heidelberg, Deutschland
| | - Jutta Hammermann
- Universitäts-Mukoviszidose-Zentrum "Christiane Herzog", Dresden, Deutschland
| | - Ingo Baumann
- Universität Heidelberg, Hals-Nasen-Ohrenklinik, Heidelberg, Deutschland
| | - Frank Brunsmann
- Allianz Chronischer Seltener Erkrankungen (ACHSE) e. V., Deutschland (Patient*innenvertreter)
| | | | - Ernst Eber
- Medizinische Universität Graz, Univ. Klinik für Kinder- und Jugendheilkunde, Klinische Abteilung für Pädiatrische Pulmonologie und Allergologie, Graz, Österreich
| | - Helmut Ellemunter
- Tirolkliniken GmbH, Department für Kinderheilkunde, Pädiatrie III, Innsbruck, Österreich
| | | | | | - Saskia Gruber
- Medizinische Universität Wien, Universitätsklinik für Kinder- und Jugendheilkunde, Wien, Österreich
| | - Assen Koitschev
- Klinikum Stuttgart - Standort Olgahospital, Klinik für Hals-Nasen-Ohrenkrankheiten, Stuttgart, Deutschland
| | - Julia Ley-Zaporozhan
- Klinik und Poliklinik für Radiologie, Kinderradiologie, LMU München, Deutschland
| | | | - Hans-Joachim Mentzel
- Universitätsklinikum Jena, Sektion Kinderradiologie, Institut für Diagnostische und Interventionelle Radiologie, Jena, Deutschland
| | - Thomas Nüßlein
- Gemeinschaftsklinikum Mittelrhein, Klinik für Kinder- und Jugendmedizin Koblenz und Mayen, Koblenz, Deutschland
| | - Felix C Ringshausen
- Medizinische Hochschule Hannover, Klinik für Pneumologie und Infektiologie und Deutsches Zentrum für Lungenforschung (DZL), Hannover, Deutschland
| | - Ludwig Sedlacek
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover, Deutschland
| | - Christina Smaczny
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
| | - Olaf Sommerburg
- Universitätsklinikum Heidelberg, Sektion Pädiatrische Pneumologie, Allergologie und Mukoviszidose-Zentrum, Heidelberg, Deutschland
| | | | - Ralf-Peter Vonberg
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover, Deutschland
| | | | - Jovita Zerlik
- Altonaer Kinderkrankenhaus gGmbH, Abteilung Physiotherapie, Hamburg, Deutschland
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2
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Schwarz C, Bend J, Hebestreit H, Hogardt M, Hügel C, Illing S, Mainz JG, Rietschel E, Schmidt S, Schulte-Hubbert B, Sitter H, Wielpütz MO, Hammermann J, Baumann I, Brunsmann F, Dieninghoff D, Eber E, Ellemunter H, Eschenhagen P, Evers C, Gruber S, Koitschev A, Ley-Zaporozhan J, Düesberg U, Mentzel HJ, Nüßlein T, Ringshausen FC, Sedlacek L, Smaczny C, Sommerburg O, Sutharsan S, Vonberg RP, Weber AK, Zerlik J. [CF Lung Disease - a German S3 Guideline: Pseudomonas aeruginosa]. Pneumologie 2024. [PMID: 38350639 DOI: 10.1055/a-2182-1907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Cystic Fibrosis (CF) is the most common autosomal recessive genetic multisystemic disease. In Germany, it affects at least 8000 people. The disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to dysfunction of CFTR, a transmembrane chloride channel. This defect causes insufficient hydration of the airway epithelial lining fluid which leads to reduction of the mucociliary clearance.Even if highly effective, CFTR modulator therapy has been available for some years and people with CF are getting much older than before, recurrent and chronic infections of the airways as well as pulmonary exacerbations still occur. In adult CF life, Pseudomonas aeruginosa (PA) is the most relevant pathogen in colonisation and chronic infection of the lung, leading to further loss of lung function. There are many possibilities to treat PA-infection.This is a S3-clinical guideline which implements a definition for chronic PA-infection and demonstrates evidence-based diagnostic methods and medical treatment in order to give guidance for individual treatment options.
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Affiliation(s)
- Carsten Schwarz
- Klinikum Westbrandenburg GmbH, Standort Potsdam, Deutschland
| | - Jutta Bend
- Mukoviszidose Institut gGmbH, Bonn, Deutschland
| | | | - Michael Hogardt
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Frankfurt, Deutschland
| | - Christian Hügel
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
| | | | - Jochen G Mainz
- Klinikum Westbrandenburg, Standort Brandenburg an der Havel, Universitätsklinikum der Medizinischen Hochschule Brandenburg (MHB), Brandenburg an der Havel, Deutschland
| | - Ernst Rietschel
- Medizinische Fakultät der Universität zu Köln, Mukoviszidose-Zentrum, Klinik und Poliklinik für Kinder- und Jugendmedizin, Köln, Deutschland
| | - Sebastian Schmidt
- Ernst-Moritz-Arndt Universität Greifswald, Kinderpoliklinik, Allgemeine Pädiatrie, Greifswald, Deutschland
| | | | - Helmut Sitter
- Philipps-Universität Marburg, Institut für theoretische Medizin, Marburg, Deutschland
| | - Marc Oliver Wielpütz
- Universitätsklinikum Heidelberg, Klinik für Diagnostische und Interventionelle Radiologie, Heidelberg, Deutschland
| | - Jutta Hammermann
- Universitäts-Mukoviszidose-Zentrum "Christiane Herzog", Dresden, Deutschland
| | - Ingo Baumann
- Universität Heidelberg, Hals-Nasen-Ohrenklinik, Heidelberg, Deutschland
| | - Frank Brunsmann
- Allianz Chronischer Seltener Erkrankungen (ACHSE) e. V., Deutschland (Patient*innenvertreter)
| | | | - Ernst Eber
- Medizinische Universität Graz, Univ. Klinik für Kinder- und Jugendheilkunde, Klinische Abteilung für Pädiatrische Pulmonologie und Allergologie, Graz, Österreich
| | - Helmut Ellemunter
- Tirolkliniken GmbH, Department für Kinderheilkunde, Pädiatrie III, Innsbruck, Österreich
| | | | | | - Saskia Gruber
- Medizinische Universität Wien, Universitätsklinik für Kinder- und Jugendheilkunde, Wien, Österreich
| | - Assen Koitschev
- Klinikum Stuttgart - Standort Olgahospital, Klinik für Hals-Nasen-Ohrenkrankheiten, Stuttgart, Deutschland
| | - Julia Ley-Zaporozhan
- Klinik und Poliklinik für Radiologie, Kinderradiologie, LMU München, Deutschland
| | | | - Hans-Joachim Mentzel
- Universitätsklinikum Jena, Sektion Kinderradiologie, Institut für Diagnostische und Interventionelle Radiologie, Jena, Deutschland
| | - Thomas Nüßlein
- Gemeinschaftsklinikum Mittelrhein, Klinik für Kinder- und Jugendmedizin Koblenz und Mayen, Koblenz, Deutschland
| | - Felix C Ringshausen
- Medizinische Hochschule Hannover, Klinik für Pneumologie und Infektiologie und Deutsches Zentrum für Lungenforschung (DZL), Hannover, Deutschland
| | - Ludwig Sedlacek
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover, Deutschland
| | - Christina Smaczny
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Deutschland
| | - Olaf Sommerburg
- Universitätsklinikum Heidelberg, Sektion Pädiatrische Pneumologie, Allergologie und Mukoviszidose-Zentrum, Heidelberg, Deutschland
| | | | - Ralf-Peter Vonberg
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover, Deutschland
| | | | - Jovita Zerlik
- Altonaer Kinderkrankenhaus gGmbH, Abteilung Physiotherapie, Hamburg, Deutschland
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Simonis A, Kreer C, Albus A, Rox K, Yuan B, Holzmann D, Wilms JA, Zuber S, Kottege L, Winter S, Meyer M, Schmitt K, Gruell H, Theobald SJ, Hellmann AM, Meyer C, Ercanoglu MS, Cramer N, Munder A, Hallek M, Fätkenheuer G, Koch M, Seifert H, Rietschel E, Marlovits TC, van Koningsbruggen-Rietschel S, Klein F, Rybniker J. Discovery of highly neutralizing human antibodies targeting Pseudomonas aeruginosa. Cell 2023; 186:5098-5113.e19. [PMID: 37918395 DOI: 10.1016/j.cell.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/17/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023]
Abstract
Drug-resistant Pseudomonas aeruginosa (PA) poses an emerging threat to human health with urgent need for alternative therapeutic approaches. Here, we deciphered the B cell and antibody response to the virulence-associated type III secretion system (T3SS) in a cohort of patients chronically infected with PA. Single-cell analytics revealed a diverse B cell receptor repertoire directed against the T3SS needle-tip protein PcrV, enabling the production of monoclonal antibodies (mAbs) abrogating T3SS-mediated cytotoxicity. Mechanistic studies involving cryoelectron microscopy identified a surface-exposed C-terminal PcrV epitope as the target of highly neutralizing mAbs with broad activity against drug-resistant PA isolates. These anti-PcrV mAbs were as effective as treatment with conventional antibiotics in vivo. Our study reveals that chronically infected patients represent a source of neutralizing antibodies, which can be exploited as therapeutics against PA.
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Affiliation(s)
- Alexander Simonis
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; German Center for Infection Research (DZIF), partner site Bonn-Cologne, 50937 Cologne, Germany.
| | - Christoph Kreer
- Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Alexandra Albus
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Katharina Rox
- Department of Chemical Biology, Helmholtz Centre for Infection Research (HZI), 38124 Braunschweig, Germany; German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, 38124 Braunschweig, Germany
| | - Biao Yuan
- Institute of Structural and Systems Biology, University Medical Center Hamburg-Eppendorf (UKE), 22607 Hamburg, Germany; Centre for Structural Systems Biology (CSSB), 22607 Hamburg, Germany; Deutsches Elektronen-Synchrotron Zentrum (DESY), 22607 Hamburg, Germany
| | - Dmitriy Holzmann
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Joana A Wilms
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Sylvia Zuber
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Lisa Kottege
- Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Sandra Winter
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Meike Meyer
- CF Centre, Pediatric Pulmonology and Allergology, University Children's Hospital Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Centre for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Kristin Schmitt
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Henning Gruell
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Sebastian J Theobald
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Anna-Maria Hellmann
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; Department of Experimental Pediatric Oncology, University Children's Hospital Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Christina Meyer
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Meryem Seda Ercanoglu
- Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Nina Cramer
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany
| | - Antje Munder
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), German Center for Lung Research, 30625 Hannover, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Gerd Fätkenheuer
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; German Center for Infection Research (DZIF), partner site Bonn-Cologne, 50937 Cologne, Germany
| | - Manuel Koch
- Institute for Dental Research and Oral Musculoskeletal Biology, Center for Biochemistry, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Harald Seifert
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, 50937 Cologne, Germany; Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Ernst Rietschel
- CF Centre, Pediatric Pulmonology and Allergology, University Children's Hospital Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Centre for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Thomas C Marlovits
- Institute of Structural and Systems Biology, University Medical Center Hamburg-Eppendorf (UKE), 22607 Hamburg, Germany; Centre for Structural Systems Biology (CSSB), 22607 Hamburg, Germany; Deutsches Elektronen-Synchrotron Zentrum (DESY), 22607 Hamburg, Germany
| | - Silke van Koningsbruggen-Rietschel
- CF Centre, Pediatric Pulmonology and Allergology, University Children's Hospital Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Centre for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Florian Klein
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; German Center for Infection Research (DZIF), partner site Bonn-Cologne, 50937 Cologne, Germany; Laboratory of Experimental Immunology, Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany
| | - Jan Rybniker
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; German Center for Infection Research (DZIF), partner site Bonn-Cologne, 50937 Cologne, Germany.
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4
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García-García I, Donica O, Cohen AA, Gonseth Nusslé S, Heini A, Nusslé S, Pichard C, Rietschel E, Tanackovic G, Folli S, Draganski B. Maintaining brain health across the lifespan. Neurosci Biobehav Rev 2023; 153:105365. [PMID: 37604360 DOI: 10.1016/j.neubiorev.2023.105365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/24/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023]
Abstract
Across the lifespan, the human body and brain endure the impact of a plethora of exogenous and endogenous factors that determine the health outcome in old age. The overwhelming inter-individual variance spans between progressive frailty with loss of autonomy to largely preserved physical, cognitive, and social functions. Understanding the mechanisms underlying the diverse aging trajectories can inform future strategies to maintain a healthy body and brain. Here we provide a comprehensive overview of the current literature on lifetime factors governing brain health. We present the growing body of evidence that unhealthy alimentary regime, sedentary behaviour, sleep pathologies, cardio-vascular risk factors, and chronic inflammation exert their harmful effects in a cumulative and gradual manner, and that timely and efficient intervention could promote healthy and successful aging. We discuss the main effects and interactions between these risk factors and the resulting brain health outcomes to follow with a description of current strategies aiming to eliminate, treat, or counteract the risk factors. We conclude that the detailed insights about modifiable risk factors could inform personalized multi-domain strategies for brain health maintenance on the background of increased longevity.
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Affiliation(s)
- Isabel García-García
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Centre for Research in Neurosciences, Lausanne University Hospital, University of Lausanne, Switzerland; Clinique la Prairie, Montreux, Switzerland
| | | | - Armand Aaron Cohen
- Department of Geriatrics and Rehabilitation, Hadassah University Medical Center Mount Scopus, Jerusalem, Israel
| | | | | | | | - Claude Pichard
- Nutrition Unit, University Hospital of Geneva, Geneva, Switzerland
| | | | | | | | - Bogdan Draganski
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Centre for Research in Neurosciences, Lausanne University Hospital, University of Lausanne, Switzerland; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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5
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Hagmeyer L, van Koningsbruggen-Rietschel S, Matthes S, Rietschel E, Randerath W. From the infant to the geriatric patient-Strategies for inhalation therapy in asthma and chronic obstructive pulmonary disease. Clin Respir J 2023. [PMID: 37054701 DOI: 10.1111/crj.13610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/26/2023] [Accepted: 03/24/2023] [Indexed: 04/15/2023]
Abstract
Inhalation therapy represents the standard of care in children, adolescents as well as in young, middle-aged and geriatric adults with asthma or chronic obstructive pulmonary disease. However, there are only few recommendations for the choice of inhalation devices, which consider both, age-specific limitations in young and geriatric patients. Transition concepts are lacking. In this narrative review, the available device technologies and the evidence for age-specific problems are discussed. Pressurized metered-dose inhalers may be favoured in patients who fulfill all cognitive, coordinative and manual power requirements. Breath-actuated metered-dose inhalers, soft-mist inhalers or the use of add-on devices such as spacers, face masks and valved holding chambers may be suitable for patients with mild to moderate impairments of these variables. In these cases, available resources of personal assistance by educated family members or caregivers should be used to allow metered-dose inhaler therapy. Dry powder inhalers may be reserved for patients with a sufficient peak inspiratory flow and good cognitive and manual abilities. Nebulizers may be indicated in persons who are either unwilling or unable to use handheld inhaler devices. After initiation of a specific inhalation therapy, close monitoring is essential to reduce handling mistakes. An algorithm is developed that considers age and relevant comorbidities to support the decision-making process for the choice of an inhaler device.
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Affiliation(s)
- Lars Hagmeyer
- Institute of Pneumology at the University of Cologne, Solingen, Germany
- Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital Solingen, Solingen, Germany
- Center for Rare Diseases, Faculty of Medicine, University of Cologne, Children's Hospital, Cologne, Germany
| | - Silke van Koningsbruggen-Rietschel
- Faculty of Medicine, University of Cologne, Pediatric Pulmonology, Allergology and Cystic Fibrosis Center, Children's Hospital, Cologne, Germany
- Center for Rare Diseases, Faculty of Medicine, University of Cologne, Children's Hospital, Cologne, Germany
| | - Sandhya Matthes
- Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital Solingen, Solingen, Germany
| | - Ernst Rietschel
- Faculty of Medicine, University of Cologne, Pediatric Pulmonology, Allergology and Cystic Fibrosis Center, Children's Hospital, Cologne, Germany
- Center for Rare Diseases, Faculty of Medicine, University of Cologne, Children's Hospital, Cologne, Germany
| | - Winfried Randerath
- Institute of Pneumology at the University of Cologne, Solingen, Germany
- Clinic for Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital Solingen, Solingen, Germany
- Center for Rare Diseases, Faculty of Medicine, University of Cologne, Children's Hospital, Cologne, Germany
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6
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Maison N, Omony J, Illi S, Thiele D, Skevaki C, Dittrich AM, Bahmer T, Rabe KF, Weckmann M, Happle C, Schaub B, Meyer M, Foth S, Rietschel E, Renz H, Kopp MV, Hansen G, von Mutius E, Grychtol R. T2-high asthma across all ages – comparative analysis in
children and adults from the ALLIANCE cohort. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- N Maison
- Dr von Hauner Children's Hospital, Ludwig Maximilians
University, Asthma and Allergy, Munich, Germany
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - J Omony
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - S Illi
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - D Thiele
- University Medical Center Schleswig-Holstein, Institute of Medical
Biometry and Statistics (IMBS), Luebeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Luebeck, Germany
| | - C Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry,
Philipps-University Marburg, Molecular Diagnostics, Marburg,
Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps
University Marburg, German Center for Lung Research (DZL), Marburg,
Germany
| | - A-M Dittrich
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
| | - T Bahmer
- LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Grosshansdorf, Germany
- University Hospital Schleswig-Holstein, Campus Kiel, Internal Medicine
Department I, Pneumology, Kiel, Germany
| | - KF Rabe
- LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Grosshansdorf, Germany
| | - M Weckmann
- University Medical Center Schleswig-Holstein, Division of Paediatric
Pneumology and Allergology, Luebeck, Germany
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Luebeck, Germany
| | - C Happle
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
| | - B Schaub
- Dr von Hauner Children's Hospital, Ludwig Maximilians
University, Asthma and Allergy, Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - M Meyer
- University Children's Hospital, University of Cologne, Cologne,
Germany
| | - S Foth
- University Children’s Hospital Marburg, University of Marburg,
Marburg, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps
University Marburg, German Center for Lung Research (DZL), Marburg,
Germany
| | - E Rietschel
- University Children's Hospital, University of Cologne, Cologne,
Germany
| | - H Renz
- Institute of Laboratory Medicine and Pathobiochemistry,
Philipps-University Marburg, Molecular Diagnostics, Marburg,
Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps
University Marburg, German Center for Lung Research (DZL), Marburg,
Germany
| | - MV Kopp
- University Children's Hospital, University of Bern, Department
of Paediatric Respiratory Medicine, Bern, Switzerland
- Airway Research Center North (ARCN), Member of the German Center for
Lung Research (DZL), Luebeck, Germany
- University Medical Center Schleswig-Holstein, Division of Paediatric
Pneumology and Allergology, Luebeck, Germany
| | - G Hansen
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
| | - E von Mutius
- Dr von Hauner Children's Hospital, Ludwig Maximilians
University, Asthma and Allergy, Munich, Germany
- Helmholtz Zentrum Munich, Institute for Asthma- and Allergy Prevention
(IAP), Munich, Germany
- Comprehensive Pneumology Center – Munich (CPC-M); Member of
German Center for Lung Research (DZL), Munich, Germany
| | - R Grychtol
- Hannover Medical School, Department of Paediatric Pneumology,
Allergology and Neonatology, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH);
Member of the German Center for Lung Research (DZL), Hannover,
Germany
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7
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Thomassen JC, Körner R, Meyer M, Striegel A, Rietschel E, van Koningsbruggen-Rietschel S. 6 Monate Zulassung von Kaftrio® in Deutschland
– erste Erfahrungen aus dem „wahren Leben“ von Menschen
mit C. Klinische Pädiatrie 2022. [DOI: 10.1055/s-0042-1754508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- JC Thomassen
- Mukoviszidose-Zentrum Köln, Pädiatrische Pneumologie
und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Uniklinik Köln, Köln, Germany
| | - R Körner
- Mukoviszidose-Zentrum Köln, Pädiatrische Pneumologie
und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Uniklinik Köln, Köln, Germany
| | - M Meyer
- Mukoviszidose-Zentrum Köln, Pädiatrische Pneumologie
und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Uniklinik Köln, Köln, Germany
| | - A Striegel
- Mukoviszidose-Zentrum Köln, Pädiatrische Pneumologie
und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Uniklinik Köln, Köln, Germany
| | - E Rietschel
- Mukoviszidose-Zentrum Köln, Pädiatrische Pneumologie
und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Uniklinik Köln, Köln, Germany
| | - S van Koningsbruggen-Rietschel
- Mukoviszidose-Zentrum Köln, Pädiatrische Pneumologie
und Allergologie, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Uniklinik Köln, Köln, Germany
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8
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Thomassen J, Trojan T, Vohlen C, Rietschel E, Alcazar MA, van Koningsbruggen-Rietschel S. WS12.05 CFTR-TGFβ1 interaction in inflammatory processes in healthy and CFTR-mutated human bronchial epithelial cells. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00223-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Trojan T, Alejandre Alcazar MA, Fink G, Thomassen JC, Maessenhausen MV, Rietschel E, Schneider PM, van Koningsbruggen-Rietschel S. The effect of TGF-β 1 polymorphisms on pulmonary disease progression in patients with cystic fibrosis. BMC Pulm Med 2022; 22:183. [PMID: 35525938 PMCID: PMC9080196 DOI: 10.1186/s12890-022-01977-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Transforming Growth Factor-β1 (TGF-β1) is a genetic modifier in patients with cystic fibrosis (CF). Several single nucleotide polymorphisms (SNPs) of TGF-β1 are associated with neutrophilic inflammation, lung fibrosis and loss of pulmonary function. Aim The aim of this study was to assess the relationship between genetic TGF-β1 polymorphisms and pulmonary disease progression in CF patients. Furthermore, the effect of TGF-β1 polymorphisms on inflammatory cytokines in sputum was investigated. Methods 56 CF-patients and 62 controls were genotyped for three relevant SNPs in their TGF-β1 sequence using the SNaPshot® technique. Individual “slopes” in forced expiratory volume in 1 s (FEV1) for all patients were calculated by using documented lung function values of the previous five years. The status of Pseudomonas aeruginosa (Pa) infection was determined. Sputum concentrations of the protease elastase, the serine protease inhibitor elafin and the cytokines IL-1β, IL-8, IL-6, TNF-α were measured after a standardized sputum induction and processing. Results The homozygous TT genotype at codon 10 was associated with a lower rate of chronic Pa infection (p < 0.05). The heterozygous GC genotype at codon 25 was associated with lower lung function decline (p < 0.05). Patients with homozygous TT genotype at the promotor SNP showed higher levels of TNF-α (p < 0,05). Higher levels of TGF-β1 in plasma were associated with a more rapid FEV1 decline over five years (p < 0.05). Conclusions Our results suggest that polymorphisms in the TGF-β1 gene have an effect on lung function decline, Pa infection as well as levels of inflammatory cytokines. Genotyping these polymorphisms could potentially be used to identify CF patients with higher risk of disease progression. TGF-β1 inhibition could potentially be developed as a new therapeutic option to modulate CF lung disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01977-1.
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Affiliation(s)
- T Trojan
- CF Centre Cologne, Children's Hospital, Faculty of Medicine and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Miguel A Alejandre Alcazar
- Translational Experimental Pediatrics - Experimental Pulmonology, Department of Pediatric and Adolescent Medicine, Center for Molecular Medicine Cologne (CMMC), and Cologne Excellence Cluster for Stress Responses in Ageing-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Institute for Lung Health (ILH), University of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - G Fink
- Translational Experimental Pediatrics - Experimental Pulmonology, Department of Pediatric and Adolescent Medicine, Center for Molecular Medicine Cologne (CMMC), and Cologne Excellence Cluster for Stress Responses in Ageing-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - J C Thomassen
- CF Centre Cologne, Children's Hospital, Faculty of Medicine and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - M V Maessenhausen
- CF Centre Cologne, Children's Hospital, Faculty of Medicine and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - E Rietschel
- CF Centre Cologne, Children's Hospital, Faculty of Medicine and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - P M Schneider
- Institute of Legal Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - S van Koningsbruggen-Rietschel
- CF Centre Cologne, Children's Hospital, Faculty of Medicine and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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10
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Maison N, Omony J, Illi S, Thiele D, Skevaki C, Dittrich AM, Bahmer T, Rabe KF, Weckmann M, Happle C, Schaub B, Meier M, Foth S, Rietschel E, Renz H, Hansen G, Kopp MV, von Mutius E, Grychtol R. T-high asthma phenotypes across life span. Eur Respir J 2022; 60:13993003.02288-2021. [PMID: 35210326 DOI: 10.1183/13993003.02288-2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/04/2022] [Indexed: 11/05/2022]
Abstract
RATIONALE In adults, personalised asthma treatment targets patients with T2-high and eosinophilic asthma phenotypes. It is unclear whether such classification is achievable in children. OBJECTIVES To define T2-high asthma with easily accessible biomarkers and compare resulting phenotypes across all ages. METHODS In the multicenter clinical ALL Age Asthma Cohort (ALLIANCE), 1125 participants (n=776 asthmatics, n=349 controls) were recruited and followed for 2 years (1 year in adults). Extensive clinical characterisation (questionnaires, blood differential count, allergy testing, lung function and sputum induction (in adults) was performed at baseline and follow-ups. Interleukin (IL)-4, IL-5 and IL-13 were measured after stimulation of whole blood with LPS or anti-CD3/CD28. MEASUREMENTS AND MAIN RESULTS Based on blood eosinophil counts and allergen-specific serum IgE antibodies (sIgE), patients were categorised into four mutually exclusive phenotypes: "Atopy-only", "Eosinophils-only", "T2-high" (eosinophilia+atopy) and "T2-low" (neither eosinophilia nor atopy). The T2-high phenotype was found across all ages, even in very young children in whom it persisted to a large degree even after 2 years of follow-up. T2-high asthma in adults was associated with childhood onset suggesting early origins of this asthma phenotype. In both children and adults, the T2-high phenotype was characterised by excessive production of specific IgE to allergens (p<0.0001) and, from school age onwards, by increased production of IL-5 after anti-CD3/CD28 stimulation of whole blood. CONCLUSIONS Using easily accessible biomarkers, patients with T2-high asthma can be identified across all ages delineating a distinct phenotype. These patients may benefit from therapy with biologicals even at younger age.
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Affiliation(s)
- Nicole Maison
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.,Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Jimmy Omony
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Sabina Illi
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Dominik Thiele
- Institute of Medical Biometry and Statistics (IMBS), University Medical Center Schleswig-Holstein, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University Marburg, Marburg, Germany.,Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany
| | - Anna-Maria Dittrich
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Thomas Bahmer
- University Hospital Schleswig-Holstein, Campus Kiel, Internal Medicine Department I, Pneumology, Kiel, Germany.,LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Klaus Friedrich Rabe
- LungenClinic Grosshansdorf GmbH, Grosshansdorf, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Markus Weckmann
- Division of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Christine Happle
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Bianca Schaub
- Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Meike Meier
- Faculty of Medicine, University Children's Hospital, University of Cologne, Cologne, Germany
| | - Svenja Foth
- Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany.,University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Ernst Rietschel
- Faculty of Medicine, University Children's Hospital, University of Cologne, Cologne, Germany
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps-University Marburg, Marburg, Germany.,Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany.,Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
| | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
| | - Matthias Volkmar Kopp
- Division of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Luebeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Munich, Germany.,Department of Pediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland
| | - Erika von Mutius
- Institute for Asthma- and Allergy Prevention (IAP), Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany .,Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.,Comprehensive Pneumology Center - Munich (CPC-M; Member of German Center for Lung Research (DZL), Munich, Germany
| | - Ruth Grychtol
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL), Hannover, Germany
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11
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Thomassen JC, Meyer M, Hagmeyer L, Striegel AK, Metz F, Körner R, Rietschel E, van Koningsbruggen-Rietschel S. 6 Monate Zulassung von Kaftrio® in Deutschland – erste Erfahrungen aus dem „wahren Leben“ von Menschen mit CF. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-021-01397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Zusammenfassung
Hintergrund
Mit der Weiterentwicklung der „Cystic-fibrosis-transmembrane-conductance-regulator“(CFTR)-Modulatoren und der Zulassung von Kaftrio® (Elexacaftor, Tezacaftor, Ivacaftor) für einen Großteil der Menschen mit CF steht neben der etablierten symptomatischen Therapie nun eine weitere vielversprechende Therapieoption zur kausalen Behandlung der CF zur Verfügung.
Fragestellung
Ziel der hier vorliegenden Arbeit ist es, erste Effekte der Kaftrio®-Therapie auf den klinischen Phänotyp von Menschen mit CF 6 Monate nach der Zulassung zu untersuchen sowie die Ergebnisse in den Kontext neuer daraus resultierender Fragestellungen für die zukünftige Behandlung von CF-Patient*innen zu stellen.
Material und Methoden
Im Rahmen dieser Arbeit wurden anonymisiert klinische Daten (FEV1, Body-Mass-Index, HbA1c, Schweiß-Chlorid-Konzentration, Leberwerte) von 56 an der Uniklinik Köln betreuten Patient*innen retrospektiv ausgewertet, die die Voraussetzungen für eine Behandlung mit Kaftrio® erfüllt haben (Alter >12 Jahre, F508del homozygot oder heterozygot) und die mindestens >4 Wochen Kaftrio® eingenommen haben. Unterschiede zwischen den Gruppen wurden mithilfe des „Paired-t“-Tests berechnet. Ein p-Wert <0,05 wurde als statistisch signifikant gewertet.
Ergebnisse
In der untersuchten Kohorte konnte unter Kaftrio®-Therapie ein durchschnittlicher Anstieg der Einsekundenkapazität (FEV1-Werte in % des Sollwertes) um 11,3 % nachgewiesen werden. Ferner kam es unter Kaftrio® zu einem signifikanten Anstieg des Body-Mass Index (BMI) (+0,89 kg/m2), einer deutlichen Reduktion der Schweiß-Chlorid-Konzentration um durchschnittlich 58,8 mmol/l sowie zu einem Anstieg der Leberwerte.
Diskussion
Unsere retrospektive Datenerhebung bestätigt die aus den Zulassungsstudien beschriebenen positiven Effekte der Kaftrio®-Therapie auf den klinischen Phänotyp der Menschen mit CF. Mit der Besserung der Lungenfunktion, des Ernährungsstatus und der daraus resultierenden gesteigerten Lebenserwartung wird neben der Reevaluation bisheriger Behandlungsstandards der Fokus zukünftig auch auf dem Erhalt der Lebensqualität durch frühzeitige Diagnostik und effiziente Therapie möglicher Begleiterkrankungen liegen müssen.
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12
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Ring J, Beyer K, Bircher A, Biedermann T, Fischer M, Fuchs T, Heller AR, Hoffmann F, Huttegger I, Jakob T, Klimek L, Kopp MV, Kugler C, Lange L, Pfaar O, Rietschel E, Ruëff F, Schnadt S, Seifert R, Stöcker B, Treudler R, Vogelberg C, Werfel T, Worm M, Sitter H, Brockow K. Kurzfassung der Leitlinie "Akuttherapie und Management der Anaphylaxie - Update 2021" für Patienten und Angehörige. Allergo J 2021; 30:24-31. [PMID: 34744321 PMCID: PMC8560215 DOI: 10.1007/s15007-021-4907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Johannes Ring
- Haut- und Laserzentrum an der Oper, Perusastraße 5, 80333 München, Germany
| | - Kirsten Beyer
- Charité Universitätsmedizin Berlin, Klinik für Pädiatrie - Pneumologie und Immunologie, Augustenburger Platz 1, 13353 Berlin, Korea
| | - Andreas Bircher
- Allergologische Poliklinik, Klinik für -Dermatologie,, Universitätsspital Basel, Basel, Schweiz
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Germany
| | - Matthias Fischer
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, ALB FILS Kliniken Göppingen, Göppingen, Germany
| | - Thomas Fuchs
- Klinik f. Dermatologie, Venerologie u. Allergologie, Georg-August-Universität, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Axel R Heller
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Florian Hoffmann
- Kinderklinik und Kinderpoliklinik im Dr. von Hauner'schen Kinderspital, Ludwig-Maximilians-Universität München, München, Germany
| | - Isidor Huttegger
- Klinik für Pädiatrie, Universitätsklinikum Salzburg, Salzburg, Österreich
| | - Thilo Jakob
- Universitätsklinikum Gießen, Klinik für Dermatologie, Venerologie und Allergologie, Gaffkystraße 14, 35392 Gießen, Germany
| | - Ludger Klimek
- FA für Dermatologie u. Allergologie, Zentrum f. Rhinologie und Allergologie, An den Quellen 10, 65183 Wiesbaden, Germany
| | - Matthias V Kopp
- Klinik für Kinder- und Jugendmedizin, UKSH Campus Lübeck, Lübeck, Germany
| | - Claudia Kugler
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Germany
| | - Lars Lange
- Abteilung für Kinder- und Judendmedizin, GFO-Kliniken Bonn - Betriebsstätte St. Marien, Robert-Koch-Str. 1, 53115 Bonn, Germany
| | - Oliver Pfaar
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Sektion Rhinologie und Allergo-logie,, Universitätsklinikum Gießen und Marburg, Marburg, Germany
| | - Ernst Rietschel
- Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Köln, Köln, Germany
| | - Franziska Ruëff
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Ludwig--Maximilians-Universität München, München, Germany
| | - Sabine Schnadt
- Deutscher Allergie- und Asthmabund (DAAB), An der Eickesmühle 15 - 19, 41238 Mönchengladbach, Germany
| | - Roland Seifert
- Institut für Pharmakologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Britta Stöcker
- Praxis für Kinderheilkunde und Jugendmedizin, Bonn, Germany
| | - Regina Treudler
- Universitätsklinikum Leipzig, Klinik f. Dermatologie u. Allergologie, Philipp-Rosenthal-Str. 23, 4103 Leipzig, Germany
| | - Christian Vogelberg
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Univ.-Klinikum Carl Gustav Carus, Fetscherstraße 74, 1307 Dresden, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Med. Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Margitta Worm
- Klinik für Dermatologie und Allergologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Helmut Sitter
- Haut- und Laserzentrum an der Oper, Perusastraße 5, 80333 München, Germany
| | - Knut Brockow
- Technische Universität München, Klinik f. Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802 München, Germany
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13
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Striegel AK, Beyer K, Rietschel E. [Diagnostic and therapeutic approach to anaphylaxis in childhood and adolescence]. Hautarzt 2021; 72:1003-1013. [PMID: 34652490 DOI: 10.1007/s00105-021-04894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2021] [Indexed: 11/28/2022]
Abstract
Anaphylaxis is a suddenly occurring potentially life-threatening systemic allergic reaction. In childhood, food allergens play a major role but insect stings and drugs are also potential triggers. The symptoms appear in minutes up to few hours on the skin, airways, gastrointestinal tract and/or the cardiovascular system. Intramuscular adrenaline is the drug of first choice due to its rapid effectiveness and its low side effect potential. A detailed patient history and the determination of potential IgE antibodies must be carried out to identify the triggers. The register for anaphylaxis has improved knowledge on epidemiology. An education in anaphylaxis is useful for every patient as well as parents and caregivers. Allergen-specific immunotherapy is currently the only causal treatment option; however, at the present time it is only available for insect bites and peanut allergy.
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Affiliation(s)
- A K Striegel
- Pädiatrische Pneumologie und Allergologie, Klinik für Kinder- und Jugendmedizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - K Beyer
- Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - E Rietschel
- Pädiatrische Pneumologie und Allergologie, Klinik für Kinder- und Jugendmedizin, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Ring J, Beyer K, Biedermann T, Bircher A, Fischer M, Fuchs T, Heller A, Hoffmann F, Huttegger I, Jakob T, Klimek L, Kopp MV, Kugler C, Lange L, Pfaar O, Rietschel E, Rueff F, Schnadt S, Seifert R, Stöcker B, Treudler R, Vogelberg C, Werfel T, Worm M, Sitter H, Brockow K. Messages for patients and relatives from the 2021 update of the guideline on acute therapy and management of anaphylaxis. ACTA ACUST UNITED AC 2021; 30:243-248. [PMID: 34603937 PMCID: PMC8475294 DOI: 10.1007/s40629-021-00185-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Johannes Ring
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
| | - Kirsten Beyer
- Department of Pediatrics, Division of Pulmonology, Immunology and Critical Care Medicine, Charité—University Hospital Berlin, Berlin, Germany
| | - Tilo Biedermann
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
| | - Andreas Bircher
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Matthias Fischer
- Clinic for Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, ALB FILS Hospitals Göppingen, Göppingen, Germany
| | - Thomas Fuchs
- Department of Dermatology, University Hospital Göttingen, Göttingen, Germany
| | - Axel Heller
- Department of Anesthesiology and Operative Intensive Care Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Florian Hoffmann
- Dr. von Hauner Children’s Hospital, Ludwig Maximilians University, Munich, Germany
| | - Isidor Huttegger
- Department of Pediatrics, University Hospital Salzburg, Salzburg, Austria
| | - Thilo Jakob
- Department of Dermatology and Allergology, University Medical Center Gießen (UKGM), Justus-Liebig-University Gießen, Gießen, Germany
| | - Ludger Klimek
- Center of Rhinology and Allergology, Wiesbaden, Germany
| | - Matthias V. Kopp
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia Kugler
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
| | | | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Ernst Rietschel
- Department of Pediatrics, University Hospital Cologne, Cologne, Germany
| | - Franziska Rueff
- Department of Dermatology and Allergology, Hospital of the Ludwig Maximilians University, Munich, Germany
| | - Sabine Schnadt
- German Allergy and Asthma Association, Mönchengladbach, Germany
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, Hannover, Germany
| | - Britta Stöcker
- Medical practice for pediatrics and youth medicine, Poppelsdorfer Allee, Bonn, Germany
| | - Regina Treudler
- Department of Dermatology, Venereology, and Allergology, Leipzig Interdisciplinary Allergy Center, University Hospital Leipzig, Leipzig, Germany
| | - Christian Vogelberg
- Department of Pediatric Pneumology and Allergology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Thomas Werfel
- Immunodermatology and Experimental Allergology Unit, Department of Dermatology, Allergology, and Venereology, Medical University Hannover, Hannover, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology, and Allergology, Charité—University Hospital Berlin, Berlin, Germany
| | - Helmut Sitter
- Institute for Surgical Research, Philipps-University Marburg, Marburg, Germany
| | - Knut Brockow
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
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Striegel AK, Beyer K, Rietschel E. Diagnostisches und therapeutisches Vorgehen bei Anaphylaxie. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thomassen JC, Trojan T, Walz M, Vohlen C, Fink G, Rietschel E, Alejandre Alcazar MA, van Koningsbruggen-Rietschel S. Reduced neutrophil elastase inhibitor elafin and elevated transforming growth factor-β 1 are linked to inflammatory response in sputum of cystic fibrosis patients with Pseudomonas aeruginosa. ERJ Open Res 2021; 7:00636-2020. [PMID: 34291109 PMCID: PMC8287132 DOI: 10.1183/23120541.00636-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/19/2021] [Indexed: 11/05/2022] Open
Abstract
Research question Pulmonary disease progression in patients with cystic fibrosis (CF) is characterised by inflammation and fibrosis and aggravated by Pseudomonas aeruginosa (Pa). We investigated the impact of Pa specifically on: 1) protease/antiprotease balance; 2) inflammation; and 3) the link of both parameters to clinical parameters of CF patients. Methods Transforming growth factor-β1 (TGF-β1), interleukin (IL)-1β, IL-8, neutrophil elastase (NE) and elastase inhibitor elafin were measured (ELISA assays), and gene expression of the NF-κB pathway was assessed (reverse transcriptase PCR) in the sputum of 60 CF patients with a minimum age of 5 years. Spirometry was assessed according to American Thoracic Society guidelines. Results Our results demonstrated the following: 1) NE was markedly increased in Pa-positive sputum, whereas elafin was significantly decreased; 2) increased IL-1β/IL-8 levels were associated with both Pa infection and reduced forced expiratory volume in 1 s, and sputum TGF-β1 was elevated in Pa-infected CF patients and linked to an impaired lung function; and 3) gene expression of NF-κB signalling components was increased in sputum of Pa-infected patients, and these findings were positively correlated with IL-8. Conclusion Our study links Pa infection to an imbalance of NE and NE inhibitor elafin and increased inflammatory mediators. Moreover, our data demonstrate an association between high TGF-β1 sputum levels and a progress in chronic lung inflammation and pulmonary fibrosis in CF. Controlling the excessive airway inflammation by inhibition of NE and TGF-β1 might be promising therapeutic strategies in future CF therapy and a possible complement to cystic fibrosis transmembrane conductance regulator (CFTR) modulators.
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Affiliation(s)
- Jan C Thomassen
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany.,Translational Experimental Pediatrics - Experimental Pulmonology, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Tobias Trojan
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Maxine Walz
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Christina Vohlen
- Translational Experimental Pediatrics - Experimental Pulmonology, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany.,Center of Molecular Medicine Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Gregor Fink
- Translational Experimental Pediatrics - Experimental Pulmonology, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Ernst Rietschel
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Miguel A Alejandre Alcazar
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany.,Translational Experimental Pediatrics - Experimental Pulmonology, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany.,Center of Molecular Medicine Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
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Maris I, Dölle‐Bierke S, Renaudin J, Lange L, Koehli A, Spindler T, Hourihane J, Scherer K, Nemat K, Kemen C, Neustädter I, Vogelberg C, Reese T, Yildiz I, Szepfalusi Z, Ott H, Straube H, Papadopoulos NG, Hämmerling S, Staden U, Polz M, Mustakov T, Cichocka‐Jarosz E, Cocco R, Fiocchi AG, Fernandez‐Rivas M, Worm M, Grünhagen J, Wittenberg M, Beyer K, Henschel A, Küper S, Möser A, Fuchs T, Ruëff F, Wedi B, Hansen G, Buck T, Büsselberg J, Drägerdt R, Pfeffer L, Dickel H, Körner‐Rettberg C, Merk H, Lehmann S, Bauer A, Nordwig A, Zeil S, Hannapp C, Wagner N, Rietschel E, Hunzelmann N, Huseynow I, Treudler R, Aurich S, Prenzel F, Klimek L, Pfaar O, Reider N, Aberer W, Varga E, Bogatu B, Schmid‐Grendelmeier P, Guggenheim R, Riffelmann F, Kreft B, Kinaciyan K, Hartl L, Ebner C, Horak F, Brehler R, Witte J, Buss M, Hompes S, Bieber T, Gernert S, Bücheler M, Rabe U, Brosi W, Nestoris S, Hawranek T, Lang R, Bruns R, Pföhler C, Eng P, Schweitzer‐Krantz S, Meller S, Rebmann H, Fischer J, Stichtenoth G, Thies S, Gerstlauer M, Utz P, Neustädter I, Klinge J, Volkmuth S, Plank‐Habibi S, Schilling B, Kleinheinz A, Brückner A, Schäkel K, Manolaraki I, Kowalski M, Solarewicz‐Madajek K, Tscheiller S, Seidenberg J, Cardona V, Garcia B, Bilo M, Cabañes Higuero N, Vega Castro A, Poziomkowska‐Gęsicka I, Büsing S, Virchow C, Christoff G, Jappe U, Müller S, Knöpfel F, Correard A, Rogala B, Montoro A, Brandes A, Muraro A, Zimmermann N, Hernandez D, Minale P, Niederwimmer J, Zahel B, Dahdah L, Arasi S, Reissig A, Eitelberger F, Asero R, Hermann F, Zeidler S, Pistauer S, Geißler M, Ensina L, Plaza Martin A, Meister J, Stieglitz S, Hamelmann E. Peanut-induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry. Allergy 2021; 76:1517-1527. [PMID: 33274436 DOI: 10.1111/all.14683] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. METHODS Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. RESULTS 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). CONCLUSIONS The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition.
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Affiliation(s)
- Ioana Maris
- Bon Secours Hospital Cork/Paediatrics and Child HealthUniversity College Cork Cork Ireland
| | - Sabine Dölle‐Bierke
- Division of Allergy and Immunology Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | | | - Lars Lange
- Department of Paediatrics St. Marien‐Hospital Bonn Germany
| | - Alice Koehli
- Division of Allergology University Children’s Hospital Zurich Zürich Switzerland
| | - Thomas Spindler
- Department of Paediatrics Medical Campus Hochgebirgsklinik Davos Davos Switzerland
| | - Jonathan Hourihane
- Paediatrics and Child Health Royal College of Surgeons in Ireland Dublin Ireland
- Children’s Health Ireland Dublin Ireland
| | | | - Katja Nemat
- Practice for paediatric pneumology and allergology Kinderzentrum Dresden‐Friedrichstadt Dresden Germany
| | - C. Kemen
- Department of Paediatrics Children’s Hospital WILHELMSTIFT Hamburg Germany
| | - Irena Neustädter
- Department of Paediatrics Hallerwiese Cnopfsche Kinderklinik Nuremberg Germany
| | - Christian Vogelberg
- Department of Paediatrics Universitätsklinikum Carl Gustav CarusTechnical University Dresden Germany
| | - Thomas Reese
- Department of Paediatrics Mathias‐Spital Rheine Rheine Germany
| | - Ismail Yildiz
- Department of Paediatrics Friedrich‐Ebert‐Krankenhaus Neumuenster Germany
| | - Zsolt Szepfalusi
- Division of Paediatric Pulmonology, Allergology and Endocrinology Department of Paediatrics and Adolescent Medicine Competence Center Paediatrics Medical University of Vienna Vienna Austria
| | - Hagen Ott
- Division of Paediatric Dermatology and Allergology Epidermolysis bullosa‐Centre HannoverChildren’s Hospital AUF DER BULT Hanover Germany
| | - Helen Straube
- Division of Allergology Darmstädter Kinderkliniken Prinzessin Margaret Darmstadt Germany
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Paediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection Immunity& Respiratory Medicine University of Manchester Manchester UK
| | - Susanne Hämmerling
- Division of Paediatric Pulmonology and Allergology University Children`s Hospital Heidelberg Heidelberg Germany
| | - Ute Staden
- Paediatric Pneumology & Allergology Medical practice Klettke/Staden Berlin Germany
| | - Michael Polz
- Department of Paediatrics GPR Klinikum Rüsselsheim Germany
| | - Tihomir Mustakov
- Chair of Allergy University Hospital Alexandrovska Sofia Bulgaria
| | - Ewa Cichocka‐Jarosz
- Department of Paediatrics Jagiellonian University Medical College Krakow Poland
| | - Renata Cocco
- Division of Allergy Clinical Immunology and Rheumatology Department of Paediatrics Federal University of São Paulo São Paulo Brazil
| | | | | | - Margitta Worm
- Division of Allergy and Immunology Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Worm M, Ring J, Klimek L, Jakob T, Lange L, Treudler R, Beyer K, Werfel T, Biedermann T, Bircher A, Fischer M, Fuchs T, Heller AR, Hoffmann F, Huttegger I, Kopp MV, Kugler C, Lommatzsch M, Pfaar O, Rietschel E, Ruëff F, Schnadt S, Seifert R, Stöcker B, Vogelberg C, Sitter H, Gieler U, Brockow K. Management des Anaphylaxie-Risikos bei Covid-19-Impfung. HNO Nachrichten 2021; 51:18-21. [PMID: 33619418 PMCID: PMC7890774 DOI: 10.1007/s00060-021-7480-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Margitta Worm
- Charité – Universitätsmedizin Berlin, Allergologie und Immunologie, Klinik für Dermatologie und Allergologie, Charitéplatz 1, 10117 Berlin, Germany
| | - Johannes Ring
- Technische Universität München, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein,, München, Germany
| | - Ludger Klimek
- Charité – Universitätsmedizin Berlin, Allergologie und Immunologie, Klinik für Dermatologie und Allergologie, Charitéplatz 1, 10117 Berlin, Germany
| | - Thilo Jakob
- Universitäts-Hautklinik Gießen, Gießen, Schweiz
| | | | - Regina Treudler
- Klinik für Dermatologie und Allergologie, Universitätsmedizin Leipzig, Leipzig, Germany
| | - Kirsten Beyer
- Technische Universität München, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein,, Berlin, Germany
| | - Thomas Werfel
- Medizinische Hochschule Hannover, Klinik und Poliklinik für Dermatologie und Allergologie, Hannover, Germany
| | - Tilo Biedermann
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein,, Technische Universität München, München, Germany
| | - Andreas Bircher
- Allergologische Poliklinik, Klinik für Dermatologie,, Universitätsspital Basel, Basel, Schweiz
| | - Matthias Fischer
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, ALB FILS Kliniken Göppingen, Göppingen, Germany
| | - Thomas Fuchs
- Hautklinik Universitätsmedizin Göttingen, Göttingen, Germany
| | - Axel R. Heller
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Florian Hoffmann
- Kinderklinik und Kinderpoliklinik im Dr. von Hauner‘schen Kinderspital, Ludwig-Maximilians-Universität München, München, Germany
| | - Isidor Huttegger
- Klinik für Pädiatrie, Universitätsklinikum Salzburg, Salzburg, Österreich
| | - Matthias Volkmar Kopp
- Sektion für Pädiatrische Pneumologie und Allergologie, Universitätsklinikum Lübeck, Lübeck, Germany
| | - Claudia Kugler
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, München, Österreich
| | - Marek Lommatzsch
- Klinik für Pneumologie, Universitätsklinikum Rostock, Rostock, Germany
| | - Oliver Pfaar
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Sektion Rhinologie und Allergologie,, Universitätsklinikum Gießen und Marburg, Marburg, Germany
| | - Ernst Rietschel
- Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Köln, Köln, Germany
| | - Franziska Ruëff
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Ludwig-Maximilians-Universität München, München, Germany
| | - Sabine Schnadt
- Deutscher Allergie- und Asthmabund e. V. (DAAB), Mönchengladbach, Germany
| | - Roland Seifert
- Institut für Pharmakologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Britta Stöcker
- Praxis für Kinderheilkunde und Jugendmedizin, Bonn, Germany
| | - Christian Vogelberg
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Helmut Sitter
- Institut für chirurgische Forschung, Philipps-Universität Marburg, Marburg, Germany
| | - Uwe Gieler
- Klinik für Psychosomatik, Vitos-Klinik Giessen-Marburg und Univ. Hautklinik Gießen, Gießen, Germany
| | - Knut Brockow
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein,, Technische Universität München, München, Germany
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Worm M, Ring J, Klimek L, Jakob T, Lange L, Treudler R, Beyer K, Werfel T, Biedermann T, Bircher A, Fischer M, Fuchs T, Heller AR, Hoffmann F, Huttegger I, Kopp MV, Kugler C, Lommatzsch M, Pfaar O, Rietschel E, Rueff F, Schnadt S, Seifert R, Stöcker B, Vogelberg C, Sitter H, Gieler U, Brockow K. [Covid-19 vaccination and risk of anaphylaxis - Recommendations for practical management]. MMW Fortschr Med 2021; 163:48-51. [PMID: 33464512 PMCID: PMC7814269 DOI: 10.1007/s15006-021-9530-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- Margitta Worm
- Allergie-Centrum-Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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20
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Ring J, Beyer K, Biedermann T, Bircher A, Fischer M, Fuchs T, Heller A, Hoffmann F, Huttegger I, Jakob T, Klimek L, Kopp MV, Kugler C, Lange L, Pfaar O, Rietschel E, Rueff F, Schnadt S, Seifert R, Stöcker B, Treudler R, Vogelberg C, Werfel T, Worm M, Sitter H, Brockow K. Guideline (S2k) on acute therapy and management of anaphylaxis: 2021 update: S2k-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Medical Association of German Allergologists (AeDA), the Society of Pediatric Allergology and Environmental Medicine (GPA), the German Academy of Allergology and Environmental Medicine (DAAU), the German Professional Association of Pediatricians (BVKJ), the Society for Neonatology and Pediatric Intensive Care (GNPI), the German Society of Dermatology (DDG), the Austrian Society for Allergology and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Anaesthesiology and Intensive Care Medicine (DGAI), the German Society of Pharmacology (DGP), the German Respiratory Society (DGP), the patient organization German Allergy and Asthma Association (DAAB), the German Working Group of Anaphylaxis Training and Education (AGATE). Allergo J Int 2021; 30:1-25. [PMID: 33527068 PMCID: PMC7841027 DOI: 10.1007/s40629-020-00158-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Johannes Ring
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
| | - Kirsten Beyer
- Department of Pediatrics, Division of Pulmonology, Immunology and Critical Care Medicine, Charité—University Hospital Berlin, Berlin, Germany
| | - Tilo Biedermann
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
| | - Andreas Bircher
- Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Matthias Fischer
- Clinic for Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, ALB FILS Hospitals Göppingen, Göppingen, Germany
| | - Thomas Fuchs
- Department of Dermatology, University Hospital Göttingen, Göttingen, Germany
| | - Axel Heller
- Department of Anesthesiology and Operative Intensive Care Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Florian Hoffmann
- Dr. von Hauner Children’s Hospital, Ludwig Maximilians University, Munich, Germany
| | - Isidor Huttegger
- Department of Pediatrics, University Hospital Salzburg, Salzburg, Austria
| | - Thilo Jakob
- Department of Dermatology and Allergology, University Medical Center Gießen (UKGM), Justus-Liebig-University Gießen, Gießen, Germany
| | - Ludger Klimek
- Center of Rhinology and Allergology, Wiesbaden, Germany
| | - Matthias V. Kopp
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia Kugler
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
| | | | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Ernst Rietschel
- Department of Pediatrics, University Hospital Cologne, Cologne, Germany
| | - Franziska Rueff
- Department of Dermatology and Allergology, Hospital of the Ludwig Maximilians University, Munich, Germany
| | - Sabine Schnadt
- German Allergy and Asthma Association, Mönchengladbach, Germany
| | - Roland Seifert
- Institute of Pharmacology, Hannover Medical School, Hannover, Germany
| | - Britta Stöcker
- Medical practice for pediatrics and youth medicine, Poppelsdorfer Allee, Bonn, Germany
| | - Regina Treudler
- Department of Dermatology, Venereology, and Allergology, Leipzig Interdisciplinary Allergy Center, University Hospital Leipzig, Leipzig, Germany
| | - Christian Vogelberg
- Department of Pediatric Pneumology and Allergology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Thomas Werfel
- Immunodermatology and Experimental Allergology Unit, Department of Dermatology, Allergology, and Venereology, Medical University Hannover, Hannover, Germany
| | - Margitta Worm
- Department of Dermatology, Venereology, and Allergology, Charité—University Hospital Berlin, Berlin, Germany
| | - Helmut Sitter
- Institute for Surgical Research, Philipps-University Marburg, Marburg, Germany
| | - Knut Brockow
- Department Dermatology and Allergology Biederstein, Technical University Munich, Biedersteiner Straße 29, 80802 Munich, Germany
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Seidenberg J, Geeske Stelljes G, Lange L, Blümchen K, Rietschel E. Fluglinien: zu wenig Hinweise für Allergiker! Allergo J 2020. [DOI: 10.1007/s15007-020-2641-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Klimek L, Worm M, Lange L, Beyer K, Rietschel E, Vogelberg C, Schnadt S, Stöcker B, Brockow K, Hagemann J, Bieber T, Wehrmann W, Becker S, Freudelsperger L, Mülleneisen NK, Nemat K, Czech W, Wrede H, Brehler R, Fuchs T, Dramburg S, Matricardi P, Hamelmann E, Werfel T, Wagenmann M, Taube C, Zuberbier T, Ring J. Management von Anaphylaxie-gefährdeten Patienten während der Covid-19-Pandemie. Allergo J 2020; 29:16-26. [PMID: 33162681 PMCID: PMC7605140 DOI: 10.1007/s15007-020-2618-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ludger Klimek
- Zentrum f. Rhinologie und Allergologie, An den Quellen 10, 65183 Wiesbaden, Germany
| | - Margitta Worm
- Allergie-Centrum-Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Lars Lange
- OA Pädiatrie - St.-Marien-Hospital, Robert-Koch-Str. 1, 53115 Bonn, Germany
| | - Kirsten Beyer
- Klinik für Pädiatrie - Pneumologie und Immunologie, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Ernst Rietschel
- Pädiatrische Pneumologie u. Allergologie, Klinikum der Univ. Köln, Kerpener Str. 62, 50924 Köln, Germany
| | | | - Sabine Schnadt
- Deutscher Allergie- und Asthmabund (DAAB), An der Eickesmühle 15 - 19, 41238 Mönchengladbach, Germany
| | - Britta Stöcker
- Kinderpneumologie u. Allergologie, Robert-Koch-Str. 1, 53115 Bonn, Germany
| | - Knut Brockow
- Klinik f. Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802 München, Germany
| | - Jan Hagemann
- Klinik f. Hals-Nasen-Ohrenheilkunde, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Thomas Bieber
- Rheinische Friedrich-Wilhelms-Universität, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Wolfgang Wehrmann
- Dermatologische Gemeinschaftspraxis, Warendorfer Str. 183, 48145 Münster, Germany
| | - Sven Becker
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinik Tübingen, Langenbeckstr. 1, 55131 Tübingen, Germany
| | - Laura Freudelsperger
- Hals-, Nasen-, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Germany
| | | | - Katja Nemat
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Wolfgang Czech
- Kinderheilkunde - Allergologie, Benediktinerring 10, 78050 VS-Villingen, Germany
| | | | - Randolf Brehler
- Wilhelm-Univ. Münster, Abtlg. Dermatologie, Von-Esmarch-Str. 58, 48149 Münster, Germany
| | - Thomas Fuchs
- Klinik f. Dermatologie, Venerologie u. Allergologie, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | | | - Paolo Matricardi
- Klinik für Pädiatrie m.S. Pneumologie, Immunologie u. Intensivmedizin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Eckard Hamelmann
- Evangelisches Krankenhaus Bielefeld gGmbH, Grenzweg 10, 33617 Bielefeld, Germany
| | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Carl-Neuberg-Str. 1, 30449 Hannover, Germany
| | - Martin Wagenmann
- Hals-Nasen-Ohren-Klinik, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Christian Taube
- Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147 Essen, Germany
| | - Torsten Zuberbier
- Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Johannes Ring
- Haut- und Laserzentrum an der Oper, Perusastraße 5, 80333 München, Germany
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Bortoluzzi CF, Pontello E, Pintani E, de Winter-de Groot KM, D'Orazio C, Assael BM, Hunink MM, Tiddens HA, Caudri D, Belessis Y, Bremont F, Bui S, Casciaro R, Cavicchi M, Cox D, Da Dalt L, De Gregorio F, Dubus J, Gartner S, Geerdink M, Hansen C, Honková L, Jenkins L, Jung A, Karpati F, Mainguy C, Möller A, Neri A, Pressler T, Proesmans M, Raia V, Reid A, Rietschel E, Robinson P, Robinson P, Rossi P, Rovira S, Schultz A, Sepe O, Skalická V, Stick S, Švabe V, Tai A, Tosco A, Vazquez C. The impact of chest computed tomography and chest radiography on clinical management of cystic fibrosis lung disease. J Cyst Fibros 2020; 19:641-646. [DOI: 10.1016/j.jcf.2019.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 01/19/2023]
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Prenzel F, Harfst J, Schwerk N, Ahrens F, Rietschel E, Schmitt-Grohé S, Rubak SML, Poplawska K, Baden W, Vogel M, Hollizeck S, Ley-Zaporozhan J, Brasch F, Reu S, Griese M. Lymphocytic interstitial pneumonia and follicular bronchiolitis in children: A registry-based case series. Pediatr Pulmonol 2020; 55:909-917. [PMID: 32040879 DOI: 10.1002/ppul.24680] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/26/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Pediatric lymphocytic interstitial pneumonia (LIP) and follicular bronchiolitis (FB) are poorly characterized lymphoproliferative disorders. We present and quantify demographics, radiological and histopathologic patterns, treatments and their responses, and outcomes in non-HIV-infected children with LIP and FB. METHODS This structured registry-based study included a retrospective chart review, blinded analysis of imaging studies and lung biopsies, genetic testing, and evaluation of treatments and outcomes. RESULTS Of the 13 patients (eight females) studied, eight had FB, four had combined LIP/FB, and one had isolated LIP; diagnoses were highly concordant between the pathologists. Most patients became symptomatic during the first 2 years of life, with a mean lag time to diagnosis of 4 years. The most common symptoms were coughing and respiratory infections (11 out of 13 each), dyspnea (10 out of 13), and wheezing (eight out of 13). Autoantibodies were found in eight out of 13 patients. In three patients, disease-causing mutations in the COPA gene were identified. CT revealed hilar lymphadenopathy (five out of 12), ground-glass opacity (eight out of 12), consolidation (five out of 12), and cysts (four out of 13). Systemic steroids as intravenous pulses (11 out of 13) or oral intake (10 out of 13) were the main treatments and showed high response rates of 100% and 90%, respectively. Within the mean observation period of 68 months, all children had chronic courses, eight out of 13 had severe diseases, two died, and one worsened. CONCLUSIONS Children with LIP/FB have chronic diseases that occurred in early childhood and were commonly associated with immune dysregulation as well as high morbidity and mortality. Early diagnosis and treatment may be crucial to improve the outcome.
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Affiliation(s)
- Freerk Prenzel
- Department of Pediatrics, Center for Pediatric Research Leipzig (CPL), University of Leipzig Medical Center, Leipzig, Germany
| | - Jacqueline Harfst
- Hauner Children's Hospital and KUBUS Research Center, University of Munich, Munich, Germany
| | - Nicolaus Schwerk
- Clinic for Pediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, Hannover, Germany
| | | | - Ernst Rietschel
- University Children's Hospital, University of Cologne, Cologne, Germany
| | | | - Sune M L Rubak
- Danish Center of Pediatric Pulmonology and Allergology, University Hospital of Aarhus, Aarhus, Denmark
| | | | - Winfried Baden
- University Children's Hospital Tübingen, Tübingen, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Sebastian Hollizeck
- Hauner Children's Hospital and KUBUS Research Center, University of Munich, Munich, Germany
| | | | - Frank Brasch
- Department of Pathology, Academic Teaching Hospital Bielefeld, Bielefeld, Germany
| | - Simone Reu
- Department of Pathology, University of Munich, Munich, Germany
| | - Matthias Griese
- Hauner Children's Hospital and KUBUS Research Center, University of Munich, Munich, Germany
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25
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Seidl E, Kiermeier H, Liebisch G, Ballmann M, Hesse S, Paul-Buck K, Ratjen F, Rietschel E, Griese M. Lavage lipidomics signatures in children with cystic fibrosis and protracted bacterial bronchitis. J Cyst Fibros 2019; 18:790-795. [DOI: 10.1016/j.jcf.2019.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/08/2019] [Accepted: 04/12/2019] [Indexed: 12/19/2022]
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26
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Thomassen JC, Trojan T, Vohlen C, Rietschel E, van Koningsbruggen-Rietschel S, Alejandre Alcazar M. P222 Elafin expression is regulated by CFTR mutation and TGF-β1 in human bronchial epithelial cells and is reduced in sputum of cystic fibrosis patients infected with Pseudomonas aeruginosa. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30515-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Gaertner VD, Michel S, Curtin JA, Pulkkinen V, Acevedo N, Söderhäll C, von Berg A, Bufe A, Laub O, Rietschel E, Heinzmann A, Simma B, Vogelberg C, Pershagen G, Melén E, Simpson A, Custovic A, Kere J, Kabesch M. Nocturnal asthma is affected by genetic interactions between RORA and NPSR1. Pediatr Pulmonol 2019; 54:847-857. [PMID: 30927345 DOI: 10.1002/ppul.24292] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 12/17/2018] [Accepted: 02/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Neuropeptide S Receptor 1 ( NPSR1) and Retinoid Acid Receptor-Related Orphan Receptor Alpha (RORA ) interact biologically, are both known candidate genes for asthma, and are involved in controlling circadian rhythm. Thus, we assessed (1) whether interactions between RORA and NPSR1 specifically affect the nocturnal asthma phenotype and (2) how this may differ from other asthma phenotypes. METHODS Interaction effects between 24 single-nucleotide polymorphisms (SNPs) in RORA and 35 SNPs in NPSR1 on asthma and nocturnal asthma symptoms were determined in 1432 subjects (763 asthmatics [192 with nocturnal asthma symptoms]; 669 controls) from the Multicenter Asthma Genetic in Childhood/International Study of Asthma and Allergies in Childhood studies. The results were validated and extended in children from the Manchester Asthma and Allergy Study (N = 723) and the Children Allergy Milieu Stockholm and Epidemiological cohort (N = 1646). RESULTS RORA* NPSR1 interactions seemed to affect both asthma and nocturnal asthma. In stratified analyses, however, interactions mainly affected nocturnal asthma and less so asthma without nocturnal symptoms or asthma severity. Results were replicated in two independent cohorts and seemed to remain constant over time throughout youth. CONCLUSION RORA* NPSR1 interactions appear to be involved in mechanisms specific for nocturnal asthma. In contrast to previous studies focusing on the role of beta 2 receptor polymorphisms in nocturnal asthma as a feature of asthma control or severity in general, our data suggest that changes in circadian rhythm control are associated with nighttime asthma symptoms.
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Affiliation(s)
- Vincent D Gaertner
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Sven Michel
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - John A Curtin
- Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, and Manchester University NHS Foundation Trust, Manchester, UK
| | - Ville Pulkkinen
- Heart and Lung Center, Division of Pulmonary Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Nathalie Acevedo
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.,Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | - Cilla Söderhäll
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Women´s and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Andrea von Berg
- Children's Department, Research Institute for the Prevention of Allergic Diseases, Marien-Hospital, Wesel, Germany
| | - Albrecht Bufe
- Department of Experimental Pneumology, Ruhr-University, Bochum, Germany
| | - Otto Laub
- Kinder- und Jugendarztpraxis Laub, Rosenheim, Germany
| | - Ernst Rietschel
- Faculty of Medicine, University Children's Hospital, University of Cologne, Cologne, Germany
| | - Andrea Heinzmann
- Center for Pediatrics, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - Burkhard Simma
- Children's Department, University Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria
| | - Christian Vogelberg
- University Children's Hospital, Technical University Dresden, Dresden, Germany
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet and Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet and Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Angela Simpson
- Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester Academic Health Science Centre, and Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Juha Kere
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Research Programs Unit, Program for Molecular Neurology, University of Helsinki, Folkhälsän Institute of Genetics, Helsinki, Finland
| | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany.,School of Basic & Medical Biosciences, King's College London, London, England
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Thomassen J, Walz ML, Trojan T, Lippach G, Rietschel E, Alejandre Alcazar M, van Koningsbruggen-Rietschel S. WS16.3 Investigation of inflammatory and fibrotic biomarkers in the sputum of cystic fibrosis patients. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30210-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Schwarz C, Schulte-Hubbert B, Bend J, Abele-Horn M, Baumann I, Bremer W, Brunsmann F, Dieninghoff D, Eickmeier O, Ellemunter H, Fischer R, Grosse-Onnebrink J, Hammermann J, Hebestreit H, Hogardt M, Hügel C, Hug M, Illing S, Jung A, Kahl B, Koitschev A, Mahlberg R, Mainz JG, Mattner F, Mehl A, Möller A, Muche-Borowski C, Nüßlein T, Puderbach M, Renner S, Rietschel E, Ringshausen FC, Schmidt S, Sedlacek L, Sitter H, Smaczny C, Tümmler B, Vonberg R, Wielpütz MO, Wilkens H, Wollschläger B, Zerlik J, Düesberg U, van Koningsbruggen-Rietschel S. [CF Lung Disease - a German S3 Guideline: Module 2: Diagnostics and Treatment in Chronic Infection with Pseudomonas aeruginosa]. Pneumologie 2018; 72:347-392. [PMID: 29758578 DOI: 10.1055/s-0044-100191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Cystic Fibrosis (CF) is the most common autosomal-recessive genetic disease affecting approximately 8000 people in Germany. The disease is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to dysfunction of CFTR, a transmembrane chloride channel. This defect causes insufficient hydration of the epithelial lining fluid which leads to chronic inflammation of the airways. Recurrent infections of the airways as well as pulmonary exacerbations aggravate chronic inflammation, lead to pulmonary fibrosis and tissue destruction up to global respiratory insufficiency, which is responsible for the mortality in over 90 % of patients. The main aim of pulmonary treatment in CF is to reduce pulmonary inflammation and chronic infection. Pseudomonas aeruginosa (Pa) is the most relevant pathogen in the course of CF lung disease. Colonization and chronic infection are leading to additional loss of pulmonary function. There are many possibilities to treat Pa-infection. This is a S3-clinical guideline which implements a definition for chronic Pa-infection and demonstrates evidence-based diagnostic methods and medical treatment for Pa-infection in order to give guidance for individual treatment options.
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Affiliation(s)
- C Schwarz
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Christiane Herzog Zentrum, Berlin
| | - B Schulte-Hubbert
- Medizinische Klinik und Poliklinik I, Pneumologie, Universitätsklinikum Dresden
| | - J Bend
- Mukoviszidose Institut, Bonn
| | - M Abele-Horn
- Universität Würzburg, Institut für Hygiene und Mikrobiologie
| | - I Baumann
- Universität Heidelberg, Hals-Nasen-Ohrenklinik, Heidelberg
| | | | - F Brunsmann
- Charité Universitätsmedizin Berlin, Deutschland (Patientenvertreter)
| | - D Dieninghoff
- Kliniken der Stadt Köln, Lungenklinik, Lehrstuhl der Universität Witten Herdecke
| | - O Eickmeier
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Christiane Herzog CF-Zentrum, Frankfurt
| | - H Ellemunter
- Tirolkliniken GmbH, Department für Kinderheilkunde Pädiatrie III, Innsbruck, Österreich
| | - R Fischer
- Zentrum für erwachsene Mukoviszidose-Patienten München-West
| | - J Grosse-Onnebrink
- Universitätsklinikum Münster UKM; Klinik für Kinder- und Jugendmedizin; Allgemeine Pädiatrie Mukoviszidose-Ambulanz, Münster
| | - J Hammermann
- Universitäts-Mukoviszidose-Zentrum "Christiane Herzog", Dresden
| | | | - M Hogardt
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Frankfurt
| | - C Hügel
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Zentrum der Inneren Medizin, Frankfurt, Deutschland
| | - M Hug
- Universitätsklinikum Freiburg, Apotheke des Klinikums Freiburg
| | - S Illing
- Olgahospital - Kinderklinik - CF-Zentrum/Jugendliche/Erwachsene Stuttgart
| | - A Jung
- Kinderspital Zürich, Abteilung Pneumologie, Zürich, Schweiz
| | - B Kahl
- Universitätsklinikum Münster UKM, Institut für Medizinische Mikrobiologie, Münster
| | - A Koitschev
- Klinikum Stuttgart - Standort Olgahospital, Klinik für Hals-Nasen-Ohrenkrankheiten, Stuttgart
| | - R Mahlberg
- Klinikum Mutterhaus der Borromäerinnen, Abteilung Innere Medizin, Trier
| | - J G Mainz
- Universitätsklinikum Jena, Mukoviszidosezentrum/Pädiatrische Pneumologie, Jena
| | - F Mattner
- Kliniken der Stadt Köln, Institut für Hygiene, Köln
| | - A Mehl
- Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Christiane Herzog Zentrum, Berlin
| | - A Möller
- Pneumologie und CF Ambulanz der Universitäts-Kinderklinik Zürich, Schweiz
| | - C Muche-Borowski
- Philipps-Universität Marburg, AWMF-Institut für Medizinisches Wissensmanagement, Marburg und Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Allgemeinmedizin, Hamburg
| | - T Nüßlein
- Gemeinschaftsklinikum Mittelrhein, Klinik für Kinder- und Jugendmedizin Koblenz und Mayen
| | - M Puderbach
- Hufeland Klinikum, Abteilung für Diagnostische und Interventionelle Radiologie, Bad Langensalza
| | - S Renner
- Allgemeines Universitätskrankenhaus, Klinik für Kinder- und Jugendheilkunde, CF Ambulanz, Wien, Österreich
| | - E Rietschel
- Mukoviszidose-Zentrum Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln
| | - F C Ringshausen
- Medizinische Hochschule Hannover, Klinik für Pneumologie und Deutsches Zentrum für Lungenforschung (DZL), Hannover
| | - S Schmidt
- Ernst-Moritz-Arndt Universität Greifswald, Zentrum für Kinder- und Jugendmedizin; Mukoviszidose Zentrum Mecklenburg/Vorpommern, Greifswald
| | - L Sedlacek
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover
| | - H Sitter
- Philipps-Universität Marburg, Institut für theoretische Medizin, Marburg
| | - C Smaczny
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Zentrum der Inneren Medizin, Frankfurt, Deutschland
| | - B Tümmler
- Medizinische Hochschule Hannover, Klinische Forschergruppe OE 6710, Klinik für Pädiatrische Pneumologie und Neonatologie
| | - R Vonberg
- Medizinische Hochschule Hannover, Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Hannover
| | - M O Wielpütz
- Diagnostische und Interventionelle Radiologie Universitätsklinikum Heidelberg, Heidelberg
| | - H Wilkens
- Universitätsklinikum des Saarlandes, Medizinische Klinik V, Pneumologie, Allergologie und Beatmungsmedizin, Homburg
| | - B Wollschläger
- Martin-Luther-Universität Halle, Universitätsklinik und Poliklinik für Innere Medizin I/Pneumologie, Halle
| | - J Zerlik
- Altonaer Kinderkrankenhaus gGmbH, Abteilung Physiotherapie, Hamburg
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Thomassen JC, Mueller MI, Alejandre Alcazar MA, Rietschel E, van Koningsbruggen-Rietschel S. Effect of Lumacaftor/Ivacaftor on glucose metabolism and insulin secretion in Phe508del homozygous cystic fibrosis patients. J Cyst Fibros 2017; 17:271-275. [PMID: 29249670 DOI: 10.1016/j.jcf.2017.11.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 10/27/2017] [Accepted: 11/29/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the effect of Lumacaftor/Ivacaftor on glucose metabolism and insulin secretion in patients with cystic fibrosis (CF) (Phe508del/Phe508del). METHODS A standard oral glucose tolerance test (OGTT) and an intravenous glucose tolerance test (IVGTT) were performed to investigate glucose metabolism and insulin secretion before and after 6-8weeks of treatment with Lumacaftor/Ivacaftor in 5 Phe508del-homozygous CF patients. The area under the curve (AUC) for glucose and insulin levels was calculated using the trapezoidal approximation. RESULTS 5 participants were investigated. Treatment with Lumacaftor/Ivacaftor was followed by an improvement of the 2h glucose levels in 3 patients and worsening in 2 patients. Analysis of the time course of blood glucose levels during OGTT revealed an increase of the AUC in 3 of 5 patients. In response to IVGTT, acute insulin secretion improved in 2 patients and worsened in 3. CONCLUSION The investigation could not demonstrate that treatment with Lumacaftor/Ivacaftor had a consistent impact on glucose tolerance and insulin secretion. Further adequately-powered studies examining glucose metabolism are needed to properly evaluate drug response in the endocrine pancreas and to test whether this treatment could eventually prevent the development of cystic fibrosis-related diabetes (CFRD).
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Affiliation(s)
- Jan C Thomassen
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Germany; Translational Experimental Pediatrics/Experimental Pulmonology, Children's Hospital, Faculty of Medicine, University of Cologne, Germany.
| | - Matthias I Mueller
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Germany
| | - Miguel A Alejandre Alcazar
- Translational Experimental Pediatrics/Experimental Pulmonology, Children's Hospital, Faculty of Medicine, University of Cologne, Germany
| | - Ernst Rietschel
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Germany
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Yavuz ST, Koc O, Gungor A, Gok F, Hawley J, O’Brien C, Thomas M, Brodlie M, Michaelis L, Mota I, Gaspar Â, Piedade S, Sampaio G, Dias JG, Paiva M, Morais-Almeida M, Madureira C, Lopes T, Lopes S, Almeida F, Sequeira A, Carvalho F, Oliveira J, Gay-Crosier F, Nenciu IV, Nita AF, Ulmeanu A, Oraseanu D, Zapucioiu C, Machinena A, Sánchez OD, Lozano MA, Feijoo RJ, Blasco JL, Gibert MP, Muñoz MTG, da Costa MD, Martín AMP, Yilmaz EA, Cavkaytar Ö, Buyuktiryaki B, Soyer O, Sackesen C, Netting M, El-Merhibi A, Gold M, Quinn P, Penttila I, Makrides M, Giavi S, Muraro A, Lauener R, Mercenier A, Bersuch E, Montagner IM, Passioti M, Celegato N, Summermatter S, Nutten S, Bourdeau T, Vissers YM, Papadopoulos NG, van der Kleij H, Warmenhoven H, van Ree R, Pieters R, Opstelten DJ, van Schijndel H, Smit J, Fitzsimons R, Timms V, Du Toit G, Kaya G, Gulec M, Saldir M, Sener O, Hassan N, Shaaban H, El-Hariri H, Mahfouz AKIE, Gabor P, Gabor B, Csaba K, Chawes B, Bønnelykke K, Stokholm J, Heickendorff L, Brix S, Rasmussen M, Bisgaard H, Hallas HW, Arianto L, Pincus M, Keil T, Reich A, Wahn U, Lau S, Grabenhenrich L, Fagerstedt S, Hesla HM, Johansson E, Rosenlund H, Mie A, Scheynius A, Alm J, Esparza-Gordillo J, Matanovic A, Marenholz I, Bauerfeind A, Rohde K, Nemat K, Lee-Kirsch MA, Nordenskjöld M, Winge MC, Krüger R, Beyer K, Kalb B, Niggemann B, Hübner N, Cordell HJ, Bradley M, Lee YA, Gough H, Schramm D, Beschorner J, Schuster A, Bauer CP, Forster J, Zepp F, Bergmann R, Bergmann K, Garcia FB, Santos N, Pité H, Papadopoulou A, Mermiri D, Xatziagorou E, Tsanakas I, Lampidi S, Priftis K, Fuertes E, Markevych I, Bowatte G, Gruzieva O, Gehring U, Becker A, Berdel D, Brauer M, Carlsten C, Hoffmann B, Kozyrskyj A, Lodge C, Pershagen G, Wijga A, Joachim H, Zivkovic Z, Djuric-Filipovic I, Jocić-Stevanovic J, Zivanovic S, Taka S, Kokkinou D, Papakonstantinou A, Stefanopoulou P, Georgountzou A, Maggina P, Stamataki S, Papaevanggelou V, Andreakos E, Gibert MP, Spera AM, Deliu M, Belgrave D, Simpson A, Custovic A, Marques JG, Carreiro-Martins P, Belo J, Serranho S, Peralta I, Neuparth N, Leiria-Pinto P, Vazquez-Ortiz M, Pascal M, Plaza AM, Juan M, Paparo L, Nocerino R, Aitoro R, Langella I, Amoroso A, Amoroso A, Di Scala C, Berni Canani R, Maity S, Rotiroti G, Gandhi M, Jonsson K, Ljung A, Hesselmar B, Adlerbert I, Brekke H, Johansen S, Wold A, Sandberg AS, Nordlund B, Lundholm C, Ullemar V, van Hage M, Örtqvist A, Almqvist C, Selby A, Grimshaw K, Clausen M, Dubakiene R, Fiocchi A, Kowalski M, Papadopoulos N, Reche M, Sigurdardottir S, Sprikkleman A, Xepapadaki P, Mills C, Roberts G, Neto HJC, Wandalsen GF, Bianca ACD, Aranda C, Rosário NA, Solé D, Mallol J, Marcos LG, Banic I, Rijavec M, Plavec D, Korosec P, Turkalj M, Bozicevic A, De Mieri M, Hamburger M, Holley S, Morris R, Mitchell F, Knibb R, Latter S, Liossi C, Hassan MMM, Barman M, Sandin A, Posa D, Perna S, Hoffmann U, Chen KW, Resch Y, Vrtala S, Valenta R, Matricardi PM, Tsilochristou O, Rohrbach A, Cappella A, Hofmaier S, Hatzler L, D’Amelio R, Björkander S, Johansson MA, Lasaviciute G, Sverremark-Ekström E, Rüschendorf F, Strachan DP, Spycher BD, Baurecht H, Margaritte-Jeannin P, Sääf A, Kerkhof M, Ege M, Baltic S, Matheson MC, Li J, Michel S, Ang WQ, McArdle W, Arnold A, Homuth G, Demenais F, Bouzigon E, Söderhäll C, de Jongste JC, Postma DS, Braun-Fahrländer C, Horak E, Ogorodova LM, Puzyrev VP, Bragina EY, Hudson TJ, Morin C, Duffy DL, Marks GB, Robertson CF, Montgomery GW, Musk B, Thompson PJ, Martin NG, James A, Sleiman P, Toskala E, Rodriguez E, Fölster-Holst R, Franke A, Lieb W, Gieger C, Heinzmann A, Rietschel E, Cichon S, Nöthen MM, Pennell CE, Sly PD, Schmidt CO, Schneider V, Heinig M, Holt PG, Kabesch M, Weidinger S, Hakonarson H, Ferreira MAR, Laprise C, Freidin MB, Genuneit J, Koppelman GH, Melén E, Dizier MH, John Henderson A, Lee YA, González-Delgado P, Caparrós E, Clemente F, Cueva B, Moreno VM, Carretero JL, Fernández J, Swan K, Gopi M, Smith T, Ramesh E, Sadasivam A, Arêde C, Borrego LM, Pires G, Santa-Marta C, Brand S, Stein K, Heine H, Kauth M, Rolfsjord LB, Bakkeheim E, Skjerven HO, Carlsen KH, Hunderi JO, Berents TL, Mowinckel P, Lødrup Carlsen KC, Munzel U, Berger W, Valiente R, Vozmediano V, Lukas JC, Rodríguez M, Guarnaccia S, Vitale L, Pluda A, D’Agata E, Colombo D, Felici S, Gretter V, Facchetti S, Pecorelli G, Quecchia C, Guibas G, Spandou E, Megremis S, West P, Papadopoulos N, Rufo JC, Madureira J, Paciência I, Aguiar L, Padrão P, Pinto M, Delgado L, Moreira P, Teixeira JP, Fernandes EO, Moreira A, Dominguez AI, Valero A, Mullol J, Del Cuvillo A, Montoro J, Jauregui I, Bartra J, Davila I, Ferrer M, Sastre J, Martins C, Lima J, Leandro MJ, Nunes G, Branco JC, Trindade H, Borrego LM, Conkar S, Kilic M, Aygun C, Sancak R, Tagalaki E, Banos L, Vlachou A, Giannoula F, Pavlakou M, Kryoni M, Makris K, Lazova S, Petrova G, Miteva D, Perenovska P, Klyucharova A, Skorohodkina O, Koumaki D, Manousaki A, Agrapidi M, Iatridou L, Eruk O, Myridakis K, Manousakis E, Koumaki V, Dimou M, Ingemansson M, Hedlin G, Pastor N, de Boissieu D, Vanderhoof J, Moore N, Maditz K, Mehdi A, Elhassan S, Beck C, Al-Hammadi A, Maris I, O’Sullivan R, Hourihane J, Raptis G, DunnGalvin A, Greenhawt M, Venter C, O’Regan E, Cronin D, O’Reilly A, Abdelaziz F, Khelifi-Touhami D, Selim N, Khelifi-Touhami T, Merida P, Plaza AM, Castellanos JH, Lozano J, Dominguez O, Piquer M, Jimenez R, Giner MT, Kakleas K, Joishy M, Maskele W, Jenkins HR, Escarrer M, Madroñero A, Guerra MT, Julia JC, Cerda JC, Contreras J, Tauler E, Vidorreta MJ, Rojo A, Del Valle S, Flynn N, Foley G, Harmon C, Fitzsimons J, Baynova K, Del Robledo ÁM, Marina L, Cortes A, Sciaraffia A, Castillo A, Juel-Berg N, Hansen KS, Poulsen LK, Lazar A, Aguiar R, Lopes A, Paes MJ, Santos AS, Pereira-Barbosa MA, Eke Gungor H, Uytun S, Sahiner UM, Altuner Torun Y, Zivanovic M, Atanasković-Marković M, Vesel T, Nahtigal M, Obermayer-Temlin A, Križnik EŠ, Maslar M, Bizjak R, Tomšič-Matic M, Posega-Devetak S, Skerbinjek-Kavalar M, Predalič M, Avčin T, Pouessel G, Beaudouin E, Moneret-Vautrin AM, Deschildre A, Viñas M, Borja B, Hernández N, Castillo MJ, Izquierdo A, Ibero M, Kocabas CN, Heming C, Garrett E, Blackstock A, Chodhari R, Belohlavkova S, Kopelentova E, Visek P, Setinova I, Svarcova I, Sjölander S, Nilsson N, Berthold M, Ekoff H, Borres M, Nilsson C, González Domínguez L, Muñoz Archidona C, Moreira Jorge A, Quevedo Teruel S, Bracamonte Bermejo T, Castillo Fernández M, Pineda de la Losa F, Echeverría Zudaire LÁ, Vrani O, Mavroudi A, Fotoulaki M, Emporiadou M, Spiroglou K, Xinias I, Sadreddini HA, Warnes M, Traves D, Kostić G, Filipovic Đ, Sittisomwong S, Sittisomwong S, Podolec Z, Hartel M, Panek D, Podolec-Rubiś M, Banasik T, Abbasi E, Moghtaderi M, Sanneerappa P, Deliu A, Kutty M, Ramesh N, Sherkat R, Sabri MR, Dehghan B, Bigdelian H, Raeesi N, Afshar M, Rahimi H, Klein C, Al-Jebouri M, Svitich OA, Zubacheva DO, Potemkin DA, Gankovskaya LV, Zverev VV, OB Doyle E, Gallagher P, Dewlett S, Man K, Pocock J, Gerrardhughes A, Wasilewska J, Kaczmarski M, Lebensztejn D, Thuraisingham C, Sinniah D, Chen Y, Mei X, Ozdogan S, Karadeniz P, Ayyildiz-Emecen D, Oncul U, Sari G, Cavdar S, Farzan N, Vijverberg SJ, Palmer CJ, Tantisira KG, Maitland-van der Zee AH, Yavuzyilmaz F, Urganci N, Usta M, Hoxha M, Basho M, Wandalsen GF, Monteiro F, Lame B, Mesonjesi E, Sherri A, Ibranji A, Gjati L, Loloci G, Bardhi A, Moghtaderi B, Farjadian S, Eghtedari D, Olaya M, Del Mar Vasquez L, Ramirez LF, Serrano CD, Usta Guc B, Asilsoy S, Ozer F, Shopova S, Papochieva V, Loekmanwidjaja J, Mallozi M, Ratner P, Soteres D, Novák Z, Yáñez A, Ildikó K, Kuna P, Tortajada M, Valiente R, Feuerhahn J, Blome C, Hadler M, Karagiannis E, Langenbruch A, Augustin M, Roux M, Kakudo S, Zeldin RK, Sokolova A, Silva TM, Zivanovic SS, Cvetkovic V, Nikolic I, Zivanovic SJ, Saranac L, Nesterenko Z, Radic S, Milenkovic B, Smiljanic S, Micic-Stanijevic M, Calovic O, Hofbauer AMB, Agertoft L, Everson L, Kearney J, Coppel J, Braithwaite S, Christiansen ES, Kjaer HF, Eller E, Mørtz CG, Halken S, Román India C, Jiménez Jiménez J, Echeverría Zudaire L, O’Connor C, Kanti V, Lünnemann L, Malise G, Ludriksone L, Stroux A, Henrich W, Abu-Dakn M, Blume-Peytavi U, Garcia Bartels N, Schario M, Stanley T, Brandenbarg N, Boardman A, McGreevy G, Rodger E, Knight K, Taylor T, Scanlan G, Christoph G, van Stuivenberg M, Mosca F, Moro G, Chirico G, Braegger CP, Riedler J, Yavuz Y, Boehm G, Arasi S, Crisafulli G, Caminiti L, Porcaro F, Pajno GB, Tanaka A, Togawa Y, Oida K, Kambe N, Arkwright P, Amagai Y, Shimojo N, Sato Y, Mochizuki H, Jang H, Ishizaka S, Matsuda H, Barlianto W, Olivianto E, Chandra Kusuma HMS, Mollica M, Trinchese G, Alfano E, Amato F, Pirozzi C, Calignano A, Meli R, Rossberg S, Gerhold K, Zimmermann K, Zaino M, Geske T, Hamelmann E, Bogovic S, van den Berg J, Janssen C, Claver A, Martin-Muñoz MF, Martorell C, Belver MT, Alonso Lebrero E, Zapatero L, Fuentes V, Piqué M, Plaza A, Muñoz C, Blasco C, Villa B, Gómez C, Nevot S, García JM, Echeverria L, DeWitt B, Holloway J, Hodge D, Ludman S, Jafari-Mamaghani M, Ebling R, Fox AT, Lack G, Lovén Björkman S, Ballardini N, Basu S, Hallet J, Srinivas J, Stringer H, Jay N, Fonseca P, Vieira C, Mastrorilli C, Caffarelli C, Asero R, Tripodi S, Dondi A, Ricci G, Povesi Dascola C, Calamelli E, Cipriani F, Di Rienzo Businco A, Bianchi A, Candelotti P, Frediani T, Verga C, Korovessi P, Tiliakou S, Tavoulari E, Moraiti KM, Tee WJ, Deiratany S, Seedhoo R, McNamara R, Okafor I, Khaleva E, Novic G, Bychkova N, Abd Al-Aziz A, Fatouh A, Motawie A, Bostany EE, Ibrahim A, Andonova S, Savov A, Zoto M, Kyriakakou M, Vassilopoulou M, Balaska A, Kostaridou S, Wartna J, Bohnen AM, Elshout G, Pols DHJ, Bindels PJE, Seys SF, Dilissen E, Van der Eycken S, Schelpe AS, Marijsse G, Troosters T, Vanbelle V, Aertgeerts S, Ceuppens JL, Dupont LJ, Peers K, Bullens DM, Lokas SB, Zivkovic J, Nogalo B, Kobal IM, Oliveira G, Pike K, Melo A, Amélia T, Cidrais Rodrigues JC, Serrano C, Lopes dos Santos JM, Lopes C, Schauer U, Bergmann KC, Moral L, Toral T, Marco N, Avilés BG, Fuentes MJ, Garde J, Montahud C, Perona J, Forniés MJ, Arroabarren E, Anda M, Sanz ML, Lizaso MT, Arregui C, May S, Hartz M, Joshi A, Park MA, Posega Devetak S, Koren Jeverica A, Castro L, Gouveia C, Marques AC, Cabral AJ, Amaral L, Carolino F, Castro E, Passos M, Cernadas JR, Amaral L, Dias de Castro E, Pineda F, Gomes A, Brough H, Röhmel J, Schwarz C, Mehl A, Stock P, Staab D, Seib C, Critchlow A, Barber A, Delavalle B, Garriga T, Vilá B, Astolfi A, Di Chiara C, Neri I, Patrizi A, Neskorodova K, Kudryavtseva A, Alvarez J, Palacios M, Martinez-Merino M, Vaquero I. 4th Pediatric Allergy and Asthma Meeting (PAAM). Clin Transl Allergy 2016. [PMCID: PMC5123301 DOI: 10.1186/s13601-016-0117-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
WORKSHOP 4: Challenging clinical scenarios (CS01–CS06) CS01 Bullous lesions in two children: solitary mastocytoma S. Tolga Yavuz, Ozan Koc, Ali Gungor, Faysal Gok CS02 Multi-System Allergy (MSA) of cystic fibrosis: our institutional experience Jessica Hawley, Christopher O’Brien, Matthew Thomas, Malcolm Brodlie, Louise Michaelis CS03 Cold urticaria in pediatric age: an invisible cause for severe reactions Inês Mota, Ângela Gaspar, Susana Piedade, Graça Sampaio, José Geraldo Dias, Miguel Paiva, Mário Morais-Almeida CS04 Angioedema with C1 inhibitor deficiency in a girl: a challenge diagnosis Cristina Madureira, Tânia Lopes, Susana Lopes, Filipa Almeida, Alexandra Sequeira, Fernanda Carvalho, José Oliveira CS05 A child with unusual multiple organ allergy disease: what is the primer? Fabienne Gay-Crosier CS06 A case of uncontrolled asthma in a 6-year-old patient Ioana-Valentina Nenciu, Andreia Florina Nita, Alexandru Ulmeanu, Dumitru Oraseanu, Carmen Zapucioiu ORAL ABSTRACT SESSION 1: Food allergy (OP01–OP06) OP01 Food protein-induced enterocolitis syndrome: oral food challenge outcomes for tolerance evaluation in a Pediatric Hospital Adrianna Machinena, Olga Domínguez Sánchez, Montserrat Alvaro Lozano, Rosa Jimenez Feijoo, Jaime Lozano Blasco, Mònica Piquer Gibert, Mª Teresa Giner Muñoz, Marcia Dias da Costa, Ana Maria Plaza Martín OP02 Characteristics of infants with food protein-induced enterocolitis syndrome and allergic proctocolitis Ebru Arik Yilmaz, Özlem Cavkaytar, Betul Buyuktiryaki, Ozge Soyer, Cansin Sackesen OP03 The clinical and immunological outcomes after consumption of baked egg by 1–5 year old egg allergic children: results of a randomised controlled trial MerrynNetting, Adaweyah El-Merhibi, Michael Gold, PatrickQuinn, IrmeliPenttila, Maria Makrides OP04 Oral immunotherapy for treatment of egg allergy using low allergenic, hydrolysed egg Stavroula Giavi, Antonella Muraro, Roger Lauener, Annick Mercenier, Eugen Bersuch, Isabella M. Montagner, Maria Passioti, Nicolò Celegato, Selina Summermatter, Sophie Nutten, Tristan Bourdeau, Yvonne M. Vissers, Nikolaos G. Papadopoulos OP05 Chemical modification of a peanut extract results in an increased safety profile while maintaining efficacy Hanneke van der Kleij, Hans Warmenhoven, Ronald van Ree, Raymond Pieters, Dirk Jan Opstelten, Hans van Schijndel, Joost Smit OP06 Administration of the yellow fever vaccine in egg allergic children Roisin Fitzsimons, Victoria Timms, George Du Toit ORAL ABSTRACT SESSION 2: Asthma (OP07–OP12) OP07 Previous exacerbation is the most important risk factor for future exacerbations in school-age children with asthma S. Tolga Yavuz, Guven Kaya, Mustafa Gulec, Mehmet Saldir, Osman Sener, Faysal Gok OP08 Comparative study of degree of severity and laboratory changes between asthmatic children using different acupuncture modalities Nagwa Hassan, Hala Shaaban, Hazem El-Hariri, Ahmed Kamel Inas E. Mahfouz OP09 The concentration of exhaled carbon monoxide in asthmatic children with different controlled stadium Papp Gabor, Biro Gabor, Kovacs Csaba OP10 Effect of vitamin D3 supplementation during pregnancy on risk of persistent wheeze in the offspring: a randomised clinical trial Bo Chawes, Klaus Bønnelykke, Jakob Stokholm, Lene Heickendorff, Susanne Brix, Morten Rasmussen, Hans Bisgaard OP11 Lung function development in childhood Henrik Wegener Hallas, Bo Chawes, Lambang Arianto, Hans Bisgaard OP12 Is the effect of maternal and paternal asthma different in female and male children before puberty? Maike Pincus, Thomas Keil, Andreas Reich, Ulrich Wahn, Susanne Lau, Linus Grabenhenrich ORAL ABSTRACT SESSION 3: Epidemiology—genetics (OP13–OP18) OP13 Lifestyle is associated with incidence and category of allergen sensitisation: the ALADDIN birth cohort Sara Fagerstedt, Helena Marell Hesla, Emelie Johansson, Helen Rosenlund, Axel Mie, Annika Scheynius, Johan Alm OP15 Maternal filaggrin mutations increase the risk of atopic dermatitis in children: an effect independent of mutation inheritance Jorge Esparza-Gordillo, Anja Matanovic, Ingo Marenholz, Anja Bauerfeind, Klaus Rohde, Katja Nemat, Min-Ae Lee-Kirsch, Magnus Nordenskjöld, Marten C. G. Winge, Thomas Keil, Renate Krüger, Susanne Lau, Kirsten Beyer, Birgit Kalb, Bodo Niggemann, Norbert Hübner, Heather J. Cordell, Maria Bradley, Young-Ae Lee OP16 Allergic multimorbidity of asthma, rhinitis and eczema in the first 2 decades of the German MAS birth cohort Thomas Keil, Hannah Gough, Linus Grabenhenrich, Dirk Schramm, Andreas Reich, John Beschorner, Antje Schuster, Carl-Peter Bauer, Johannes Forster, Fred Zepp, Young-Ae Lee, Renate Bergmann, Karl Bergmann, Ulrich Wahn, Susanne Lau OP17 Childhood anaphylaxis: a growing concern Filipe Benito Garcia, Inês Mota, Susana Piedade, Ângela Gaspar, Natacha Santos, Helena Pité, Mário Morais-Almeida OP18 Indoor exposure to molds and dampness in infancy and its association to persistent atopic dermatitis in school age. Results from the Greek ISAAC II study Athina Papadopoulou, Despina Mermiri, Elpida Xatziagorou, Ioannis Tsanakas, Stavroula Lampidi, Kostas Priftis ORAL ABSTRACT SESSION 4: Pediatric rhinitis—immunotherapy (OP19–OP24) OP19 Associations between residential greenness and childhood allergic rhinitis and aeroallergen sensitisation in seven birth cohorts Elaine Fuertes, Iana Markevych, Gayan Bowatte, Olena Gruzieva, Ulrike Gehring, Allan Becker, Dietrich Berdel, Michael Brauer, Chris Carlsten, Barbara Hoffmann, Anita Kozyrskyj, Caroline Lodge, Göran Pershagen, Alet Wijga, Heinrich Joachim OP20 Full symptom control in pediatric patients with allergic rhinitis and asthma: results of a 2-year sublingual allergen immunotherapy study Zorica Zivkovic, Ivana Djuric-Filipovic, Jasmina Jocić-Stevanovic, Snežana Zivanovic OP21 Nasal epithelium of different ages of atopic subjects present increased levels of oxidative stress and increased cell cytotoxicity upon rhinovirus infection Styliani Taka, Dimitra Kokkinou, Aliki Papakonstantinou, Panagiota Stefanopoulou, Anastasia Georgountzou, Paraskevi Maggina, Sofia Stamataki, Vassiliki Papaevanggelou, Evangelos Andreakos, Nikolaos G. Papadopoulos OP22 Cluster subcutaneous immunotherapy schedule: tolerability profile in children Monica Piquer Gibert, Montserrat Alvaro Lozano, Jaime Lozano Blasco, Olga Domínguez Sánchez, Rosa Jiménez Feijoo, Marcia Dias da Costa, Mª Teresa Giner Muñoz, Adriana Machinena Spera, Ana Maria Plaza Martín OP23 Rhinitis as a risk factor for asthma severity in 11-year old children: population-based cohort study Matea Deliu, Danielle Belgrave, Angela Simpson, Adnan Custovic OP24 The Global Lung Function Initiative equations in airway obstruction evaluation of asthmatic children João Gaspar Marques, Pedro Carreiro-Martins, Joana Belo, Sara Serranho, Isabel Peralta, Nuno Neuparth, Paula Leiria-Pinto POSTER DISCUSSION SESSION 1: Food allergy (PD01–PD05) PD01 Allergen-specific humoral and cellular responses in children who fail egg oral immunotherapy due to allergic reactions Marta Vazquez-Ortiz, Mariona Pascal, Ana Maria Plaza, Manel Juan PD02 FoxP3 epigenetic features in children with cow milk allergy Lorella Paparo, Rita Nocerino, Rosita Aitoro, Ilaria Langella, Antonio Amoroso, Alessia Amoroso, Carmen Di Scala, Roberto Berni Canani PD04 Combined milk and egg allergy in early childhood: let them eat cake? Santanu Maity, Giuseppina Rotiroti, Minal Gandhi PD05 Introduction of complementary foods in relation to allergy and gut microbiota in farm and non-farm children Karin Jonsson, Annika Ljung, Bill Hesselmar, Ingegerd Adlerbert, Hilde Brekke, Susanne Johansen, Agnes Wold, Ann-Sofie Sandberg POSTER DISCUSSION SESSION 2: Asthma and wheeze (PD06–PD16) PD06 The association between asthma and exhaled nitric oxide is influenced by genetics and sensitisation Björn Nordlund, Cecilia Lundholm, Villhelmina Ullemar, Marianne van Hage, Anne Örtqvist, Catarina Almqvist PD09 Prevalence patterns of infant wheeze across Europe Anna Selby, Kate Grimshaw, Thomas Keil, Linus Grabenhenrich, Michael Clausen, Ruta Dubakiene, Alessandro Fiocchi, Marek Kowalski, Nikos Papadopoulos, Marta Reche, Sigurveig Sigurdardottir, Aline Sprikkleman, Paraskevi Xepapadaki, Clare Mills, Kirsten Beyer, Graham Roberts PD10 Epidemiologic changes in recurrent wheezing infants Herberto Jose Chong Neto, Gustavo Falbo Wandalsen, Ana Carolina Dela Bianca, Carolina Aranda, Nelson Augusto Rosário, Dirceu Solé, Javier Mallol, Luis García Marcos PD13 A single nucleotide polymorphism in the GLCCI1 gene is associated with response to asthma treatment in children IvanaBanic, Matija Rijavec, Davor Plavec, Peter Korosec, Mirjana Turkalj PD14 Pollen induced asthma: Could small molecules in pollen exacerbate the protein-mediated allergic response? Alen Bozicevic, Maria De Mieri, Matthias Hamburger PD15 A qualitative study to understand how we can empower teenagers to better self-manage their asthma Simone Holley, Ruth Morris, Frances Mitchell, Rebecca Knibb, Susan Latter, Christina Liossi, Graham Roberts PD16 Polymorphism of endothelial nitric oxide synthase (eNOS) gene among Egyptian children with bronchial asthma Mostafa M. M. Hassan POSTER DISCUSSION SESSION 3: Mechanisms—Epidemiology (PD17–PD21) PD17 Pregnancy outcomes in relation to development of allergy in a Swedish birth cohort Malin Barman, Anna Sandin, Agnes Wold, Ann-Sofie Sandberg PD18 Evolution of the IgE response to house dust mite molecules in childhood Daniela Posa, Serena Perna, Carl-Peter Bauer, Ute Hoffmann, Johannes Forster, Fred Zepp, Antje Schuster, Ulrich Wahn, Thomas Keil, Susanne Lau, Kuan-Wei Chen, Yvonne Resch, Susanne Vrtala, Rudolf Valenta, Paolo Maria Matricardi PD19 Antibody recognition of nsLTP-molecules as antigens but not as allergens in the German-MAS birth cohort Olympia Tsilochristou, Alexander Rohrbach, Antonio Cappella, Stephanie Hofmaier, Laura Hatzler, Carl-Peter Bauer, Ute Hoffmann, Johannes Forster, Fred Zepp, Antje Schuster, RaffaeleD’Amelio, Ulrich Wahn, Thomas Keil, Susanne Lau, Paolo Maria Matricardi PD20 Early life colonization with Lactobacilli and Staphylococcus aureus oppositely associates with the maturation and activation of FOXP3+ CD4 T-cells Sophia Björkander, Maria A. Johansson, Gintare Lasaviciute, Eva Sverremark-Ekström PD21 Genome-wide meta-analysis identifies 7 susceptibility loci involved in the atopic march Ingo Marenholz, Jorge Esparza-Gordillo, Franz Rüschendorf, Anja Bauerfeind, David P. Strachan, Ben D. Spycher, Hansjörg Baurecht, Patricia Margaritte-Jeannin, Annika Sääf, Marjan Kerkhof, Markus Ege, Svetlana Baltic, Melanie C Matheson, Jin Li, Sven Michel, Wei Q. Ang, Wendy McArdle, Andreas Arnold, Georg Homuth, Florence Demenais, Emmanuelle Bouzigon, Cilla Söderhäll, Göran Pershagen, Johan C. de Jongste, Dirkje S Postma, Charlotte Braun-Fahrländer, Elisabeth Horak, Ludmila M. Ogorodova, Valery P. Puzyrev, Elena Yu Bragina, Thomas J Hudson, Charles Morin, David L Duffy, Guy B Marks, Colin F Robertson, Grant W Montgomery, Bill Musk, Philip J Thompson, Nicholas G. Martin, Alan James, Patrick Sleiman, Elina Toskala, Elke Rodriguez, Regina Fölster-Holst, Andre Franke, Wolfgang Lieb, Christian Gieger, Andrea Heinzmann, Ernst Rietschel, Thomas Keil, Sven Cichon, Markus M Nöthen, Craig E Pennell, Peter D Sly, Carsten O Schmidt, Anja Matanovic, Valentin Schneider, Matthias Heinig, Norbert Hübner, Patrick G. Holt, Susanne Lau, Michael Kabesch, Stefan Weidinger, Hakon Hakonarson, Manuel AR Ferreira, Catherine Laprise, Maxim B. Freidin, Jon Genuneit, Gerard H Koppelman, Erik Melén, Marie-Hélène Dizier, A. John Henderson, Young Ae Lee POSTER DISCUSSION SESSION 4: Food allergy—Anaphylaxis (PD22–PD26) PD22 Atopy patch test in food protein induced enterocolitis caused by solid food Purificacion González-Delgado, Esther Caparrós, Fernando Clemente, Begoña Cueva, Victoria M. Moreno, Jose Luis Carretero, Javier Fernández PD23 Watermelon allergy: a novel presentation Kate Swan, George Du Toit PD24 A pilot study evaluating the usefulness of a guideline template for managing milk allergy in primary care Mudiyur Gopi, Tim Smith, Edara Ramesh, Arun Sadasivam PD26 Efficacy and safety of cow’s milk oral immunotherapy protocol Inês Mota, Filipe Benito Garcia, Susana Piedade, Angela Gaspar, Graça Sampaio, Cristina Arêde, Luís Miguel Borrego, Graça Pires, Cristina Santa-Marta, Mário Morais-Almeida POSTER DISCUSSION SESSION 5: Prevention and treatment—Allergy (PD27–PD36) PD27 Allergy-protection by the lactic acid bacterium Lactococcus lactis G121: mode-of-action as revealed in a murine model of experimental allergy Stephanie Brand, Karina Stein, Holger Heine, Marion Kauth PD29 The relationship between quality of life and morning salivary cortisol after acute bronchiolitis in infancy Leif Bjarte Rolfsjord, Egil Bakkeheim, Johan Alm, Håvard Ove Skjerven, Kai-Håkon Carlsen, Jon Olav Hunderi, Teresa Løvold Berents, Petter Mowinckel, Karin C. Lødrup Carlsen PD30 Randomised trial of the efficacy of MP29-02* compared with fluticasone propionate nasal spray in children aged ≥6 years to <12 years with allergic rhinitis Ulrich Wahn, Ullrich Munzel, William Berger PD31 10 mg of oral bilastine in 2 to 11 years old children has similar exposure to the adult therapeutic dose (20 mg) Ulrich Wahn, Román Valiente, Valvanera Vozmediano, John C. Lukas, Mónica Rodríguez PD33 Daily symptoms, nocturnal symptoms, activity limitations and reliever therapies during the three steps of IOEASMA programme: a comparison Sebastiano Guarnaccia, Luigi Vitale, Ada Pluda, Emanuele D’Agata, Denise Colombo, Stefano Felici, Valeria Gretter, Susanna Facchetti, Gaia Pecorelli, Cristina Quecchia PD34 Sensitisation to an inert aeroallergen in weaning rats and longstanding disease, in a sensitisation-tolerant and easily tolerisable rodent strain George Guibas, Evangelia Spandou, Spyridon Megremis, Peter West, Nikolaos Papadopoulos PD35 Bacterial and fungi exposure in school and allergic sensitisation in children João Cavaleiro Rufo, Joana Madureira, Inês Paciência, Lívia Aguiar, Patrícia Padrão, Mariana Pinto, Luís Delgado, Pedro Moreira, João Paulo Teixeira, Eduardo Oliveira Fernandes, André Moreira PD36 Comparative study of allergy rhinitis between two populations: children vs. adults Adriana Izquierdo Dominguez, Antonio Valero, Joaquim Mullol, Alfonso Del Cuvillo, Javier Montoro, Ignacio Jauregui, Joan Bartra, Ignacio Davila, Marta Ferrer, Joaquin Sastre POSTER VIEWING SESSION 1: Inflammation—Genetics—Immunology—Dermatology (PP01–PP09) PP01 Immune profile in late pregnancy: immunological markers in atopic asthmaticwomen as risk factors for atopy in the progeny Catarina Martins, Jorge Lima, Maria José Leandro, Glória Nunes, Jorge Cunha Branco, Hélder Trindade, Luis Miguel Borrego PP02 The impact of neonatal sepsis on development of allergic diseases Secil Conkar, Mehtap Kilic, Canan Aygun, Recep Sancak PP03 Clinical overview of selective IgE deficiency in childhood Athina Papadopoulou, Eleni Tagalaki, Lambros Banos, Anna Vlachou, Fotini Giannoula, Despina Mermiri PP04 Inverse relationship between serum 25(ΟΗ) vitamin D3 and total IgE in children and adolescence Athina Papadopoulou, Stavroula Lampidi, Marina Pavlakou, Maria Kryoni, Kostas Makris PP05 PP06 PP07 Asthma control questionnaire and specific IgE in children Snezhina Lazova, Guergana Petrova, Dimitrinka Miteva, Penka Perenovska PP08 Features of chronic urticaria of adolescents Aliya Klyucharova, Olesya Skorohodkina PP09 Cutaneous mastocytosis in children: a clinical analysis of 8 cases in Greece Dimitra Koumaki, Alkisti Manousaki, Maria Agrapidi, Lida Iatridou, Omima Eruk, Konstantinos Myridakis, Emmanouil Manousakis, Vasiliki Koumaki POSTER VIEWING SESSION 2: Food allergy—Anaphylaxis (PP10–PP47) PP10 Prognostic factors in egg allergy Maria Dimou, Maria Ingemansson, Gunilla Hedlin PP11 Evaluation of the efficacy of an amino acid-based formula in infants who are intolerant to extensively hydrolysed protein formula Nitida Pastor, Delphine de Boissieu, Jon Vanderhoof, Nancy Moore, Kaitlin Maditz PP12 Anaphylaxis and epinephrine auto-injector use: a survey of pediatric trainees Adeli Mehdi, Shaza Elhassan, Carolin Beck, Ahmed Al-Hammadi PP13 Anaphylaxis in children: acute management in the Emergency Department Ioana Maris, Ronan O’Sullivan, Jonathan Hourihane, PP14 Understanding Cumbrian schools preparedness in managing children at risk of anaphylaxis in order to provide training and support which will create healthy and safe environments for children with allergies George Raptis, Louise Michaelis PP15 A new valid and reliable parent and child questionnaire to measure the impact of food protein enterocolitis syndrome on children: the FPIES Quality of Life Questionnaire (FPIESQL), Parent and Child Short Form Audrey DunnGalvin, Matthew Greenhawt, Carina Venter, Jonathan Hourihane PP16 An in-depth case study investigation of the experiences of teenagers and young adults in growing up and living with food allergy with emphasis on coping, management and risk, support, and social and self-identity Evelyn O’Regan, Duncan Cronin, Jonathan Hourihane, Anna O’Reilly, Audrey DunnGalvin PP17 Cow’s milk protein allergy in Constantine. A retrospective study of 62 cases between 1996 and 2013 Foued Abdelaziz, Dounia Khelifi-Touhami, Nihad Selim, Tahar Khelifi-Touhami PP18 PP19 Cow’s milk and egg oral immunotherapy in children older than 5 years Pablo Merida, Ana Mª Plaza, Juan Heber Castellanos, Adrianna Machinena, Montserrat Alvaro Lozano, Jaime Lozano, Olga Dominguez, Monica Piquer, Rosa Jimenez, Mª Teresa Giner PP20 Professionals’ awareness of management of Cow’s Milk Protein Allergy (CMPA) in North Wales Hospitals Konstantinos Kakleas, Manohar Joishy, Wendmu Maskele, Huw R. Jenkins PP21 PP22 Anaphylaxis: the great unknown for teachers. Presentation of a protocol for schools Mercedes Escarrer, Agustín Madroñero, Maria Teresa Guerra, Juan Carlos Julia, Juan Carlos Cerda, Javier Contreras, Eulalia Tauler, Maria Jesus Vidorreta, Ana Rojo, Silvia Del Valle PP23 Challenges facing children with food allergies and their parents in out of school activity sectors Niamh Flynn PP24 A review of food challenges at a Regional Irish Centre Gary Foley, Carol Harmon, John Fitzsimons PP25 The use of epinephrine in infants with anaphylaxis Krasimira Baynova, Ávila Maria Del Robledo, Labella Marina PP26 PP27 PP28 Mother’s psychological state predicts the expression of symptoms in food allergic children Aaron Cortes, Alicia Sciaraffia, Angela Castillo PP29 The correlation between sIgE towards tree nuts and birch pollen in a Danish Pediatric Allergy Clinic Nanna Juel-Berg, Kirsten Skamstrup Hansen, Lars Kærgaard Poulsen PP30 Food allergy in children: evaluation of parents’ use of online social media Andreia Florina Nita, Ioana Valentina Nenciu, Adina Lazar, Dumitru Oraseanu PP31 The impact of food allergy on quality of life: FAQLQ questionnaire Rita Aguiar, Anabela Lopes, Maria J. Paes, Amélia S. Santos, M. A. Pereira-Barbosa PP32 An unexpected cause of anaphylaxis: potato Hatice Eke Gungor, Salih Uytun, Umit Murat Sahiner, Yasemin Altuner Torun PP33 Is it clinical phenotype of allergic diseases determined by sensitisation to food? Mirjana Zivanovic, Marina Atanasković-Marković PP34 PP35 Prescribing adrenaline auto-injectors in children in 2014: the data from regional pediatricians Tina Vesel, Mihaela Nahtigal, Andreja Obermayer-Temlin, Eva Šoster Križnik, Mirjana Maslar, Ruben Bizjak, Marjeta Tomšič-Matic, Sonja Posega-Devetak, Maja Skerbinjek-Kavalar, Mateja Predalič, Tadej Avčin PP36 Who should have an adrenaline autoinjector? Adherence to the European and French guidelines among 121 allergists from the Allergy Vigilance Network Guillaume Pouessel, Etienne Beaudouin, Anne M. Moneret-Vautrin, Antoine Deschildre, Allergy Vigilance Network PP37 Anaphylaxis by Anacardium Occidentale Marta Viñas, Bartolomé Borja, Nora Hernández, Mª José Castillo, Adriana Izquierdo, Marcel Ibero PP38 Anaphylaxis with honey in a child S. Tolga Yavuz, Ali Gungor, Betul Buyuktiryaki, Ozan Koc, Can Naci Kocabas, Faysal Gok PP39 Evaluation of courses adopted to children on prevention, recognition and management of anaphylaxis Tina Vesel, Mihaela Nahtigal PP40 Symptomatic dust mites and shrimp allergy: three pediatric case reports Filipa Almeida, Susana Lopes, Cristina Madureira, Tânia Lopes, Fernanda Carvalho PP41 Poor identification rates of nuts by high risk individuals: a call for improved education and support for families Camille Heming, Emily Garrett, Adam Blackstock, Santanu Maity, Rahul Chodhari PP42 DAFALL: database of food allergies in the Czech Republic Simona Belohlavkova, Eliska Kopelentova, Petr Visek, Ivana Setinova, Ivana Svarcova PP43 Serological cross-reactivity between grass and wheat is not only caused by profilins and CCDs Sigrid Sjölander, Nora Nilsson, Malin Berthold, Helena Ekoff, Gunilla Hedlin, Magnus Borres, Caroline Nilsson PP44 Oil body associated proteins in children with nuts allergy. Allergens to consider in IgE-mediated nuts allergy Loreto González Domínguez, Cristina Muñoz Archidona, Ana Moreira Jorge, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Miriam Castillo Fernández, Fernando Pineda de la Losa, Luis Ángel Echeverría Zudaire PP45 PP46 Protective effect of helicobacter pylori infection against food allergy in children Olga Vrani, Antigone Mavroudi, Maria Fotoulaki, Maria Emporiadou, Kleomenis Spiroglou, Ioannis Xinias PP47 Anaphylaxis pathway: A road tryp-tase to success? Helyeh A. Sadreddini, Mia Warnes, Donna Traves POSTER VIEWING SESSION 3: Miscellaneous (PP48–PP58) PP48 Surveillance study on safety of SLIT in pediatric population Ivana Djuric-Filipovic, Zorica Zivkovic, Snežana Zivanovic, Gordana Kostić, Đorđe Filipovic PP49 Efficacy and safety of mixed mite subcutaneous immunotherapy among allergic rhinitis patients in the Northeastern Thailand Sawapon Sittisomwong, Siripong Sittisomwong PP50 Effect of inhaled beclomethasone or placebo on brain stem activity in a patient chronically treated with steroids: preliminary report Zygmunt Podolec, Marcin Hartel, Daria Panek, Magdalena Podolec-Rubiś, Tomasz Banasik PP51 Sensitisation to aeroallergens in patients with allergic rhinitis, asthma and atopic dermatitis in Shiraz, Southwestern Iran Elham Abbasi, Mozhgan Moghtaderi PP52 Referring a child for allergy test: how appropriate are we? Phani Sanneerappa, Alina Deliu, Moosa Kutty, Nagabathula Ramesh PP53 EBV lymphoproliferative disease and cardiac lymphoma in a STK4 deficient patient Roya Sherkat, Mohammad Reza Sabri, Bahar Dehghan, Hamid Bigdelian, Nahid Raeesi, Mino Afshar, Hamid Rahimi, Christoph Klein PP54 A case study: the effect of massive honeybees attack on various body parameters atopic girl including allergy Mohemid Al-Jebouri PP55 The role of TLR9, NLRP3 and proIL-1β in activation of antiviral innate immunity Oxana A. Svitich, Daria O. Zubacheva, Dmitrii A. Potemkin, Ludmila V. Gankovskaya, Vitalii V. Zverev PP56 Overnight pulse oximetry, as a screening tool to diagnose obstructive sleep apnoea. How effective is it? Phani Sanneerappa, Elaine OB Doyle, Paul Gallagher, Nagabathula Ramesh PP57 The presentation and management of acute urticaria and allergic reactions in children in a multi-ethnic, inner city Emergency Department (ED) Sherine Dewlett, Kin Man, Minal Gandhi, James Pocock, Anna Gerrardhughes PP58 Food allergens responsible for delayed-type sensitisation in atopy patch test in children diagnosed with autism spectrum disorder Jolanta Wasilewska, Maciej Kaczmarski, Dariusz Lebensztejn POSTER VIEWING SESSION 4: Asthma—Rhinitis (PP59–PP87) PP59 Systematic review of incense as a trigger factor for asthma Chandramani Thuraisingham, Davendralingam Sinniah PP60 Increased risks of mood and anxiety disorders in children with asthma Yue Chen, Xiaomei Mei PP61 PP62 Asthma Control Test (ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) association in children Sebnem Ozdogan, Pinar Karadeniz, Durdugul Ayyildiz-Emecen, Ummuhan Oncul PP63 Seasonal and gender variations in vitamin D levels in children with asthma and its association with pulmonary function tests Sebnem Ozdogan, Gizem Sari, Sabanur Cavdar PP64 Defining treatment response in childhood asthma: rationale and design of the Pharmacogenomics in the Childhood Asthma (PiCA) consortium Niloufar Farzan, Susanne J. Vijverberg, Colin J. Palmer, Kelan G. Tantisira, Anke-Hilseon Maitland-van der Zee behalf of the PiCA consortium PP65 Prevalence of asthma and allergic disease in patients with inflammatory disease compared to celiac disease Fatma Yavuzyilmaz, Sebnem Ozdogan, Nafiye Urganci, Merve Usta PP66 A severe case with cystic fibrosis (CF) asthma Mehmet Hoxha, Maksim Basho PP67 Severe asthma exacerbation complicated with pneumothorax in a child with uncontrolled asthma due to poor treatment compliance Ioana Valentina Nenciu, Andreia Florina Nita, Adina Lazar, Alexandru Ulmeanu, Carmen Zapucioiu, Dumitru Oraseanu PP68 Evaluation of the Pediatric Quality of Life inventory (PedsQL) asthma module among low income asthmatic children and adolescents in Sao Paolo, Brazil Gustavo F. Wandalsen, Fernanda Monteiro, Dirceu Solé PP69 Early initiation of specific immunotherapy in asthma patients leads to higher benefits Blerta Lame, Eris Mesonjesi, Arjeta Sherri PP70 Treatment resistant asthma and rhinosinusitis with recurrent pulmonary infections. Is it primary ciliary dyskinesia? Alkerta Ibranji, Laert Gjati, Gjustina Loloci, Ardii Bardhi PP71 The comparison of sensitisation to animal allergens in children- and adult- onset patients with asthma Behnam Moghtaderi, Shirin Farjadian, Dorna Eghtedari PP72 Characterisation of children less than five years with wheezing episodes in Cali, Colombia Manuela Olaya, Laura Del Mar Vasquez, Luis Fernando Ramirez, Carlos Daniel Serrano PP73 Evaluation of the patients with recurrent croup Belgin Usta Guc, Suna Asilsoy, Fulya Ozer PP74 Obesity in adolescence compromising the asthma control Guergana Petrova, Sylvia Shopova, Vera Papochieva, Snezhina Lazova, Dimitrinka Miteva, Penka Perenovska PP75 Sleep behavior in children with persistent allergic rhinitis Gustavo F. Wandalsen, Jessica Loekmanwidjaja, Márcia Mallozi, Dirceu Solé PP76 Randomised trial of the safety of MP29-02* compared with fluticasone propionate nasal spray in children aged ≥4 years to <12 years with allergic rhinitis William Berger, Ulrich Wahn, Paul Ratner, Daniel Soteres PP77 Safety and tolerability evaluation of bilastine 10 mg in children from 2 to 11 years of age with allergic rhinoconjunctivitis or urticaria Zoltán Novák, Anahí Yáñez, Kiss Ildikó, Piotr Kuna, Miguel Tortajada, Román Valiente, the Bilastine Pediatric Safety Study Group PP78 Sensitisation to Alternaria alternata: Is it a risk factor for severe rhinitis? Susana Lopes, Filipa Almeida, Tânia Lopes, Cristina Madureira, José Oliveira, Fernanda Carvalho PP79 Validation of the Patient Benefit Index (PBI) for the assessment of patient-related outcomes in allergic rhinitis in children Julia Feuerhahn, Christine Blome, Meike Hadler, Efstrathios Karagiannis, Anna Langenbruch, Matthias Augustin PP80 Efficacy of sublingual tablet of house dust mite allergen extracts in adolescents with house dust mite-associated allergic rhinitis Michel Roux, Shinji Kakudo, Efstrathios Karagiannis, Robert K. Zeldin PP81 Lung function improvement in a child treated with omalizumab for bronchial asthma Anna Sokolova, Tiago Milheiro Silva PP82 How to treat a child suffering from asthma, allergic rhinitis, allergy to peanuts and diabetes at the same time? Snezana S. Zivanovic, Vesna Cvetkovic, Ivana Nikolic, Sonja J. Zivanovic PP83 Nitric oxide in exhaled air in the relationship of the degree of sensitisation to aeroallergens Snezana S. Zivanovic, Ljiljana Saranac, Ivana Nikolic, Sonja J. Zivanovic, Zorica Zivkovic PP84 Clinical basis of diagnostic errors in pediatric asthma Zoia Nesterenko PP85 PP86 Childhood asthma control in Serbia and organised Asthma Educational Intervention (AEI) Snezana Radic, Branislava Milenkovic, Spomenka Smiljanic, Milka Micic-Stanijevic, Olivera Calovic PP87 Experience from a group of adolescents with severe allergic asthma treated with Omalizumab Anne Marie Bro Hofbauer, Lone Agertoft THEMATIC POSTER SESSION 1: Prevention and Treatment—Epidemiology (TP01–TP18) TP01 A cost effective primary school asthma education program: pilot study from inner London schools Lucy Everson, Jessica Kearney, Jonny Coppel, Simon Braithwaite, Rahul Chodhari TP02 The prevalence of allergic diseases among 14–15 years old adolescents in two Danish birth cohorts 14 years apart Elisabeth S. Christiansen, Henrik Fomsgaard Kjaer, Esben Eller, Charlotte G. Mørtz, Susanne Halken TP03 Does pattern of sensitisation to phleum pratense change with age? Is it different in children with allergic rhinitis or asthma? Cristina Román India, Ana Moreira Jorge, Loreto González Domínguez, Cristina Muñoz Archidona, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Juana Jiménez Jiménez, Luis Echeverría Zudaire TP04 Practicalities of prevention of peanut allergy: modelling a national response to LEAP Cathal O’Connor, Jonathan Hourihane TP05 Comparison of the influence of sunflower seed oil and skin care lotion on the skin barrier function of newborns: a randomised controlled trial Varvara Kanti, Lena Lünnemann, Günther Malise, Laine Ludriksone, Andrea Stroux, Wolfgang Henrich, Michael Abu-Dakn, Ulrike Blume-Peytavi, Natalie Garcia Bartels TP06 The effect of daily skin care on skin barrier properties in infants with dry skin and risk for atopic dermatitis Varvara Kanti, Lena Lünnemann, Laine Ludriksone, Marianne Schario, Andrea Stroux, Ulrike Blume-Peytavi, Natalie Garcia Bartels TP07 Change in sum total aeroallergen skin prick test wheal diameters at 6 months predicts which children will respond to subcutaneous immunotherapy by three years Thorsten Stanley, Nicolien Brandenbarg TP08 Are mobile apps regarding adrenaline auto-injectors accessed by adolescents for support and education in the community? Alia Boardman, Gary McGreevy, Emily Rodger, Katherine Knight, Victoria Timms, Trisha Taylor, Gemma Scanlan, Roisin Fitzsimons TP09 TP10 Prevention of early atopic dermatitis among low-atopy-risk infants by immunoactive prebiotics is not sustained after the first year of life Grüber Christoph, Ulrich Wahn, Margriet van Stuivenberg, Fabio Mosca, Guido Moro, Gaetano Chirico, Christian P. Braegger, Joseph Riedler, Yalcin Yavuz, Günther Boehm TP11 TP12 TP13 Treatment with Omalizumab in a 16-year-old Caucasian girl with refractory solar urticaria Stefania Arasi, Giuseppe Crisafulli, Lucia Caminiti, Federica Porcaro, Giovanni Battista Pajno TP14 Ultra-pure soft water ameliorates skin conditions of adult and child patients with atopic dermatitis Akane Tanaka, Yaei Togawa, Kumiko Oida, Naotomo Kambe, Peter Arkwright, Yosuke Amagai, Naoki Shimojo, Yasunori Sato, Hiroyuki Mochizuki, Hyosun Jang, Saori Ishizaka, Hiroshi Matsuda TP15 Potential adjuvant effect of immunomodulator to improve specific immunotherapy in asthmatic child Wisnu Barlianto, Ery Olivianto, H. M. S. Chandra Kusuma TP16 How can Component Resolved Diagnosis (CRD) influence in Specific Immunotherapy (SIT) prescription, in a Spanish children population Ana Moreira Jorge, Cristina Román India, Loreto González Domínguez, Cristina Muñoz Archidona, Juana Jiménez Jiménez, Teresa Bracamonte Bermejo, Sergio Quevedo Teruel, Luis Echeverría Zudaire TP17 Mitochondrial dysfunction in food allergy: effects of L. rhamnosus GG in a mice model of peanut allergy Rosita Aitoro, Mariapia Mollica, Roberto Berni Canani, Giovanna Trinchese, Elena Alfano, Antonio Amoroso, Lorella Paparo, Francesco Amato, Claudio Pirozzi, Antonio Calignano, Rosaria Meli TP18 Prediction of atopic diseases in childhood: elevated blood eosinophils in infancy in a high risk birth cohort Siri Rossberg, Kerstin Gerhold, Kurt Zimmermann, Mohammad Zaino, Thomas Geske, Eckard Hamelmann, Susanne Lau THEMATIC POSTER SESSION 2: Food allergy—Anaphylaxis (TP19–TP38) TP19 TP20 TP21 Double-blind provocation tests in non-IgE mediated cow’s milk allergy and the occurrence of placebo reactions Sarah Bogovic, Jochem van den Berg, Chantal Janssen TP22 Gradual introduction of baked egg (BE) in egg allergic patients under 2 years old Angela Claver TP23 Randomised controlled trial of SOTI with raw hen’s egg in children with persistent egg allergy I: safety and efficacy of daily vs. weekly protocols of induction Mª Flor Martin-Muñoz, C. Martorell, M. T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, Cristina Blasco, B. Villa, C. Gómez, S. Nevot, J. M. García, L. Echeverria TP24 Randomised controlled trial of SOTI with raw hen’s egg in children with persistent egg allergy II: a randomised controlled trial to study a safer, more effective and easy to perform maintenance (daily vs. every two days) pattern of egg SOTI Mª Flor Martin-Muñoz, C. Martorell, M. T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, Cristina Blasco, B. Villa, C. Gómez, S. Nevot, J. M. García, L. Echeverria TP25 Determining the safety of baked egg home reintroduction for children with mild egg allergy Brenda DeWitt, Judith Holloway, Donald Hodge TP26 Demographics, investigations and patterns of sensitisation in children with oral allergy syndrome in a London Teaching Hospital Sian Ludman, Merhdad Jafari-Mamaghani, Rosemary Ebling, Adam T. Fox, Gideon Lack, George Du Toit TP27 Airborne peanut challenge in children: allergic reactions are rare Sofia Lovén Björkman, Caroline Nilsson, Natalia Ballardini TP28 The nutty question on Pediatric Wards: to be or “nut” to be? Supriyo Basu, Jenny Hallet, Jyothi Srinivas TP29 TP30 TP31 Allergy education in nursery schools Hazel Stringer, Nicola Jay TP32 Food allergy in the first year of life Tânia Lopes, Cristina Madureira, Filipa Almeida, Susana Lopes, Paula Fonseca, Clara Vieira, Fernanda Carvalho TP33 Prevalence and geographic distribution of oral allergy syndrome in Italian children: a multicenter study Carla Mastrorilli, Carlo Caffarelli, Riccardo Asero, Salvatore Tripodi, Arianna Dondi, Gianpaolo Ricci, Carlotta Povesi Dascola, Elisabetta Calamelli, Francesca Cipriani, Andrea Di Rienzo Businco, Annamaria Bianchi, Paolo Candelotti, Tullio Frediani, Carmen Verga, Paolo Maria Matricardi TP34 Are common standardised allergen extracts used in skin test enough in the diagnosis of nuts allergy? Cristina Muñoz Archidona, Loreto González Domínguez, Ana Moreira Jorge, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Miriam Castillo Fernández, Fernando Pineda de la Losa, Luis Ángel Echeverría Zudaire TP35 Evaluation of IgE sensitisation in children with allergic proctocolitis and its relationship to atopic dermatitis Despina Mermiri, Paraskevi Korovessi, Skevi Tiliakou, Evaggelia Tavoulari, Kalliopi-Maria Moraiti, Fotini Giannoula, Athina Papadopoulou TP36 Food allergy in children: are we managing them appropriately in the Emergency Department? Wan Jean Tee, Samir Deiratany, Raymond Seedhoo, Roisin McNamara, Ike Okafor TP37 Importance of oil body associated allergenic proteins in nuts suspected allergy children Loreto González Domínguez, Ana Moreira Jorge, Cristina Muñoz Archidona, Teresa Bracamonte Bermejo, Sergio Quevedo Teruel, Fernando Pineda de la Losa, Miriam Castillo Fernández, Luis Ángel Echeverría Zudaire TP38 Practical application of basophil activation test in children with food allergy Ekaterina Khaleva, Gennady Novic, Natalia Bychkova THEMATIC POSTER SESSION 3: Asthma (TP39–TP57) TP39 Effect of corticosteroid therapy upon serum magnesium level in chronic asthmatic children Amany Abd Al-Aziz, Amany Fatouh, Ayat Motawie, Eman El Bostany, Amr Ibrahim TP40 ADAM33 in Bulgarian children with asthma Guergana Petrova, Dimitrinka Miteva, Snezhina Lazova, Penka Perenovska, Sylvia Andonova, Alexey Savov TP41 TP42 The impact of vitamin D serum levels in asthma and allergic rhinitis Maria Zoto, Marialena Kyriakakou, Paraskevi Xepapadaki, Nikolaos G. Papadopoulos TP43 Life-threatening, first reported, paradoxical bronchospasm after nebulised Salbutamol in a 10 year old child Paraskevi Korovessi, Mariza Vassilopoulou, Athina Balaska, Lambros Banos, Stavroula Kostaridou, Despina Mermiri TP44 TP45 Asthma symptoms in children with treatment for allergic rhinoconjunctivitis Jorien Wartna, Arthur M. Bohnen, Gijs Elshout, David H. J. Pols, Patrick J. E. Bindels Erasmus MC, Rotterdam, The Netherlands TP46 Atopy increased the risk of developing exercise-induced bronchoconstriction in young athletes Sven F. Seys; Ellen Dilissen, Sarah Van der Eycken, An-Sofie Schelpe, Gudrun Marijsse, Thierry Troosters, Vincent Vanbelle, Sven Aertgeerts, Jan L. Ceuppens, Lieven J. Dupont, Koen Peers, Dominique M. Bullens TP47 The effect of higher BMI on risk for asthma and treatment outcome in overweight and obese children Ivana Banic, Sandra Bulat Lokas, Jelena Zivkovic, Boro Nogalo, Iva Mrkic Kobal, Davor Plavec, Mirjana Turkalj TP48 TP49 TP50 TP51 TP52 The impact of a multidisciplinary project intended to change the culture of nebulisers towards pressurised metered dose inhalers Georgeta Oliveira, Katharine Pike, Alda Melo, Tomás Amélia, José Carlos Cidrais Rodrigues, Cristina Serrano, José Manuel Lopes dos Santos, Carla Lopes TP53 TP54 TP55 TP56 Increased asthma control in patients with severe persistent allergic asthma after 12 month of nightly temperature controlled laminar airflow (TLA) Eckard Hamelmann, Uwe Schauer, Karl-Christian Bergmann TP57 THEMATIC POSTER SESSION 4: Drug allergy—Dermatology (TP58–TP77) TP58 Should we proceed directly to provocation challenges to diagnose drug allergy? Our experience says yes Luis Moral, Teresa Toral, Nuria Marco, Beléns García Avilés, Mª Jesús Fuentes, Jesús Garde, Cristina Montahud, Javier Perona, Mª José Forniés TP59 Anaphylaxis to 13-valent pneumococcal vaccine Esozia Arroabarren, Marta Anda, Maria Luisa Sanz, Maria Teresa Lizaso, Candida Arregui TP60 Intrapartum antibiotic exposure for treatment of group B streptococcus was not associated with the development of penicillin allergy in children Sara May, Martha Hartz, Avni Joshi, Miguel A. Park TP61 Evaluation of suspected drug hypersensitivity reactions in 169 children referred to the General Hospital Sonja Posega Devetak, Tina Vesel, Anja Koren Jeverica, Tadej Avčin TP62 Drug provocation testing: experience of a tertiary hospital Leonor Castro, Carolina Gouveia, Ana Carvalho Marques, Antonio Jorge Cabral TP63 Perioperative anaphylaxis: a growing concern in pediatric population Luis Amaral, Fabrícia Carolino, Eunice Castro, Madalena Passos, Josefina R. Cernadas TP64 Raising awareness of hypersensitivity to non-steroidal anti-inflammatory drugs in the pediatric age Fabrícia Carolino, Luís Amaral, Eunice Dias de Castro, Josefina R. Cernadas TP65 Perioperative anaphylaxis in young children: how to confirm the suspicion Josefina R. Cernadas, Fabrícia Carolino, Luís Amaral, Fernando Pineda, Armanda Gomes TP66 A case study of a child suspected to be penicillin allergic-digging deeper Katherine Knight, Roisin Fitzsimons, Helen Brough TP67 Prevalence, characteristics and risk factors of hypersensitivity reactions to antibiotics in patients with cystic fibrosis Jobst Röhmel, Carsten Schwarz, Anne Mehl, Philippe Stock, Doris Staab TP68 Antibiotic drug hypersensitivity in cystic fibrosis: A pilot study using cellular allergy tests for diagnostics Jobst Röhmel, Carsten Schwarz, Christine Seib, Doris Staab, Philippe Stock TP69 Oral antibiotics challenges in children Anita Critchlow, Alyson Barber, Nicola Jay TP70 Hypersensitivity reaction to vancomycin: a new successful desensitization protocol Belen Delavalle, Teresa Garriga, Blanca Vilá, Cristina Blasco TP71 TP72 Clinical phenotypes according to FLG gene loss of function mutations in children with atopic dermatitis Francesca Cipriani, Annalisa Astolfi, Costanza Di Chiara, Elisabetta Calamelli, Iria Neri, Annalisa Patrizi, Gianpaolo Ricci TP73 TP74 Urticaria in children: clinical and epidemiological features Katerina Neskorodova, Asya Kudryavtseva TP75 TP76 Acute urticaria at the Pediatrics Emergency Department: is it allergy? Esozia Arroabarren, Jorge Alvarez, Marta Anda, Miriam Palacios, Marta Martinez-Merino, Ibone Vaquero TP77
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Brockow K, Beyer K, Biedermann T, Fischer J, Gieler U, Giessler-Fichtner O, Gebert N, Jakob T, Klimek L, Kugler C, Reese I, Rietschel E, Ruëff F, Schnadt S, Siemens C, Szczepanski R, Worm M, Ring J, Lange L. Versorgung von Patienten mit Anaphylaxie — Möglichkeiten und Defizite. Allergo J 2016. [DOI: 10.1007/s15007-016-1158-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Konrad K, Kapellen T, Lilienthal E, Prinz N, Bauer M, Thon A, Rietschel E, Wiemann D, Holl RW. Does β-Cell Autoimmunity Play a Role in Cystic Fibrosis-Related Diabetes? Analysis Based on the German/Austrian Diabetes Patienten Verlaufsdokumentation Registry. Diabetes Care 2016; 39:1338-44. [PMID: 27271187 DOI: 10.2337/dc16-0020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/03/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Research on β-cell autoimmunity in cystic fibrosis (CF)-related diabetes (CFRD) is still rare. We aimed to analyze the frequency of β-cell autoimmunity and the influence on age at diabetes onset, insulin requirement, type of insulin therapy, and hypoglycemic or ketoacidotic events in patients with CFRD compared with antibody-negative patients with CFRD in the Diabetes Patienten Verlaufsdokumentation (DPV) registry. RESEARCH DESIGN AND METHODS We analyzed data of 837 patients with CFRD in the German/Austrian DPV database by multivariable mixed-regression modeling. RESULTS In our cohort, 8.5% of patients with CFRD (n = 72) were found to be β-cell antibody positive. There was a female preponderance in this patient group: 65.3 vs. 57.6%. Diabetes onset (median [interquartile range]) was earlier (14.00 [10.15-15.90] vs. 16.10 [13.50-21.20] years; P < 0.005), and insulin dose/kg body weight was higher (0.95 [0.61-1.15] vs. 0.67 [0.33-1.04] IU/kg; P < 0.05). There were also differences in the type of insulin treatment. Insulin pump therapy was used significantly more often in patients with CFRD with β-cell autoimmunity (18.2 vs. 6.4%; P < 0.05). The differences for multiple daily injections (ICT) and conventional therapy (CT) were not significant (ICT: 67.7 vs. 79.0%; CT: 15.2 vs. 14.6). Oral antidiabetic agents were rarely used in both groups. Rate of severe hypoglycemia with coma and rate of ketoacidosis were higher in antibody-positive patients (hypoglycemia with coma: 8.0 vs. 1.4, P < 0.05; ketoacidosis: 9.3 vs. 0.9, P < 0.05). CONCLUSIONS Presence of β-cell autoantibodies in our cohort of patients with CFRD (8.5%) appeared to be greater than in the general population and was associated with female sex, earlier onset of diabetes, and higher insulin requirement. Insulin pump therapy was used significantly more often in patients with β-cell antibodies. Severe hypoglycemia and ketoacidosis were significantly more frequent in CFRD with β-cell autoimmunity compared with β-cell antibody-negative patients with CFRD.
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Affiliation(s)
- Katja Konrad
- Department of Pediatric and Adolescent Medicine, University of Cologne, Cologne, Germany Department of Pediatric and Adolescent Medicine, Elisabeth-Hospital Essen, Essen, Germany
| | - Thomas Kapellen
- Department of Pediatrics, University of Leipzig, Leipzig, Germany
| | | | - Nicole Prinz
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Maria Bauer
- Department of Pediatric and Adolescent Medicine, University of Linz, Linz, Austria
| | - Angelika Thon
- Department of Pediatrics, Hannover Medical School, Hannover, Germany
| | - Ernst Rietschel
- Department of Pediatric and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - Dagobert Wiemann
- Department of Pediatrics, University of Magdeburg, Magdeburg, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany German Center for Diabetes Research, München-Neuherberg, Germany
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Hartmann K, Biedermann T, Brockow K, Grabbe J, Horny HP, Lippert U, Maurer M, Raithel M, Rietschel E, Ruëff F, Sotlar K. Mastozytose. Allergo J 2016. [DOI: 10.1007/bf03362057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hompes S, Scherer K, Köhli A, Ruëff F, Mahler V, Lange L, Treudler R, Rietschel E, Szépfalusi Z, Lang R, Rabe U, Reese T, Beyer K, Schwerk N, Worm M. Nahrungsmittelanaphylaxie: Daten aus dem Anaphylaxie-Register. Allergo J 2016. [DOI: 10.1007/bf03362320] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Muche-Borowski C, Kopp M, Reese I, Sitter H, Werfel T, Schäfer T, Beyer K, Friedrichs F, Hamelmann E, Hellermann M, Huss-Marp J, Kleinheinz A, Lau S, Rietschel E, Rudack C, Schmidt S, Schnadt S, Schnitzer S. S3-Leitlinie Allergieprävention — Update 2009. Allergo J 2016. [DOI: 10.1007/bf03362104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Thomassen J, Alcazar M, Walz ML, Broekaert I, Lippach G, Rietschel E, van Koningsbruggen-Rietschel S. WS04.5 TGFβ 1 – a possible biomarker for disease progression in cystic fibrosis? J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30082-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fuchs SI, Schwerk N, Pittschieler K, Ahrens F, Baden W, Bals R, Fähndrich S, Gleiber W, Griese M, Hülskamp G, Köhnlein T, Reckling L, Rietschel E, Staab D, Gappa M. Lung clearance index for monitoring early lung disease in alpha-1-antitrypsin deficiency. Respir Med 2016; 116:93-9. [PMID: 27296827 DOI: 10.1016/j.rmed.2016.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/23/2016] [Accepted: 04/26/2016] [Indexed: 11/28/2022]
Abstract
Patients with alpha-1-antitrypsin deficiency (AATD) and a PI-ZZ genotype are at high risk to develop severe emphysema during adulthood. However, little is known about early stages of emphysema and disease manifestation in other PI-types. Spirometry is commonly used for monitoring although early manifestation of emphysema is suspected within the peripheral airways that are not accessible by forced expiratory manoeuvres. We hypothesized that the Lung Clearance Index (LCI) derived from multiple breath nitrogen-washout (N2-washout) is useful to bridge this diagnostic gap. Patients from age 4 years onward and different PI-types performed N2-washout and spirometry. Results were compared to controls. 193 patients (4-79 years, 75% PI-ZZ) and 33 controls (8-60 years) were included. Mean (SD) LCI in patients was 9.1 (3.1) and 6.3 (0.6) in controls (p ≤ 0.001). 47% of adult patients with other than PI-ZZ genotypes and 39% of all patients with normal spirometry had abnormal LCIs. The LCI measured by N2-washout discriminates between patients with AATD and controls, reflects AATD related lung disease in all stages and appears to identify early peripheral lung changes in younger age than spirometry. We conclude that a normal spirometry does not exclude presence of AATD related lung disease even in genotypes other than PI-ZZ.
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Affiliation(s)
- Susanne I Fuchs
- Department of Paediatrics and Research Institute, Marien Hospital Wesel, Germany.
| | - Nicolaus Schwerk
- Paediatric Pulmonology, Allergology and Neonatology, Medical University Hannover, Germany
| | | | | | | | - Robert Bals
- Department 5, University of Saarland, Homburg, Germany
| | | | | | - Matthias Griese
- Dr. von Haunersches Kinderspital, Medical University Munich, Germany
| | - Georg Hülskamp
- Department of Paediatrics, Clemenshospital Münster, Germany
| | | | | | - Ernst Rietschel
- Cystic Fibrosis Centre, University Hospital of Cologne, Germany
| | - Doris Staab
- Paediatric Pulmonologie and Allergology, Charité Berlin, Germany
| | - Monika Gappa
- Department of Paediatrics and Research Institute, Marien Hospital Wesel, Germany
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van Koningsbruggen-Rietschel S, Heuer HE, Merkel N, Posselt HG, Staab D, Sieder C, Ziegler J, Krippner F, Rietschel E. Pharmacokinetics and safety of an 8 week continuous treatment with once-daily versus twice-daily inhalation of tobramycin in cystic fibrosis patients. J Antimicrob Chemother 2015; 71:711-7. [PMID: 26626719 DOI: 10.1093/jac/dkv399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 10/26/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We evaluated the pharmacokinetics, safety and tolerability of two different continuous treatment regimens of tobramycin inhalation solution (TIS) in 29 cystic fibrosis (CF) patients chronically infected with Pseudomonas aeruginosa. PATIENTS AND METHODS In this randomized, multicentre, open-label, two-period crossover study, TIS (300 mg/5 mL) was administered via PARI eFlow(®) rapid once daily and twice daily each for 8 weeks. Serum pharmacokinetics of these two regimens was analysed. Tobramycin levels were determined before the morning dose and at 30, 60 and 90 min after the end of nebulization in the middle and at the end of each 8 week cycle. At these timepoints, trough and peak serum tobramycin concentrations (Cmax, mg/L) as well as the area under the curve for 0-90 min of tobramycin (AUC0-90min) were assessed in order to evaluate the risk of systemic toxicity. Safety parameters and forced expiratory volume in 1 s (FEV1) were assessed. RESULTS For once-daily treatment, tobramycin levels were 10% higher after 8 weeks compared with 4 weeks (AUC0-90min ratio = 1.096, 90% CI = 0.860-1.396, P = 0.5237). For twice-daily treatment, tobramycin levels after 8 weeks showed a 40% decrease compared with 4 weeks (AUC0-90min ratio = 0.608, 90% CI = 0.461-0.802, P = 0.0055). The AUC0-90min ratio at 8 weeks (once daily versus twice daily) did not differ significantly (AUC0-90min ratio = 0.749, 90% CI = 0.514-1.092, P = 0.2009). The mean FEV1 did not differ markedly compared between treatment periods or with baseline. No audiological or nephrotoxic side effects were noted. CONCLUSIONS Continuous treatment with TIS (once daily or twice daily) over 8 weeks appears to be safe and tolerable.
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Affiliation(s)
| | | | - N Merkel
- University Children's Hospital, Halle, Germany
| | - H G Posselt
- University Children's Hospital, Frankfurt, Germany
| | - D Staab
- CF Center, Children's Hospital Charité, Berlin, Germany
| | - C Sieder
- Novartis Pharma GmbH, Nuernberg, Germany
| | - J Ziegler
- Novartis Pharma GmbH, Nuernberg, Germany
| | - F Krippner
- Novartis Pharma GmbH, Nuernberg, Germany
| | - E Rietschel
- CF Center, Children's Hospital, Faculty of Medicine, University of Cologne, Cologne, Germany
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Toncheva AA, Potaczek DP, Schedel M, Gersting SW, Michel S, Krajnov N, Gaertner VD, Klingbeil JM, Illig T, Franke A, Winkler C, Hohlfeld JM, Vogelberg C, von Berg A, Bufe A, Heinzmann A, Laub O, Rietschel E, Simma B, Genuneit J, Muntau AC, Kabesch M. Childhood asthma is associated with mutations and gene expression differences of ORMDL genes that can interact. Allergy 2015; 70:1288-99. [PMID: 26011647 DOI: 10.1111/all.12652] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Genomewide association studies identified ORMDL3 as a plausible asthma candidate gene. ORMDL proteins regulate sphingolipid metabolism and ceramide homeostasis and participate in lymphocyte activation and eosinophil recruitment. Strong sequence homology between the three ORMDL genes and ORMDL protein conservation among different species suggest that they may have shared functions. We hypothesized that if single nucleotide polymorphisms (SNPs) in ORMDL3 alter its gene expression and play a role in asthma, variants in ORMDL1 and ORMDL2 might also be associated with asthma. METHODS Asthma associations of 44 genotyped SNPs were determined in at least 1303 subjects (651 asthmatics). ORMDL expression was evaluated in peripheral blood mononuclear cells (PBMC) from 55 subjects (eight asthmatics) before and after allergen stimulation, and in blood (n = 60, 5 asthmatics). Allele-specific cis-effects on ORMDL expression were assessed. Interactions between human ORMDL proteins were determined in living cells. RESULTS Sixteen SNPs in all three ORMDLs were associated with asthma (14 in ORMDL3). Baseline expression of ORMDL1 (P = 1.7 × 10(-6) ) and ORMDL2 (P = 4.9 × 10(-5) ) was significantly higher in PBMC from asthmatics, while induction of ORMDLs upon stimulation was stronger in nonasthmatics. Disease-associated alleles (rs8079416, rs4795405, rs3902920) alter ORMDL3 expression. ORMDL proteins formed homo- and heterooligomers and displayed similar patterns of interaction with SERCA2 and SPT1. CONCLUSIONS Polymorphisms in ORMDL genes are associated with asthma. Asthmatics exhibit increased ORMDL levels, suggesting that ORMDLs contribute to asthma. Formation of heterooligomers and similar interaction patterns with proteins involved in calcium homeostasis and sphingolipid metabolism could indicate shared biological roles of ORMDLs, influencing airway remodeling and hyperresponsiveness.
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Affiliation(s)
- A. A. Toncheva
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
| | - D. P. Potaczek
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
| | - M. Schedel
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
- Department of Pediatrics; National Jewish Health; Denver CO USA
| | - S. W. Gersting
- Department of Molecular Pediatrics; Dr. von Hauner Children's Hospital; Ludwig-Maximilians-University; Munich Germany
| | - S. Michel
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
| | - N. Krajnov
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
| | - V. D. Gaertner
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
| | - J. M. Klingbeil
- Department of Molecular Pediatrics; Dr. von Hauner Children's Hospital; Ludwig-Maximilians-University; Munich Germany
| | - T. Illig
- Research Unit of Molecular Epidemiology; Helmholtz Zentrum Munich; Neuherberg Germany
- Hannover Unified Biobank; Hannover Medical School; Hannover Germany
| | - A. Franke
- Institute of Clinical Molecular Biology; Christian-Albrechts-University Kiel; Kiel Germany
| | - C. Winkler
- Department of Clinical Airway Research; Fraunhofer Institute for Toxicology and Experimental Medicine; Hannover Germany
- Department of Respiratory Medicine; Hannover Medical School; Hannover Germany
| | - J. M. Hohlfeld
- Department of Clinical Airway Research; Fraunhofer Institute for Toxicology and Experimental Medicine; Hannover Germany
- Department of Respiratory Medicine; Hannover Medical School; Hannover Germany
| | - C. Vogelberg
- University Children's Hospital; Technical University Dresden; Dresden Germany
| | - A. von Berg
- Research Institute for the Prevention of Allergic Diseases; Children's Department; Marien-Hospital; Wesel Germany
| | - A. Bufe
- Department of Experimental Pneumology; Ruhr-University; Bochum Germany
| | - A. Heinzmann
- University Children's Hospital; Albert Ludwigs University; Freiburg Germany
| | - O. Laub
- Kinder- und Jugendarztpraxis Laub; Rosenheim Germany
| | - E. Rietschel
- University Children's Hospital; University of Cologne; Cologne Germany
| | - B. Simma
- Children's Department; University Teaching Hospital; Landeskrankenhaus Feldkirch; Feldkirch Austria
| | - J. Genuneit
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - A. C. Muntau
- University Children's Hospital; University Medical Center Hamburg Eppendorf; Hamburg Germany
| | - M. Kabesch
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
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Klimek L, Beyer K, Biedermann T, Brockow K, Fischer J, Jung K, von Kopp M, Lange L, Niggemann B, Rietschel E, Ring J, Worm M. Aut-idem für Adrenalin-Autoinjektoren? Allergo J 2015. [DOI: 10.1007/s15007-015-0860-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schedel M, Michel S, Gaertner VD, Toncheva AA, Depner M, Binia A, Schieck M, Rieger MT, Klopp N, von Berg A, Bufe A, Laub O, Rietschel E, Heinzmann A, Simma B, Vogelberg C, Genuneit J, Illig T, Kabesch M. Polymorphisms related to ORMDL3 are associated with asthma susceptibility, alterations in transcriptional regulation of ORMDL3, and changes in TH2 cytokine levels. J Allergy Clin Immunol 2015; 136:893-903.e14. [PMID: 25930191 DOI: 10.1016/j.jaci.2015.03.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 02/27/2015] [Accepted: 03/12/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chromosome 17q21, harboring the orosomucoid 1-like 3 (ORMDL3) gene, has been consistently associated with childhood asthma in genome-wide association studies. OBJECTIVE We investigated genetic variants in and around ORMDL3 that can change the function of ORMDL3 and thus contribute to asthma susceptibility. METHODS We performed haplotype analyses and fine mapping of the ORMDL3 locus in a cross-sectional (International Study of Asthma and Allergies in Childhood Phase II, n = 3557 total subjects, n = 281 asthmatic patients) and case-control (Multicenter Asthma Genetics in Childhood Study/International Study of Asthma and Allergies in Childhood Phase II, n = 1446 total subjects, n = 763 asthmatic patients) data set to identify putative causal single nucleotide polymorphisms (SNPs) in the locus. Top asthma-associated polymorphisms were analyzed for allele-specific effects on transcription factor binding and promoter activity in vitro and gene expression in PBMCs after stimulation ex vivo. RESULTS Two haplotypes (H1 and H2) were significantly associated with asthma in the cross-sectional (P = 9.9 × 10(-5) and P = .0035, respectively) and case-control (P = 3.15 × 10(-8) and P = .0021, respectively) populations. Polymorphisms rs8076131 and rs4065275 were identified to drive these effects. For rs4065275, a quantitative difference in transcription factor binding was found, whereas for rs8076131, changes in upstream stimulatory factor 1 and 2 transcription factor binding were observed in vitro by using different cell lines and PBMCs. This might contribute to detected alterations in luciferase activity paralleled with changes in ORMDL3 gene expression and IL-4 and IL-13 cytokine levels ex vivo in response to innate and adaptive stimuli in an allele-specific manner. Both SNPs were in strong linkage disequilibrium with asthma-associated 17q21 SNPs previously related to altered ORMDL3 gene expression. CONCLUSION Polymorphisms in a putative promoter region of ORMDL3, which are associated with childhood asthma, alter transcriptional regulation of ORMDL3, correlate with changes in TH2 cytokines levels, and therefore might contribute to the childhood asthma susceptibility signal from 17q21.
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Affiliation(s)
- Michaela Schedel
- Department of Pediatrics, National Jewish Health, Denver, Colo; Department of Pediatric Pneumology, Allergy, and Neonatology, Hannover Medical School, Hannover, Germany
| | - Sven Michel
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Department of Pediatric Pneumology, Allergy, and Neonatology, Hannover Medical School, Hannover, Germany
| | - Vincent D Gaertner
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany
| | - Antoaneta A Toncheva
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Department of Pediatric Pneumology, Allergy, and Neonatology, Hannover Medical School, Hannover, Germany
| | - Martin Depner
- Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Aristea Binia
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Nestlé Research Centre, Nutrition & Health Department, Lausanne, Switzerland
| | - Maximilian Schieck
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Department of Pediatric Pneumology, Allergy, and Neonatology, Hannover Medical School, Hannover, Germany
| | - Marie T Rieger
- Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Norman Klopp
- Research Group of Molecular Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany; Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Andrea von Berg
- Research Institute for the Prevention of Allergic Diseases, Children's Department, Marien-Hospital, Wesel, Germany
| | - Albrecht Bufe
- Department of Experimental Pneumology, Ruhr-University, Bochum, Germany
| | - Otto Laub
- Children's Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Ernst Rietschel
- University Children's Hospital, University of Cologne, Cologne, Germany
| | - Andrea Heinzmann
- University Children's Hospital, Albert Ludwigs University, Freiburg, Germany
| | - Burkard Simma
- Children's Department, Feldkirch Hospital, Feldkirch, Austria
| | | | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Thomas Illig
- Research Group of Molecular Epidemiology, Helmholtz Centre Munich, Neuherberg, Germany; Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO), Regensburg, Germany; Department of Pediatric Pneumology, Allergy, and Neonatology, Hannover Medical School, Hannover, Germany.
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Rietschel E. Abstracts für den 10. DAK — erstmals in der Domstadt! Allergo J 2015. [DOI: 10.1007/s15007-015-0790-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brockow K, Schallmayer S, Beyer K, Biedermann T, Fischer J, Gebert N, Grosber M, Jakob T, Klimek L, Kugler C, Lange L, Pfaar O, Przybilla B, Rietschel E, Rueff F, Schnadt S, Szczepanski R, Worm M, Kupfer J, Gieler U, Ring J. Effects of a structured educational intervention on knowledge and emergency management in patients at risk for anaphylaxis. Allergy 2015; 70:227-35. [PMID: 25407693 DOI: 10.1111/all.12548] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Structured educational programmes for patients at risk for anaphylaxis have not yet been established. Patients and caregivers often lack adequate skills in managing the disease. METHODS To investigate effects of structured patient education intervention on knowledge, emergency management skills and psychological parameters in patients with previous episodes of anaphylaxis and caregivers of affected children 95 caregivers (11 male, 84 female, mean age 37 years) of affected children and 98 patients (32 male, 66 female, mean age 47.5 years) were randomly assigned to an intervention (IG) or control group (CG) in a multicentre randomized controlled trial. The IG received two 3-h schooling modules of group education; the CG received standard auto-injector training only. Knowledge of anaphylaxis and emergency management competence in a validated training anaphylaxis situation as main outcome measures as well as secondary psychological parameters were assessed at baseline and 3 months after intervention. RESULTS In comparison with controls, the intervention led to significant improvement of knowledge from baseline to 3-month follow-up (caregivers: IG 3.2/13.2 improvement/baseline vs CG 0.7/12.6; P < 0.001; patients: IG 3.9/10.8 vs 1.3/12.6; P < 0.001). Moreover, emergency management competence was increased after intervention as compared to controls (caregivers: IG 8.6/11.2 vs CG 1.2/10.8; P < 0.001; patients: 7.1/11.0 vs 1.1/11.1; P < 0.001). Intervention showed significant reduction of caregiver anxiety (-1.9/8.4 vs -0.7/7.5; P < 0.05). There were no significant changes in the depression scores. CONCLUSION Structured patient education programmes may be beneficial in the management of anaphylaxis by increasing patients' empowerment to prevent and treat the disease.
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Affiliation(s)
- K. Brockow
- Department of Dermatology und Allergology Biederstein; Technische Universität München; Munich Germany
| | - S. Schallmayer
- Department of Psychosomatics and Psychotherapy; University Hospital Giessen and Marburg; Giessen Germany
| | - K. Beyer
- Department of Paediatric Pneumology and Immunology; Allergy-Center-Charité; Charité Universitätsmedizin Berlin; Berlin Germany
| | - T. Biedermann
- Department of Dermatology; University of Tübingen; Tübingen Germany
| | - J. Fischer
- Department of Dermatology; University of Tübingen; Tübingen Germany
| | - N. Gebert
- Department of Paediatric Pneumology and Immunology; Allergy-Center-Charité; Charité Universitätsmedizin Berlin; Berlin Germany
| | - M. Grosber
- Department of Dermatology und Allergology Biederstein; Technische Universität München; Munich Germany
| | - T. Jakob
- Allergy Research Group; Department of Dermatology; University Medical Center Freiburg; Freiburg Germany
| | - L. Klimek
- Department of Otolaryngology; Center for Rhinology and Allergology Wiesbaden; Mannheim University Hospital; Mannheim Germany
| | - C. Kugler
- Department of Dermatology und Allergology Biederstein; Technische Universität München; Munich Germany
| | - L. Lange
- Division for Pediatrics; St.-Marien-Hospital; Bonn Germany
| | - O. Pfaar
- Department of Otolaryngology; Center for Rhinology and Allergology Wiesbaden; Mannheim University Hospital; Mannheim Germany
| | - B. Przybilla
- Department of Dermatology und Allergology; Ludwig-Maximilians University; Munich Germany
| | - E. Rietschel
- Children's Hospital; University of Cologne; Cologne Germany
| | - F. Rueff
- Department of Dermatology und Allergology; Ludwig-Maximilians University; Munich Germany
| | - S. Schnadt
- German Allergy and Asthma Assiciation; Mönchengladbach Germany
| | | | - M. Worm
- Department of Dermatology and Allergy; Allergy-Center-Charité; Charité Universitätsmedizin Berlin; Berlin Germany
| | - J. Kupfer
- Institute of Medical Psychology; Justus-Liebig-Universität Giessen; Giessen Germany
| | - U. Gieler
- Department of Psychosomatics and Psychotherapy; University Hospital Giessen and Marburg; Giessen Germany
| | - J. Ring
- Department of Dermatology und Allergology Biederstein; Technische Universität München; Munich Germany
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Sharma V, Michel S, Gaertner V, Franke A, Vogelberg C, von Berg A, Bufe A, Heinzmann A, Laub O, Rietschel E, Simma B, Frischer T, Genuneit J, Zeilinger S, Illig T, Schedel M, Potaczek DP, Kabesch M. Fine-mapping of IgE-associated loci 1q23, 5q31, and 12q13 using 1000 Genomes Project data. Allergy 2014; 69:1077-84. [PMID: 24930997 DOI: 10.1111/all.12431] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Genome-wide association studies (GWAS) repeatedly identified 1q23 (FCER1A), 5q31 (RAD50-IL13 and IL4), and 12q13 (STAT6) as major susceptibility loci influencing the regulation of total serum IgE levels. As GWAS may be insufficient to capture causal variants, we performed fine-mapping and re-genotyping of the three loci using 1000 Genomes Project datasets. METHODS Linkage disequilibrium tagging polymorphisms and polymorphisms of putative functional relevance were genotyped by chip technology (24 polymorphisms) or MALDI-TOF-MS (40 polymorphisms) in at least 1303 German children (651 asthmatics). The effect of polymorphisms on total serum IgE, IgE percentiles, and atopic diseases was assessed, and a risk score model was applied for gene-by-gene interaction analyses. Functional effects of putative causal variants from these three loci were studied in silico. RESULTS Associations from GWAS were confirmed and extended. For 1q23 and 5q31, the majority of associations were found with mild to moderately elevated IgE levels, while in the 12q13 locus, single-nucleotide polymorphisms (SNPs) were associated with strongly elevated IgE levels. Gene-by-gene interaction analyses suggested that the presence of mutations in all three loci increases the risk for elevated IgE up to fourfold. CONCLUSION This fine-mapping study confirmed previous associations and identified novel associations of SNPs in 1q23, 5q31, and 12q13 with different levels of serum IgE and their concomitant contribution to IgE regulation.
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Affiliation(s)
- V. Sharma
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
| | - S. Michel
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
| | - V. Gaertner
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
| | - A. Franke
- Institute of Clinical Molecular Biology; Christian-Albrechts-University Kiel; Kiel Germany
| | - C. Vogelberg
- University Children's Hospital; Technical University Dresden; Dresden Germany
| | - A. von Berg
- Children's Department; Research Institute for the Prevention of Allergic Diseases; Marien-Hospital; Wesel Germany
| | - A. Bufe
- Department of Experimental Pneumology; Ruhr-University; Bochum Germany
| | - A. Heinzmann
- University Children's Hospital; Albert Ludwigs University; Freiburg Germany
| | - O. Laub
- Kinder-und Jugendarztpraxis Laub; Rosenheim Germany
| | - E. Rietschel
- University Children's Hospital; University of Cologne; Cologne Germany
| | - B. Simma
- Children's Department; University Teaching Hospital; Landeskrankenhaus Feldkirch; Feldkirch Austria
| | - T. Frischer
- University Children's Hospital Vienna; Vienna Austria
| | - J. Genuneit
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - S. Zeilinger
- Research Unit of Molecular Epidemiology; Helmholtz Zentrum Munich; Neuherberg Germany
| | - T. Illig
- Research Unit of Molecular Epidemiology; Helmholtz Zentrum Munich; Neuherberg Germany
- Hannover Unified Biobank; Hannover Medical School; Hannover Germany
| | - M. Schedel
- Division of Cell Biology; Department of Pediatrics; National Jewish Health; Denver CO USA
| | - D. P. Potaczek
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
- Institute of Laboratory Medicine; Philipps-Universität Marburg; Marburg Germany
| | - M. Kabesch
- Department of Pediatric Pneumology, Allergy and Neonatology; Hannover Medical School; Hannover Germany
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
- German Lung Research Center (DZL)
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Heinbockel L, Palacios-Chaves L, Alexander C, Rietschel E, Behrends J, Correa W, Fukuoka S, Gutsmann T, Ulmer AJ, Brandenburg K. Mechanism of Hbγ-35-induced an increase in the activation of the human immune system by endotoxins. Innate Immun 2014; 21:305-13. [PMID: 25034969 DOI: 10.1177/1753425914535957] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Endotoxins (LPS) are highly potent immune stimulatory molecules and are mainly known for triggering Gram-negative sepsis. However, besides their toxic effects, this stimulatory function may be advantageous, for example when used as an adjuvant during vaccination. Thus, there is always a narrow range between the useful wake-up of the immune system and its overwhelming reaction, which can lead to diseases like sepsis. This raises the question of which conformational properties are responsible for making the LPS aggregates more or less potent. As described previously, the size, type and form of LPS aggregates play a major role in their immune stimulatory activity. In this study we investigate the role of these parameters. On the one hand, we use a peptide (Pep19-2.5; Aspidasept) that causes a change of the LPS aggregate structure into a less toxic state; on the other hand, we use a potent immune stimulating peptide (Hbγ-35), leading to higher toxicity. We have found opposing effects on LPS aggregate conformations allowing a better understanding of the processes of immune stimulation.
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Affiliation(s)
- Lena Heinbockel
- Research Center Borstel, Division of Biophysics, Borstel, Germany
| | - Leyre Palacios-Chaves
- Research Center Borstel, Division of Biophysics, Borstel, Germany Instituto de Agrobiotecnología CSIC-UPNA-Gobierno de Navarra, Pamplona, Spain
| | | | | | - Jochen Behrends
- Research Center Borstel, Division of Fluorescence Cytometry, Borstel, Germany
| | - Wilmar Correa
- Research Center Borstel, Division of Biophysics, Borstel, Germany
| | - Satoshi Fukuoka
- National Institute of Advanced Industrial Science and Technology (AIST), Takamatsu, Japan
| | - Thomas Gutsmann
- Research Center Borstel, Division of Biophysics, Borstel, Germany
| | - Artur J Ulmer
- Research Center Borstel, Division of Biophysics, Borstel, Germany
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Boyle MP, Bell SC, Konstan MW, McColley SA, Rowe SM, Rietschel E, Huang X, Waltz D, Patel NR, Rodman D. A CFTR corrector (lumacaftor) and a CFTR potentiator (ivacaftor) for treatment of patients with cystic fibrosis who have a phe508del CFTR mutation: a phase 2 randomised controlled trial. Lancet Respir Med 2014; 2:527-38. [PMID: 24973281 DOI: 10.1016/s2213-2600(14)70132-8] [Citation(s) in RCA: 328] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The phe508del CFTR mutation causes cystic fibrosis by limiting the amount of CFTR protein that reaches the epithelial cell surface. We tested combination treatment with lumacaftor, an investigational CFTR corrector that increases trafficking of phe508del CFTR to the cell surface, and ivacaftor, a CFTR potentiator that enhances chloride transport of CFTR on the cell surface. METHODS In this phase 2 clinical trial, we assessed three successive cohorts, with the results of each cohort informing dose selection for the subsequent cohort. We recruited patients from 24 cystic fibrosis centres in Australia, Belgium, Germany, New Zealand, and the USA. Eligibility criteria were: confirmed diagnosis of cystic fibrosis, age at least 18 years, and a forced expiratory volume in 1 s (FEV1) of 40% or more than predicted. Cohort 1 included phe508del CFTR homozygous patients randomly assigned to either lumacaftor 200 mg once per day for 14 days followed by addition of ivacaftor 150 mg or 250 mg every 12 h for 7 days, or 21 days of placebo. Together, cohorts 2 and 3 included phe508del CFTR homozygous and heterozygous patients, randomly assigned to either 56 days of lumacaftor (cohort 2: 200 mg, 400 mg, or 600 mg once per day, cohort 3: 400 mg every 12 h) with ivacaftor 250 mg every 12 h added after 28 days, or 56 days of placebo. The primary outcomes for all cohorts were change in sweat chloride concentration during the combination treatment period in the intention-to-treat population and safety (laboratory measurements and adverse events). The study is registered with ClinicalTrials.gov, number NCT01225211, and EudraCT, number 2010-020413-90. FINDINGS Cohort 1 included 64 participants. Cohort 2 and 3 combined contained 96 phe508del CFTR homozygous patients and 28 compound heterozygotes. Treatment with lumacaftor 200 mg once daily and ivacaftor 250 mg every 12 h decreased mean sweat chloride concentration by 9.1 mmol/L (p<0.001) during the combination treatment period in cohort 1. In cohorts 2 and 3, mean sweat chloride concentration did not decrease significantly during combination treatment in any group. Frequency and nature of adverse events were much the same in the treatment and placebo groups during the combination treatment period; the most commonly reported events were respiratory. 12 of 97 participants had chest tightness or dyspnoea during treatment with lumacaftor alone. In pre-planned secondary analyses, a significant decrease in sweat chloride concentration occurred in the treatment groups between day 1 and day 56 (lumacaftor 400 mg once per day group -9.1 mmol/L, p<0.001; lumacaftor 600 mg once per day group -8.9 mmol/L, p<0.001; lumacaftor 400 mg every 12 h group -10.3 mmol/L, p=0.002). These changes were significantly greater than the change in the placebo group. In cohort 2, the lumacaftor 600 mg once per day significantly improved FEV1 from day 1 to 56 (difference compared with placebo group: +5.6 percentage points, p=0.013), primarily during the combination period. In cohort 3, FEV1 did not change significantly across the entire study period compared with placebo (difference +4.2 percentage points, p=0.132), but did during the combination period (difference +7.7 percentage points, p=0·003). Phe508del CFTR heterozygous patients did not have a significant improvement in FEV1. INTERPRETATION We provide evidence that combination lumacaftor and ivacaftor improves FEV1 for patients with cystic fibrosis who are homozygous for phe508del CFTR, with a modest effect on sweat chloride concentration. These results support the further exploration of combination lumacaftor and ivacaftor as a treatment in this setting. FUNDING Vertex Pharmaceuticals, Cystic Fibrosis Foundation Therapeutics Development Network.
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Affiliation(s)
| | - Scott C Bell
- The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Michael W Konstan
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Steven M Rowe
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ernst Rietschel
- Children's Hospital, University of Cologne, Cologne, Germany
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49
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Worm* M, Eckermann* O, Dölle S, Aberer W, Beyer K, Hawranek T, Hompes S, Koehli A, Mahler V, Nemat K, Niggemann B, Pföhler C, Rabe U, Reissig A, Rietschel E, Scherer K, Treudler R, Ruëff F. Triggers and treatment of anaphylaxis: an analysis of 4,000 cases from Germany, Austria and Switzerland. Dtsch Arztebl Int 2014; 111:367-75. [PMID: 24939374 PMCID: PMC4075276 DOI: 10.3238/arztebl.2014.0367] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 03/24/2014] [Accepted: 03/24/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Anaphylaxis is the most severe manifestation of a mast cell-dependent immediate reaction and may be fatal. According to data from the Berlin region, its incidence is 2-3 cases per 100 000 persons per year. METHOD We evaluated data from the anaphylaxis registry of the German-speaking countries for 2006-2013 and data from the protocols of the ADAC air rescue service for 2010-2011 to study the triggers, clinical manifestations, and treatment of anaphylaxis. RESULTS The registry contained data on 4141 patients, and the ADAC air rescue protocols concerned 1123 patients. In the registry, the most common triggers for anaphylaxis were insect venom (n = 2074; 50.1%), foods (n = 1039; 25.1%), and drugs (n = 627; 15.1%). Within these groups, the most common triggers were wasp (n = 1460) and bee stings (n = 412), legumes (n = 241), animal proteins (n = 225), and analgesic drugs (n = 277). Food anaphylaxis was most frequently induced by peanuts, cow milk, and hen's egg in children and by wheat and shellfish in adults. An analysis of the medical emergency cases revealed that epinephrine was given for grade 3 or 4 anaphylaxis to 14.5% and 43.9% (respectively) of the patients in the anaphylaxis registry and to 19% and 78% of the patients in the air rescue protocols. CONCLUSION Wasp and bee venom, legumes, animal proteins, and analgesic drugs were the commonest triggers of anaphylaxis. Their relative frequency was age-dependent. Epinephrine was given too rarely, as it is recommended in the guidelines for all cases of grade 2 and above.
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Affiliation(s)
- Margitta Worm*
- Allergy Center Charité, Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin
- Margitta Worm and Oliver Eckermann have equally contributed to the manuscript
| | - Oliver Eckermann*
- ADAC Air Rescue Service Senftenberg
- Margitta Worm and Oliver Eckermann have equally contributed to the manuscript
| | - Sabine Dölle
- Allergy Center Charité, Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin
| | - Werner Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Austria
| | - Kirsten Beyer
- Department of Pediatrics, Pneumonology and Immunology, Charité – Universitätsmedizin Berlin
| | - Thomas Hawranek
- Allergy Clinic, Department of Dermatology, SALK, Paracelsus Medical University, Salzburg, Austria
| | - Stephanie Hompes
- Allergy Center Charité, Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin
| | - Alice Koehli
- Pediatric Allergology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Vera Mahler
- Department of Dermatology, University Hospital Erlangen-Nürnberg
| | - Katja Nemat
- Department of Pediatric Pneumology and Allergology at the KID Center, Dresden-Friedrichstadt
| | - Bodo Niggemann
- Department of Pediatrics, Pneumonology and Immunology, Charité – Universitätsmedizin Berlin
| | - Claudia Pföhler
- Department of Dermatology, Venerology and Allergy at the Saarland University, Homburg/Saar
| | - Uta Rabe
- Department of Allergology, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen
| | - Angelika Reissig
- Department of Internal Medicine I: Pneumology & Allergology/Immunology, Friedrich Schiller University Jena
| | - Ernst Rietschel
- Department of Pediatric Pulmonology and Allergology, Children’s Hospital of the University of Cologne
| | - Kathrin Scherer
- Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Schweiz
| | - Regina Treudler
- Department of Dermatology, Venereology and Allergology, University of Leipzig
| | - Franziska Ruëff
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich
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50
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Kerem E, Konstan MW, De Boeck K, Accurso FJ, Sermet-Gaudelus I, Wilschanski M, Elborn JS, Melotti P, Bronsveld I, Fajac I, Malfroot A, Rosenbluth DB, Walker PA, McColley SA, Knoop C, Quattrucci S, Rietschel E, Zeitlin PL, Barth J, Elfring GL, Welch EM, Branstrom A, Spiegel RJ, Peltz SW, Ajayi T, Rowe SM. Ataluren for the treatment of nonsense-mutation cystic fibrosis: a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Respir Med 2014; 2:539-47. [PMID: 24836205 DOI: 10.1016/s2213-2600(14)70100-6] [Citation(s) in RCA: 268] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Ataluren was developed to restore functional protein production in genetic disorders caused by nonsense mutations, which are the cause of cystic fibrosis in 10% of patients. This trial was designed to assess the efficacy and safety of ataluren in patients with nonsense-mutation cystic fibrosis. METHODS This randomised, double-blind, placebo-controlled, phase 3 study enrolled patients from 36 sites in 11 countries in North America and Europe. Eligible patients with nonsense-mutation cystic fibrosis (aged ≥ 6 years; abnormal nasal potential difference; sweat chloride >40 mmol/L; forced expiratory volume in 1 s [FEV1] ≥ 40% and ≤ 90%) were randomly assigned by interactive response technology to receive oral ataluren (10 mg/kg in morning, 10 mg/kg midday, and 20 mg/kg in evening) or matching placebo for 48 weeks. Randomisation used a block size of four, stratified by age, chronic inhaled antibiotic use, and percent-predicted FEV1. The primary endpoint was relative change in percent-predicted FEV1 from baseline to week 48, analysed in all patients with a post-baseline spirometry measurement. This study is registered with ClinicalTrials.gov, number NCT00803205. FINDINGS Between Sept 8, 2009, and Nov 30, 2010, 238 patients were randomly assigned, of whom 116 in each treatment group had a valid post-baseline spirometry measurement. Relative change from baseline in percent-predicted FEV1 did not differ significantly between ataluren and placebo at week 48 (-2.5% vs -5.5%; difference 3.0% [95% CI -0.8 to 6.3]; p=0.12). The number of pulmonary exacerbations did not differ significantly between treatment groups (rate ratio 0.77 [95% CI 0.57-1.05]; p=0.0992). However, post-hoc analysis of the subgroup of patients not using chronic inhaled tobramycin showed a 5.7% difference (95% CI 1.5-10.1) in relative change from baseline in percent-predicted FEV1 between the ataluren and placebo groups at week 48 (-0.7% [-4.0 to 2.1] vs -6.4% [-9.8 to -3.7]; nominal p=0.0082), and fewer pulmonary exacerbations in the ataluern group (1.42 events [0.9-1.9] vs 2.18 events [1.6-2.7]; rate ratio 0.60 [0.42-0.86]; nominal p=0.0061). Safety profiles were generally similar for ataluren and placebo, except for the occurrence of increased creatinine concentrations (ie, acute kidney injury), which occurred in 18 (15%) of 118 patients in the ataluren group compared with one (<1%) of 120 patients in the placebo group. No life-threatening adverse events or deaths were reported in either group. INTERPRETATION Although ataluren did not improve lung function in the overall population of nonsense-mutation cystic fibrosis patients who received this treatment, it might be beneficial for patients not taking chronic inhaled tobramycin. FUNDING PTC Therapeutics, Cystic Fibrosis Foundation, US Food and Drug Administration's Office of Orphan Products Development, and the National Institutes of Health.
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Affiliation(s)
- Eitan Kerem
- Center for Cystic Fibrosis, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Michael W Konstan
- Rainbow Babies & Children's Hospital and Case Western Reserve University, Cleveland, OH, USA.
| | - Kris De Boeck
- University Hospitals Leuven/Catholic University of Leuven, Leuven, Belgium
| | | | - Isabelle Sermet-Gaudelus
- Centre de Ressource et de Competence de la Mucoviscidose, Service de Pediatrie Generale, Service de Pneumologie Pediatrique, Service de Radiologie Pediatrique, Centre d'Investigation Clinique Hôpital Necker-Enfants Malades, Paris, France
| | - Michael Wilschanski
- Center for Cystic Fibrosis, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - J Stuart Elborn
- Centre for Infection and Immunity, Queen's University, Belfast, Northern Ireland, UK
| | - Paola Melotti
- Centro Regionale Veneto di Ricerca, Prevenzione e Cura Fibrosi Cistica, Azienda Ospedaliera di Verona, Verona, Italy
| | - Inez Bronsveld
- Department of Pulmonology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Isabelle Fajac
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Physiology, Hôpital Cochin, AP-HP, Paris, France
| | - Anne Malfroot
- Cystic Fibrosis Clinic, Universitair Ziekenhuis Brussel/Vrije Universiteit Brussel, Brussels, Belgium
| | - Daniel B Rosenbluth
- Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA
| | | | - Susanna A McColley
- Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christiane Knoop
- Department of Chest Medicine, Hôpital Universitaire Erasme, Brussels, Belgium
| | - Serena Quattrucci
- Regional Cystic Fibrosis Centre, Paediatrics and Infant Neuropsychiatry Department, 'Sapienza' University of Rome, Rome, Italy
| | - Ernst Rietschel
- Cystic Fibrosis Centre, Children's Hospital University of Cologne, Cologne, Germany
| | - Pamela L Zeitlin
- Pediatric Pulmonology, Johns Hopkins Pediatric Specialty Clinic, Rubenstein Child Health, Baltimore, MD, USA
| | - Jay Barth
- PTC Therapeutics, South Plainfield, NJ, USA
| | | | | | | | | | | | | | - Steven M Rowe
- Translational Research Unit, Pulmonary and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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