1
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Dramburg S, Grittner U, Potapova E, Travaglini A, Tripodi S, Arasi S, Pelosi S, Acar Şahin A, Aggelidis X, Barbalace A, Bourgoin A, Bregu B, Brighetti MA, Caeiro E, Caglayan Sozmen S, Caminiti L, Charpin D, Couto M, Delgado L, Di Rienzo Businco A, Dimier C, Dimou MV, Fonseca JA, Goksel O, Hernandez D, Hernandez Toro CJ, Hoffmann TM, Jang DT, Kalpaklioglu F, Lame B, Llusar R, Makris M, Mazon A, Mesonjesi E, Nieto A, Öztürk AB, Pahus L, Pajno G, Panasiti I, Papadopoulos NG, Pellegrini E, Pereira AM, Pereira M, Pinar NM, Priftanji A, Psarros F, Sackesen C, Sfika I, Suarez J, Thibaudon M, Uguz U, Verdier V, Villella V, Xepapadaki P, Yazici D, Matricardi PM. Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study. Allergy 2024; 79:908-923. [PMID: 38311961 DOI: 10.1111/all.16029] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.
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Affiliation(s)
- S Dramburg
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - U Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E Potapova
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Travaglini
- Department of Biology, Tor Vergata University, Rome, Italy
- Italian Aerobiology Monitoring Network - Italian Aerobiology Association, Rome, Italy
| | - S Tripodi
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
- Allergolology Service, Policlinico Casilino, Rome, Italy
| | - S Arasi
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's Research Hospital (IRCCS), Rome, Italy
| | | | - A Acar Şahin
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - X Aggelidis
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece
| | - A Barbalace
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - A Bourgoin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - B Bregu
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - M A Brighetti
- Department of Biology, Tor Vergata University, Rome, Italy
| | - E Caeiro
- MED- Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, University of Évora, Évora, Portugal
- Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal
| | | | - L Caminiti
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - D Charpin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - M Couto
- Immunoallergology, Hospital CUF Trindade, Porto, Portugal
| | - L Delgado
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
| | | | - C Dimier
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - M V Dimou
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - J A Fonseca
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - O Goksel
- Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma. Faculty of Medicine, Ege University, Izmir, Turkey
| | - D Hernandez
- Department of Allergy, Health Research Institute Hospital La Fe, Valencia, Spain
| | - C J Hernandez Toro
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T M Hoffmann
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D T Jang
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - F Kalpaklioglu
- Department of Immunology and Allergic Diseases, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - B Lame
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - R Llusar
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - M Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece
| | - A Mazon
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - E Mesonjesi
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - A Nieto
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - A B Öztürk
- Division of Allergy and Immunology, Department of Pulmonary Medicine, Arel University, School of Medicine, Istanbul, Turkey
| | - L Pahus
- Aix Marseille Univ, APHM, INSERM CIC 1409, INSERM U1263, INRA 1260 (C2VN), Marseille, France
| | - G Pajno
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - I Panasiti
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | - E Pellegrini
- Department of Reggio Calabria, ARPA - Regional Agency for Environmental Protection, Calabria, Italy
| | - A M Pereira
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Pereira
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - N M Pinar
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - A Priftanji
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - F Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - C Sackesen
- Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey
| | - I Sfika
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - J Suarez
- Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain
| | - M Thibaudon
- Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - U Uguz
- Department of Biology, Faculty of Science, Ege University, Izmir, Turkey
| | - V Verdier
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - V Villella
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - P Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - D Yazici
- Cellular and Molecular Medicine, KUTTAM, Graduate School of Health Sciences, Koç University, Istanbul, Turkey
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - P M Matricardi
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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2
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Bousquet J, Melén E, Haahtela T, Koppelman GH, Togias A, Valenta R, Akdis CA, Czarlewski W, Rothenberg M, Valiulis A, Wickmann M, Aguilar D, Akdis M, Ansotegui IJ, Barbara C, Bedbrook A, Bindslev Jensen C, Bosnic-Anticevich S, Boulet LP, Brightling CE, Brussino L, Burte E, Bustamante M, Canonica GW, Cecchi L, Celedon JC, Chaves-Loureiro C, Costa E, Cruz AA, Erhola M, Gemicioglu B, Fokkens WJ, Garcia Aymerich J, Guerra S, Heinrich J, Ivancevich JC, Keil T, Klimek L, Kuna P, Kupczyk M, Kvedariene V, Larenas-Linnemann DE, Lemonnier N, Lodrup Carlsen KC, Louis R, Makris M, Maurer M, Momas I, Morais-Almeida M, Mullol J, Naclerio RN, Nadeau K, Nadif R, Niedoszytko M, Okamoto Y, Ollert M, Papadopoulos NG, Passalacqua G, Patella V, Pawankar R, Pham-Thi N, Pfaar O, Regateiro FS, Ring J, Rouadi PW, Samolinski B, Sastre J, Savouré M, Scichilone N, Shamji MH, Sheikh A, Siroux V, Sousa-Pinto B, Standl M, Sunyer J, Taborda-Barata L, Toppila-Salmi S, Torres MJ, Tsiligianni I, Valovirta E, Vandenplas O, Ventura MT, Weiss S, Yorgancioglu A, Zhang L, Abdul Latiff AH, Aberer W, Agache I, Al-Ahmad M, Alobid I, Arshad HS, Asayag E, Baharudin A, Battur L, Bennoor KS, Berghea EC, Bergmann KC, Bernstein D, Bewick M, Blain H, Bonini M, Braido F, Buhl R, Bumbacea R, Bush A, Calderon M, Calvo G, Camargos P, Caraballo L, Cardona V, Carr W, Carreiro-Martins P, Casale T, Cepeda Sarabia AM, Chandrasekharan R, Charpin D, Chen YZ, Cherrez-Ojeda I, Chivato T, Chkhartishvili E, Christoff G, Chu DK, Cingi C, Correia da Sousa J, Corrigan C, Custovic A, D'Amato G, Del Giacco S, De Blay F, Devillier P, Didier A, do Ceu Teixeira M, Dokic D, Douagui H, Doulaptsi M, Durham S, Dykewicz M, Eiwegger T, El-Sayed ZA, Emuzyte R, Emuzyte R, Fiocchi A, Fyhrquist N, Gomez RM, Gotua M, Guzman MA, Hagemann J, Hamamah S, Halken S, Halpin DMG, Hofmann M, Hossny E, Hrubiško M, Irani C, Ispayeva Z, Jares E, Jartti T, Jassem E, Julge K, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu O, Kardas P, Kirenga B, Kraxner H, Kull I, Kulus M, La Gruta S, Lau S, Le Tuyet Thi L, Levin M, Lipworth B, Lourenço O, Mahboub B, Mäkelä MJ, Martinez-Infante E, Matricardi P, Miculinic N, Migueres N, Mihaltan F, Mohamad Y, Moniusko M, Montefort S, Neffen H, Nekam K, Nunes E, Nyembue Tshipukane D, O'Hehir RE, Ogulur I, Ohta K, Okubo K, Ouedraogo S, Olze H, Pali-Schöll I, Palomares O, Palosuo K, Panaitescu C, Panzner P, Park HS, Pitsios C, Plavec D, Popov TA, Puggioni F, Quirce S, Recto M, Repka-Ramirez R, Roballo-Cordeiro C, Roche N, Rodriguez-Gonzales M, Romantowski J, Rosario Filho N, Rottem M, Sagara H, Sarquis-Serpa F, Sayah Z, Scheire S, Schmid-Grendelmeier P, Sisul JC, Sole D, Soto-Martinez M, Sova M, Sperl A, Spranger O, Stelmach R, Suppli Ulrik C, Thomas M, To T, Todo-Bom A, Tomazic PV, Urrutia-Pereira M, Valentin-Rostan M, van Ganse E, Van Hage M, Vasankari T, Vichyanond P, Viegi G, Wallace D, Wang DY, Williams S, Worm M, Yiallouros P, Yiallouros P, Yusuf O, Zaitoun F, Zernotti M, Zidarn M, Zuberbier J, Fonseca JA, Zuberbier T, Anto JM. Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis. Allergy 2023; 78:1169-1203. [PMID: 36799120 DOI: 10.1111/all.15679] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023]
Abstract
Asthma, rhinitis and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease", coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitisation and multimorbidity, (iii) advances in mHealth for novel phenotype definition, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis". This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitisation patterns (mono- or pauci-sensitisation versus polysensitisation), (iii) severity of symptoms and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and auto-immune diseases.
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Affiliation(s)
- J Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.,University Hospital Montpellier, Montpellier, France.,Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - E Melén
- Sach´s Children and Youth Hospital, Södersjukhuset, and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - G H Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, GRIAC Research Institute, Groningen, the Netherlands
| | - A Togias
- Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - W Czarlewski
- Medical Consulting Czarlewski, Levallois, France.,MASK-air, Montpellier, France
| | - M Rothenberg
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - A Valiulis
- Institute of Clinical Medicine and Institute of Health Sciences, Vilnius, Lithuania.,Medical Faculty of Vilnius University, Vilnius, Lithuania
| | - M Wickmann
- Institute of Environmental medicine, Karolinska Institutet, Stockholm, Sweden
| | - D Aguilar
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Barcelona, Spain
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - C Barbara
- Portuguese Nacional Programme for Respiratory Diseases, Direção -Geral da Saúde, Faculdade de Medicina de Lisboa, Instituto de Saúde Ambiental, Lisbon, Portugal
| | | | - C Bindslev Jensen
- Odense Research Center for Anaphylaxis (ORCA), and Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Finland
| | - S Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - L P Boulet
- Quebec Heart and Lung Institute, Laval University, Québec City, Quebec, Canada
| | - C E Brightling
- Institute of Lung Health, NIHR Biomedical Research Centre, Department of Respiratory and Infection Sciences, University of Leicester, Leicester, UK
| | - L Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino, Torino, Italy.,Mauriziano Hospital, Torino, Italy
| | - E Burte
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
| | - M Bustamante
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - G W Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - J C Celedon
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - C Chaves-Loureiro
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - A A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - M Erhola
- Pirkanmaa Welfare district, Tampere, Finland
| | - B Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - J Garcia Aymerich
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - S Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - J Heinrich
- Ludwig Maximilians University Munich, University Hospital Munich - Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - L Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Germany.,Center for Rhinology and Allergology, Wiesbaden, Germany
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - M Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - V Kvedariene
- Institute of Clinical medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - N Lemonnier
- Institute for Advanced Biosciences, UGA - INSERM U1209 - CNRS UMR5309, Site Santé, Allée des Alpes, La Tronche, France
| | | | - R Louis
- Department of Pulmonary Medicine, CHU, Liege, Liège, Belgium.,GIGA I3 research group, University of Liege, Belgium
| | - M Makris
- Allergy Unit "D Kalogeromitros", 2nd Dpt of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Greece
| | - M Maurer
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - I Momas
- Department of Public health and health products, Paris Descartes University-Sorbonne Paris Cité, EA 4064 and Paris Municipal Department of social action, childhood, and health, Paris, France
| | | | - J Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.,Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Spain
| | - R N Naclerio
- Department of Otolaryngology - Head and Neck Surgery - Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - K Nadeau
- Stanford University School of Medicine, Sean N. Parker Center for Allergy and Asthma Research, Stanford, USA
| | - R Nadif
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
| | - M Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Y Okamoto
- Chiba University Hospital, Chiba, Japan.,Chiba Rosai Hospital, Chiba, Japan
| | - M Ollert
- Odense Research Center for Anaphylaxis (ORCA), and Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Finland.,Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Italy
| | - V Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.,Agency of Health ASL, Salerno, Italy
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - N Pham-Thi
- Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
| | - O Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - F S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (ICBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Ring
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.,Christine Kühne Center for Allergy Research and Education (CK-Care), Davos, Switzerland
| | - P W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon.,Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
| | - B Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Poland
| | - J Sastre
- Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
| | - M Savouré
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
| | - N Scichilone
- PROMISE Department, University of Palermo, Palermo, Italy
| | - M H Shamji
- National Heart and Lung Institute, Imperial College, and NIHR Imperial Biomedical Research Centre, London, UK
| | - A Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - V Siroux
- INSERM, Université Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Université Joseph Fourier, Grenoble, France
| | - B Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research; University of Porto, Porto, Portugal.,RISE - Health Research Network; University of Porto, Porto, Portugal
| | - M Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - J Sunyer
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L Taborda-Barata
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.,UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - M J Torres
- Allergy Unit, Málaga Regional University Hospital-IBIMA, Málaga, Spain
| | - I Tsiligianni
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.,Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - E Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.,Terveystalo Allergy Clinic, Turku, Finland
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL, Namur, and Université Catholique de Louvain, Yvoir, Belgium
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - S Weiss
- Harvard Medical School and Channing Division of Network Medicine, Boston, USA
| | - A Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - A H Abdul Latiff
- Allergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - M Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - I Alobid
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro Médico Teknon, Barcelona, Spain
| | - H S Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton.,David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - E Asayag
- Argentine Society of Allergy and Immunopathology, Buenos Ayres, Argentian
| | - A Baharudin
- Department of Otorhinolaryngology, Head and Neck, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - L Battur
- Mongolian Association of Hospital Managers, Ulaanbaatar, Mongolia
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - E C Berghea
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - K C Bergmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - D Bernstein
- Division of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - M Bewick
- University of Central Lancashire Medical School, Preston, UK
| | - H Blain
- Department of Geriatrics, Montpellier University hospital, MUSE, Montpellier, France
| | - M Bonini
- Department of Clinical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy and National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, UK
| | - F Braido
- University of Genoa, Department of Internal Medicine (DiMI), and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - R Buhl
- Dept of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany
| | - R Bumbacea
- Department of Allergy, "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
| | - A Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | - M Calderon
- Imperial College and National Heart and Lung Institute, London, UK
| | - G Calvo
- Pediatrics Department, Universidad Austral de Chile, Valvidia, Chile
| | - P Camargos
- Federal University of Minas Gerais, Medical School, Department of Pediatrics, Belo Horizonte, Brazil
| | - L Caraballo
- Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer piso, Cartagena, Colombia
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain.,ARADyAL research network, Barcelona, Spain
| | - W Carr
- Allergy & Asthma Associates of Southern California, A Medical Group , Southern California Research, Mission Viejo, CA, USA
| | - P Carreiro-Martins
- NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.,Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - T Casale
- Division of Allergy/immunology, University of South Florida, Tampa, FLA, USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia and SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Branquilla, Columbia
| | - R Chandrasekharan
- Department of ENT, Badr al Samaa Hospital, Salalah, Sultanate of Oman
| | - D Charpin
- Clinique des bronches, allergie et sommeil, Hôpital Nord, Marseille, France
| | - Y Z Chen
- The capital institute of pediatrics, Beijing, China
| | - I Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Guayas, Ecuador
| | - T Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - E Chkhartishvili
- David Tatishvili Medical Center; David Tvildiani Medical University-AIETI Medical School, Tbilisi, Georgia
| | - G Christoff
- Medical University - Sofia, Faculty of Public Health, Sofia, Bulgaria
| | - D K Chu
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - C Cingi
- skisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey
| | - J Correia da Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - C Corrigan
- Division of Asthma, Allergy & Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK
| | - A Custovic
- National Heart and Lung Institute, Imperial College London, UK
| | - G D'Amato
- Division of Respiratory and Allergic Diseases,Hospital 'A Cardarelli', University of Naples Federico II, Naples, Italy
| | - S Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, and Federation of translational medicine, University of Strasbourg, Strasbourg, France
| | - P Devillier
- VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - A Didier
- Department of Respiratory Diseases, Larrey Hospital, Toulouse University Hospital, Toulouse, France
| | - M do Ceu Teixeira
- Hospital Dr Agostinho Neto,Praia, Faculdade de Medicina de Cabo Verde
| | - D Dokic
- University Clinic of Pulmology and Allergy, Medical Faculty Skopje, Republic of Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers, Algeria
| | - M Doulaptsi
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Crete, Heraklion, Crete
| | - S Durham
- Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, UK
| | - M Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - T Eiwegger
- The Hospital for Sick Children, Department of Paediatrics, Division of Clinical Immunology and Allergy, Food allergy and Anaphylaxis Program, The University of Toronto, Toronto, Ontario, Canada
| | - Z A El-Sayed
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - R Emuzyte
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Emuzyte
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Fiocchi
- Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - N Fyhrquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - R M Gomez
- School of Health Sciences, Catholic University of Salta, Salta, Argentina
| | - M Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi, Georgia
| | - M A Guzman
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - J Hagemann
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Germany
| | - S Hamamah
- Biology of reproduction department, INSERM 1203, University hospital, Montpellier, France
| | - S Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - D M G Halpin
- University of Exeter, Medical School, College of Medicine and Health, University of Exeter, Exeter, Devon, UK
| | - M Hofmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - E Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - M Hrubiško
- Department of Clinical Immunology and Allergy, Oncology Institute of St Elisabeth, Bratislava, Slovakia
| | - C Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Z Ispayeva
- President of Kazakhstan Association of Allergology and Clinical Immunology, Department of Allergology and clinical immunology of the Kazakh National Medical University, Almaty, Kazakhstan
| | - E Jares
- Servicio de Alergia, Consultorios Médicos Privados, Buenos Aires, Argentina
| | - T Jartti
- EDEGO Research Unit, University of Oulu, Oulu, Finland
| | - E Jassem
- Medical University of Gdańsk, Department of Pneumology, Gdansk, Poland
| | - K Julge
- Tartu University Institute of Clinical Medicine, Children's Clinic, Tartu, Estonia
| | - J Just
- Sorbonne université, Hôpital américain de Paris, Neuilly, France
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland.,ALL-MED Medical Research Institute, Wroclaw, Poland
| | | | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - O Kalyoncu
- Hacettepe University, School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Ankara, Turkey
| | - P Kardas
- Department of Family Medicine, Medical University of Lodz, Poland
| | - B Kirenga
- Makerere University Lung Institute, Kampala, Uganda
| | - H Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - I Kull
- Sach´s Children and Youth Hospital, Södersjukhuset, and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - M Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Poland
| | - S La Gruta
- Institute of Translational Pharmacology, National Research Council, Palermo, Italy
| | - S Lau
- Department of Paediatric Respiratory Medicine, Immunology and Crital Care Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - L Le Tuyet Thi
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - M Levin
- Division Paediatric Allergology, University of Cape Town, Cape Town, South Africa
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, UK
| | - O Lourenço
- Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - M J Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - P Matricardi
- Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - N Migueres
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, and Federation of translational medicine, University of Strasbourg, Strasbourg, France
| | - F Mihaltan
- National Institute of Pneumology M Nasta, Bucharest, Romania
| | - Y Mohamad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia and Syrian Private University-, Damascus, Syria
| | - M Moniusko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystock, Poland
| | - S Montefort
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, MSD, Malta
| | - H Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - K Nekam
- Hungarian Allergy Association, Budapest, Hungary
| | - E Nunes
- Eduardo Mondlane University · Faculty of Medicine, Maputo, Mozambique
| | | | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - I Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - K Ohta
- National Hospital Organization Tokyo National Hospital, and JATA Fukujuji Hospital, Tokyo, Japan
| | - K Okubo
- Dept of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - H Olze
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - I Pali-Schöll
- Dept of Comparative Medicine; Messerli Research Institute of the University of Veterinary Medicine, Medical University, and University of Vienna, Vienna, Austria
| | - O Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - K Palosuo
- Department of Dermatology, University of Helsinki and Hospital for Skin and Allergic Diseases, Helsinki, Finland
| | - C Panaitescu
- OncoGen Center, County Clinical Emergency Hospital "Pius Branzeu," and University of Medicine and Pharmacy V Babes, Timisoara, Romania
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - C Pitsios
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - D Plavec
- Srebrnjak Children's Hospital, Zagreb; Medical Faculty, University JJ Strossmayer of Osijek, Croatia
| | - T A Popov
- Clinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria
| | - F Puggioni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - S Quirce
- QDepartment of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - M Recto
- Asian Hospital And Medical Center, Manilla, Philippines
| | - R Repka-Ramirez
- Division of Allergy, Asthma and Immunology, Clinics Hospital, San Lorenzo, Paraguay
| | | | - N Roche
- Pneumologie, AP-HP, Centre Université de Paris Cité, Hôpital Cochin, Paris, France.,UMR 1016, Institut Cochin, Paris, France
| | - M Rodriguez-Gonzales
- Pediatric Allergy and Clinical Immunology, Hospital Espanol de Mexico, Mexico City, Mexico
| | - J Romantowski
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - N Rosario Filho
- Department of Pediatrics, Federal University of Parana, Curitiba, Brazil
| | - M Rottem
- Division of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - H Sagara
- Showa University School of Medicine, Tokyo, Japan
| | - F Sarquis-Serpa
- Asthma Reference Center - School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil
| | - Z Sayah
- SMAIC Société Marocaine d' Allergologie et Immunologie Clinique, Rabat, Morocco
| | - S Scheire
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - J C Sisul
- Allergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay
| | - D Sole
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - M Soto-Martinez
- Division of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica
| | - M Sova
- Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
| | - A Sperl
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Germany
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - C Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - M Thomas
- University of Southampton, Southampton, UK
| | - T To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Portugal
| | - P V Tomazic
- Dept of General ORL, H&NS, Medical University of Graz, ENT-University Hospital Graz, Austria
| | | | | | - E van Ganse
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon1, Lyon, France
| | - M Van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - T Vasankari
- Fihla, Finnish Lung Association, Helsinki, Finland.,University of Turku, Turku, Finland
| | - P Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa
| | - D Wallace
- Nova Southeastern University, Florida, USA
| | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - S Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - M Worm
- Division of Allergy and Immunology Department of Dermatology, Allergy and Venerology Charité Universitätsmedizin Berlin Berlin, Germany
| | - P Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - P Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - O Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - F Zaitoun
- Lebanese-American University, Clemenceau Medical Center DHCC, Dubai, UAE
| | - M Zernotti
- Universidad Católica de Córdoba, Universidad Nacional de Villa Maria, Argentina
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.,University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - J Zuberbier
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - J A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research; University of Porto, Porto, Portugal.,RISE - Health Research Network; University of Porto, Porto, Portugal
| | - T Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - J M Anto
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Lengi A, Makris M, Corl B. A flow cytometric method for measuring and isolating mammary epithelial cells from bovine milk. JDS Communications 2021; 2:426-430. [PMID: 36337102 PMCID: PMC9623637 DOI: 10.3168/jdsc.2021-0135] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/25/2021] [Indexed: 11/19/2022]
Abstract
Flow cytometry using an antibody against butyrophilin allows quantification of mammary epithelial cells in milk. Sorting butyrophilin-positive or CD45-negative cells isolates epithelial cells from milk. Selection for cytokeratin was not effective in this flow cytometry application.
Sampling frequent time points of mammary signaling pathways is not possible with tissue biopsies. We have validated a flow cytometry and cell sorting procedure for isolating live bovine mammary epithelial cells from somatic cell populations in milk using butyrophilin 1A1 as a marker for mammary epithelial cells and CD45 as a marker for hematopoietic cells. Hoechst 33342 staining and propidium iodide exclusion were used to select for nucleated live cells. Positive selection of butyrophilin (BTN)-expressing cells was performed by fluorescence-activated cell sorting. Quantitative real-time PCR performed on mRNA isolated from these cells showed a 226-fold increase in κ-casein (CSN3) mRNA expression in BTN single-positive cells compared with unsorted cells, whereas CD45 single-positive cells showed a significant decrease. A negative selection strategy for cells not expressing the hematopoietic cell marker CD45 also resulted in a cell population with a 196-fold increase in CSN3 mRNA expression compared with unsorted cells. We found no enrichment of CSN3 mRNA expression after sorting cells using cytokeratin antibodies. The noninvasive assays described here allow for daily or more frequent sampling time points for measurement of mammary epithelial cells during the course of lactation.
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Affiliation(s)
- A.J. Lengi
- Department of Dairy Science, Virginia Tech, Blacksburg 24061-0315
| | - M. Makris
- Flow Cytometry Laboratory, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg 24061
| | - B.A. Corl
- Department of Dairy Science, Virginia Tech, Blacksburg 24061-0315
- Corresponding author
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4
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Bédard A, Basagaña X, Anto JM, Garcia-Aymerich J, Devillier P, Arnavielhe S, Bedbrook A, Onorato GL, Czarlewski W, Murray R, Almeida R, Fonseca JA, Correia da Sousa J, Costa E, Morais-Almeida M, Todo-Bom A, Cecchi L, De Feo G, Illario M, Menditto E, Monti R, Stellato C, Ventura MT, Annesi-Maesano I, Bosse I, Fontaine JF, Pham-Thi N, Thibaudon M, Schmid-Grendelmeier P, Spertini F, Chavannes NH, Fokkens WJ, Reitsma S, Dubakiene R, Emuzyte R, Kvedariene V, Valiulis A, Kuna P, Samolinski B, Klimek L, Mösges R, Pfaar O, Shamai S, Roller-Wirnsberger RE, Tomazic PV, Ryan D, Sheikh A, Haahtela T, Toppila-Salmi S, Valovirta E, Cardona V, Mullol J, Valero A, Makris M, Papadopoulos NG, Prokopakis EP, Psarros F, Bachert C, Hellings PW, Pugin B, Bindslev-Jensen C, Eller E, Kull I, Melén E, Wickman M, De Vries G, van Eerd M, Agache I, Ansotegui IJ, Bosnic-Anticevich S, Cruz AA, Casale T, Ivancevich JC, Larenas-Linnemann DE, Sofiev M, Wallace D, Waserman S, Yorgancioglu A, Laune D, Bousquet J. Treatment of allergic rhinitis during and outside the pollen season using mobile technology. A MASK study. Clin Transl Allergy 2020; 10:62. [PMID: 33298191 PMCID: PMC7726888 DOI: 10.1186/s13601-020-00342-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/25/2020] [Indexed: 02/02/2023] Open
Abstract
Background The analysis of mobile health (mHealth) data has generated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pollen season. The aim was to collect novel information including the phenotypic characteristics of the users. Methods The Allergy Diary–MASK-air–mobile phone app, freely available via Google Play and App, was used to collect the data of daily visual analogue scales (VASs) for overall allergic symptoms and medication use. Fluticasone Furoate (FF), Mometasone Furoate (MF), Azelastine Fluticasone Proprionate combination (MPAzeFlu) and eight oral H1-antihistamines were studied. Phenotypic characteristics were recorded at entry. The ARIA severity score was derived from entry data. This was an a priori planned analysis. Results 9037 users filled in 70,286 days of VAS in 2016, 2017 and 2018. The ARIA severity score was lower outside than during the pollen season. Severity was similar for all treatment groups during the pollen season, and lower in the MPAzeFlu group outside the pollen season. Days with MPAzeFlu had lower VAS levels and a higher frequency of monotherapy than the other treatments during the season. Outside the season, days with MPAzeFlu also had a higher frequency of monotherapy. The number of reported days was significantly higher with MPAzeFlu during and outside the season than with MF, FF or oral H1-antihistamines. Conclusions This study shows that the overall efficacy of treatments is similar during and outside the pollen season and indicates that medications are similarly effective during the year.
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Affiliation(s)
- A Bédard
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - X Basagaña
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - J M Anto
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - J Garcia-Aymerich
- ISGlobal, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - P Devillier
- UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | | | | | - W Czarlewski
- Medical Consulting Czarlewski, Levallois, France
| | - R Murray
- Research fellow, OPC, and Director, Cambridge, UK.,Medscript, Paraparaumu, New Zealand
| | - R Almeida
- Faculdade de Medicina da Universidade do Porto, Lda Porto, Portugal
| | - J A Fonseca
- Faculdade de Medicina da Universidade do Porto, Lda Porto, Portugal.,MEDIDA, Lda, Porto, Portugal
| | - J Correia da Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - E Costa
- Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.,UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | | | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - G De Feo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - M Illario
- Division for Health Innovation, Campania Region, Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - E Menditto
- CIRFF, Federico II University, Naples, Italy
| | - R Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino, Mauriziano Hospital, Turin, Italy
| | - C Stellato
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M T Ventura
- Medical School Saint Antoine, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Université, Paris, France
| | - I Annesi-Maesano
- Medical School Saint Antoine, Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM, Sorbonne Université, Paris, France
| | - I Bosse
- Allergist La Rochelle, La Rochelle, France
| | | | - N Pham-Thi
- Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
| | - M Thibaudon
- RNSA (Réseau National de Surveillance Aérobiologique), Brussieu, France
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - F Spertini
- Service Immunologie et Allergie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - R Dubakiene
- Clinic of Chest Diseases, Immunology and Allergology, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- Department of Pathology, Faculty of Medicine and Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Institute of Clinical Medicine, Vilnius, Lithuania
| | - A Valiulis
- Vilnius University Institute of Clinical Medicine, Clinic of Children's Diseases, Department of Public Health, and Institute of Health Sciences, Vilnius, Lithuania.,European Academy of Paediatrics, EAP/UEMS-SP), Brussels, Belgium
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - R Mösges
- Medical Faculty, CRI-Clinical Research International-Ltd, Institute of Medical Statistics, and Computational Biology, University of Cologne, Hamburg, Germany
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - S Shamai
- Medical Faculty, CRI-Clinical Research International-Ltd, Institute of Medical Statistics, and Computational Biology, University of Cologne, Hamburg, Germany
| | | | - P V Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - D Ryan
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - A Sheikh
- The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | - E Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku, Terveystalo Allergy Clinic, Turku, Finland
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, ARADyAL Research Network, Barcelona, Spain
| | - J Mullol
- Rhinology Unit, & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - A Valero
- Pneumology and Allergy Department CIBERES and Clinical, & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Makris
- Allergy Unit "D Kalogeromitros", 2nd Dpt of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - N G Papadopoulos
- Division of Infection, & Respiratory Medicine, Royal Manchester Children's Hospital Immunity, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou," University of Athens, Athens, Greece
| | - E P Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - F Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - C Bachert
- Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium.,Sun Yat-sen University, International Airway Research Center, Guangzou, China.,Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - P W Hellings
- Academic Medical Center, Univ of Amsterdam, Dept of Otorhinolaryngology, Univ Hospitals Leuven, Leuven, The Netherlands.,European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - B Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - C Bindslev-Jensen
- Odense University Hospital, Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - E Eller
- Odense University Hospital, Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - I Kull
- Thermofisher Scientific, Uppsala, Sweden
| | - E Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sach´s Children and Youth Hospital, Södersjukhuset, Sweden
| | - M Wickman
- Sachs' Children and Youth Hospital, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - G De Vries
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - M van Eerd
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - I Agache
- Peercode BV, Geldermalsen, The Netherlands
| | | | - S Bosnic-Anticevich
- Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia, Erandio, Spain.,Woolcock Institute of Medical Research, University of Sydney, Woolcock Emphysema Centre, Sydney Local Health District, Glebe, NSW, Australia
| | - A A Cruz
- Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil.,WHO GARD Planning Group, Salvador, Brazil
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FLA, USA
| | - J C Ivancevich
- Clinica Santa Isabel, Servicio de Alergia e Immunologia, Buenos Aires, Argentina
| | - D E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - M Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - D Wallace
- Nova Southeastern University, Fort Lauderdale, FL, USA
| | - S Waserman
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - A Yorgancioglu
- Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - D Laune
- KYomed INNOV, Montpellier, France
| | - J Bousquet
- CHU de Montpellier, Montpellier, France. .,University Hospital, Montpellier, France. .,INSERM U 1168, VIMA : Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France. .,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny Le Bretonneux, France. .,Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. .,Department of Dermatology and Allergy, Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany.
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5
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Noone D, O'Mahony B, Peyvandi F, Makris M, Bok A. Evolution of Haemophilia Care in Europe: 10 years of the principles of care. Orphanet J Rare Dis 2020; 15:184. [PMID: 32660500 PMCID: PMC7358930 DOI: 10.1186/s13023-020-01456-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/30/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The European principles of care in haemophilia marked their first decade in 2018. These guiding principles were the beginning of the European Haemophilia Consortium (EHC) review of countries' adherence to these principles in 2009, 2012, 2015 and 2018. The aim of this paper was to examine the implementation of the principles and how they have impacted the evolution of care in the last decade, as well as to identify remaining gaps and proposes future directions. METHODS In 2018, the EHC distributed a survey to EHC national member organisations in English and Russian and encouraged them to discuss responses with local clinicians for accuracy. Data was also cross-referenced and validated for countries in earlier surveys using additional available resources. RESULTS The 10-year-old European principles had a significant impact on the development of care for haemophilia and related bleeding disorders in Europe. They set objectives around which multi-stakeholder groups have established recommendations and specific steps for the progressive improvement of care for bleeding disorders. However, some have been promoted and implemented more than others. CONCLUSION Monitoring adherence to, and impact of, the European Principles of Care significantly assists in tracking developments and highlighting gaps. Countries' inability to report consistent and coherent data remains a challenge and hinders both provision of treatment and care for patients as well as optimal national and European healthcare systems.
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Affiliation(s)
- D Noone
- European Haemophilia Consortium, Brussels, Belgium.
| | - B O'Mahony
- European Haemophilia Consortium, Brussels, Belgium.,Trinity College Dublin, Dublin, Ireland
| | - F Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Makris
- Department of Coagulation, Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK
| | - A Bok
- European Haemophilia Consortium, Brussels, Belgium
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6
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Makris M, Farrugia A. Comparative analysis of marketed factor VIII products: comment. J Thromb Haemost 2019; 17:232-233. [PMID: 30376211 DOI: 10.1111/jth.14321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 11/30/2022]
Affiliation(s)
- M Makris
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - A Farrugia
- School of Surgery, University of Western Australia, Crawley, Australia
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7
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Makris M, Oldenburg J, Mauser-Bunschoten EP, Peerlinck K, Castaman G, Fijnvandraat K. The definition, diagnosis and management of mild hemophilia A: communication from the SSC of the ISTH. J Thromb Haemost 2018; 16:2530-2533. [PMID: 30430726 DOI: 10.1111/jth.14315] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/19/2018] [Indexed: 02/03/2023]
Affiliation(s)
- M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - J Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
| | | | - K Peerlinck
- Department of Vascular Medicine and Haemostasis, Haemophilia Centre, University Hospitals Leuven, Leuven, Belgium
| | - G Castaman
- Centre for Bleeding Disorders, Department of Oncology, Careggi University Hospital, Florence, Italy
| | - K Fijnvandraat
- Department of Pediatric Hematology, Academic Medical Centre, Amsterdam, the Netherlands
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8
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Collins PW, Liesner R, Makris M, Talks K, Chowdary P, Chalmers E, Hall G, Riddell A, Percy CL, Hay CR, Hart DP. Treatment of bleeding episodes in haemophilia A complicated by a factor VIII inhibitor in patients receiving Emicizumab. Interim guidance from UKHCDO Inhibitor Working Party and Executive Committee. Haemophilia 2018; 24:344-347. [PMID: 30070072 DOI: 10.1111/hae.13495] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [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: 03/19/2018] [Indexed: 02/03/2023]
Abstract
Emicizumab is a bispecific antibody that activates FX to FXa in the absence of FVIII. It has been shown to reduce bleeding episodes in people with haemophilia A complicated by a FVIII inhibitor. Despite the protection against bleeds, some breakthrough bleeds are inevitable and these may require additional haemostatic treatment. Emicizumab has been associated with severe adverse events when co-administered with activated prothrombin complex concentrate. To minimize the risk of adverse events, the UK Haemophilia Centre Doctors' Organisation issues the following updated interim guidance to its Inhibitor Guidelines for managing patients receiving Emicizumab based on the limit published information available in February 2018.
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Affiliation(s)
| | - R Liesner
- Great Ormond Street Hospital, London, UK
| | - M Makris
- University of Sheffield, Sheffield, UK
| | - K Talks
- Royal Victoria Infirmary, Newcastle, UK
| | | | - E Chalmers
- Royal Hospital for Children, Glasgow, UK
| | - G Hall
- John Radcliffe Hospital, Oxford, UK
| | | | - C L Percy
- Queen Elizabeth Hospital, Birmingham, UK
| | - C R Hay
- Central Manchester University Hospitals, Manchester, UK
| | - D P Hart
- Barts and The London School of Medicine and Dentistry, Queen Mary University London, Royal London Hospital, London, UK
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9
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Affiliation(s)
- M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK.,Department of Immunity, Inflammation and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - C Hermans
- Haemostasis and Thrombosis Unit, Haemophilia Clinic, Division of Haematology, St-Luc University Hospital, Catholic university of Louvain, Brussels, Belgium
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10
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Affiliation(s)
- M Makris
- The Departments of Haematology, Doncaster Royal Infirmary and Royal Hallamshire Hospital, Sheffield, UK
| | - G Bardhan
- The Departments of Haematology, Doncaster Royal Infirmary and Royal Hallamshire Hospital, Sheffield, UK
| | - F E Preston
- The Departments of Haematology, Doncaster Royal Infirmary and Royal Hallamshire Hospital, Sheffield, UK
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11
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Samreth D, Arnavielhe S, Ingenrieth F, Bedbrook A, Onorato GL, Murray R, Almeida R, Mizani MA, Fonseca J, Costa E, Malva J, Morais-Almeida M, Pereira AM, Todo-Bom A, Menditto E, Stellato C, Ventura MT, Larenas-Linnemann D, Fuentes-Pérez JM, Huerta-Villalobos YR, Cruz AA, Stelmach R, da Silva J, Emuzyte R, Kvedariene V, Valiulis A, Annesi-Maesano I, Bosse I, Demoly P, Devillier P, Fontaine JF, Kuna P, Samolinski B, Klimek L, Mösges R, Pfaar O, Shamai S, Bewick M, Ryan D, Sheikh A, Anto JM, Cardona V, Mullol J, Valero A, Chavannes NH, Fokkens WJ, Reitsma S, Roller-Wirnsberger RE, Tomazic PV, Haahtela T, Toppila-Salmi S, Valovirta E, Makris M, Papadopoulos NG, Prokopakis EP, Psarros F, Gemicioğlu B, Yorgancioglu A, Bindslev-Jensen C, Eller E, Kull I, Wickman M, Bachert C, Hellings PW, Pugin B, Bosnic-Anticevich S, O'Hehir RE, Kolek V, Sova M, Wehner K, De Vries G, van Eerd M, Laune D, Wittmann J, Bousquet J, Poncelet P. Geolocation with respect to personal privacy for the Allergy Diary app - a MASK study. World Allergy Organ J 2018; 11:15. [PMID: 30061979 PMCID: PMC6048852 DOI: 10.1186/s40413-018-0194-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/19/2018] [Indexed: 12/25/2022] Open
Abstract
Background Collecting data on the localization of users is a key issue for the MASK (Mobile Airways Sentinel networK: the Allergy Diary) App. Data anonymization is a method of sanitization for privacy. The European Commission's Article 29 Working Party stated that geolocation information is personal data.To assess geolocation using the MASK method and to compare two anonymization methods in the MASK database to find an optimal privacy method. Methods Geolocation was studied for all people who used the Allergy Diary App from December 2015 to November 2017 and who reported medical outcomes. Two different anonymization methods have been evaluated: Noise addition (randomization) and k-anonymity (generalization). Results Ninety-three thousand one hundred and sixteen days of VAS were collected from 8535 users and 54,500 (58.5%) were geolocalized, corresponding to 5428 users. Noise addition was found to be less accurate than k-anonymity using MASK data to protect the users' life privacy. Discussion k-anonymity is an acceptable method for the anonymization of MASK data and results can be used for other databases.
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Affiliation(s)
| | | | - F Ingenrieth
- Selbstregulierung Informationswirtschaft eV, Berlin, Germany
| | - A Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - G L Onorato
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - R Murray
- MedScript Ltd, Dundalk, Co Louth, Ireland
| | - R Almeida
- 5Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto; and Medina, Lda, Porto, Portugal
| | - M A Mizani
- 6Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - J Fonseca
- 5Center for Health Technology and Services Research- CINTESIS, Faculdade de Medicina, Universidade do Porto; and Medina, Lda, Porto, Portugal
| | - E Costa
- 7UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - J Malva
- 8Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, Ageing@Coimbra EIP-AHA Reference Site, University of Coimbra, Coimbra, Portugal
| | | | - A M Pereira
- 10Allergy Unit, CUF-Porto Hospital and Institute; Center for Research in Health Technologies and information systems CINTESIS, Universidade do Porto, Porto, Portugal
| | - A Todo-Bom
- 11Imunoalergologia Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - E Menditto
- 12CIRFF, Federico II University, Naples, Italy
| | - C Stellato
- 13Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - M T Ventura
- 14Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - D Larenas-Linnemann
- 15Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México City, Mexico
| | | | | | - A A Cruz
- 17ProAR - Nucleo de Excelencia em Asma, Brasil and WHO GARD Planning Group, Federal University of Bahia, Salvador, Brazil
| | - R Stelmach
- 18Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - J da Silva
- 19Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis, SC Brazil
| | - R Emuzyte
- 20Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Kvedariene
- 21Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Valiulis
- 22Clinic of Children's Diseases, and Institute of Health Sciences, Department of Public Health, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - I Annesi-Maesano
- 24Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, Medical School Saint Antoine, INSERM and Sorbonne Université, Paris, France
| | - I Bosse
- Allergist, La Rochelle, France
| | - P Demoly
- 26Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P Devillier
- 27UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | | | - P Kuna
- 29Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - B Samolinski
- 30Samolinski. Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - R Mösges
- 32Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International Ltd, Hamburg, Germany
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,34Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - S Shamai
- 32Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.,CRI-Clinical Research International Ltd, Hamburg, Germany
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK.,37Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Medical School, Edinburgh, UK
| | - A Sheikh
- 6Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - J M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,39IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,40CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,41Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Cardona
- 42S Allergologia, S Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - J Mullol
- 43Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
| | - A Valero
- 44Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - N H Chavannes
- 45Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - W J Fokkens
- 46Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands
| | - S Reitsma
- 46Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands
| | | | - P V Tomazic
- 48Department of ENT, Medical University of Graz, Graz, Austria
| | - T Haahtela
- 49Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S Toppila-Salmi
- 49Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - E Valovirta
- 50Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo allergy clinic, Turku, Finland
| | - M Makris
- 51Division of Infection, Immunity 1 Respiratory Medicine, University of Manchester, Manchester, UK.,52Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - N G Papadopoulos
- 51Division of Infection, Immunity 1 Respiratory Medicine, University of Manchester, Manchester, UK.,52Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - E P Prokopakis
- 53Department of Otorhinolaryngology University of Crete School of Medicine, Heraklion, Greece
| | - F Psarros
- Allergy Department Athens Naval Hospital, Athens, Greece
| | - B Gemicioğlu
- 55Department of Pulmonary Diseases, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - A Yorgancioglu
- 56Department of Pulmonary Diseases, Faculty of Medicine, Turkey and GARD Executive Committee, Celal Bayar University, Manisa, Turkey
| | - C Bindslev-Jensen
- 57Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - E Eller
- 57Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - I Kull
- 58Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - M Wickman
- 59Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - C Bachert
- 60Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - P W Hellings
- 61Department of Otorhinolaryngology, Univ Hospitals Leuven, Leuven, Belgium.,62Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands.,Euforea, Brussels, Belgium
| | | | - S Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - R E O'Hehir
- 65Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria Australia.,66Department of Immunology, Monash University, Melbourne, Victoria Australia
| | - V Kolek
- 67Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - M Sova
- 67Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - K Wehner
- 68Fachbereich Biologie, Technische Universität, Darmstadt, Germany
| | - G De Vries
- Peercode BV, Geldermalsen, The Netherlands
| | - M van Eerd
- Peercode BV, Geldermalsen, The Netherlands
| | | | - J Wittmann
- Selbstregulierung Informationswirtschaft eV, Berlin, Germany
| | - J Bousquet
- Euforea, Brussels, Belgium.,70INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, France.,Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
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12
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Nesbitt IM, Goodeve AC, Guilliatt AM, Makris M, Preston FE, Peake IR. Characterisation of Type 2N von Willebrand Disease Using Phenotypic and Molecular Techniques. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1650401] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Summaryvon Willebrand factor (vWF) is a multimeric glycoprotein found in plasma non covalently linked to factor VIII (FVIII). Type 2N von Willebrand disease (vWD) is caused by a mutation in the vWF gene that results in vWF with a normal multimeric pattern, but with reduced binding to FVIII.We have utilised methods for the phenotypic and genotypic detection of type 2N vWD. The binding of FVIII to vWF in 69 patients, 36 with type 1 vWD, 32 with mild haemophilia A and one possible haemophilia A carrier with low FVIII levels was studied. Of these, six were found to have reduced binding (five type 1 vWD, one possible haemophilia A carrier), DNA was extracted from these patients and exons 18-23 of the vWF gene encoding the FVIII binding region of vWF were analysed. After direct sequencing and chemical cleavage mismatch detection, a Thr28Met mutation was detected in two unrelated individuals, one of whom appears to be a compound heterozygote for the mutation and a null allele. No mutations were found in the region of the vWF gene encoding the FVIII binding region of vWF in the other four patients
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Affiliation(s)
- I M Nesbitt
- The Sections of Molecular Genetics and Haematology, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK
| | - A C Goodeve
- The Sections of Molecular Genetics and Haematology, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK
| | - A M Guilliatt
- The Sections of Molecular Genetics and Haematology, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK
| | - M Makris
- The Sections of Molecular Genetics and Haematology, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK
| | - F E Preston
- The Sections of Molecular Genetics and Haematology, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK
| | - I R Peake
- The Sections of Molecular Genetics and Haematology, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK
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13
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Affiliation(s)
- C. Harrison
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - G. Saccullo
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Department of Infection, Immunity and Cardiovascular disease; University of Sheffield; Sheffield UK
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14
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Watson S, Daly M, Dawood B, Gissen P, Makris M, Mundell S, Wilde J, Mumford A. Phenotypic approaches to gene mapping in platelet function disorders. Hamostaseologie 2017. [DOI: 10.1055/s-0037-1617145] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
SummaryPlatelet number or function disorders cause a range of bleeding symptoms from mild to severe. Patients with platelet dysfunction but normal platelet number are the most prevalent and typically have mild bleeding symptoms. The study of this group of patients is particularly difficult because of the lack of a gold-standard test of platelet function and the variable penetrance of the bleeding phenotype among affected individuals.The purpose of this short review is to discuss the way in which this group of patients can be investigated through platelet phenotyping in combination with targeted gene sequencing. This approach has been used recently to identify patients with mutations in key platelet activation receptors, namely those for ADP, collagen and thromboxane A2 (TxA2). One interesting finding from this work is that for some patients, mild bleeding is associated with heterozygous mutations in platelet proteins that are co-inherited with other genetic disorders of haemostasis such as type 1 von Willebrand‘s disease. Thus, the phenotype of mild bleeding may be multifactorial in some patients and may be considered to be a complex trait.
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15
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Colvin B, Gupta V, Shields ML, Smith MP, Makris M. Venous Thrombosis Following the Use of Intermediate Purity FVIII Concentrate to Treat Patients with Von Willebrand’s Disease. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613227] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryWe describe four patients with von Willebrand’s disease (VWD) who experienced venous thrombosis after treatment with an intermediate purity factor VIII (FVIII) concentrate (Haemate P®) was used to cover invasive or surgical procedures. Most patients had additional risk factors for venous thromboembolism (VTE) and it is difficult to be certain of the contribution of the concentrate to the VTE. In view of the recognised association between high factor VIII activity (FVIII:C) levels and VTE there is a physiological basis for this complication and it is important to consider this when administering FVIII containing concentrates to VWD patients.
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16
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Coughlan TC, Blagg JL, Abulola M, Daly ME, Hampton KK, Makris M, Peake IR, Goodeve AC. Null Alleles Are not a Common Cause of Type 1 von Willebrand Disease in the British Population. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Beauchamp NJ, Makris M, Preston FE, Peake IR, Daly ME. Major Structural Defects in the Antithrombin Gene in Four Families with Type I Antithrombin Deficiency. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613898] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe molecular basis of quantitative antithrombin deficiency was investigated in four families predicted to have major antithrombin gene rearrangements. A 1,442 bp deletion and insertion of the sequence 5’T(n = 38-40)GAGACG was characterised in one case. Sequence surrounding the breakpoints contained two perfect, and one imperfect, inverted repeats which may have mediated formation of a stem loop structure on one strand during DNA replication potentiating the deletion. A 9,219 bp deletion spanning introns 2 to 5 was identified in a second family. The identical 6 bp sequence was upstream of each breakpoint and the 5’ breakpoint was located in a sequence of the Alu 3 repeat predicted to be susceptible to strand breakage during transcription. This may have promoted misalignment, and deletion, of one of the repeats and the intervening DNA. A novel 1.8 kb antithrombin gene fragment was present in DNA digests from affected members of the third family suggesting a partial antithrombin gene duplication event while in the remaining family, evidence supporting a complete gene deletion was obtained.
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18
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Daly ME, Makris M, Preston FE, Peake IR, Beauchamp NJ. A Novel Mutation in Intron K of the PROS1 Gene Causes Aberrant RNA Splicing and Is a Common Cause of Protein S Deficiency in a UK Thrombophilia Cohort. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1615020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryIn the course of investigating the molecular basis of protein S deficiency in 31 index cases with thrombophilia, we identified seven kindred where the underlying defect was a novel A to G transition 9 bp upstream of exon 12 in intron K of the PROS1 gene. In all but one case, the mutation caused type I deficiency. One individual had type III deficiency. While ectopic transcript analysis using the BstXI dimorphism in exon 15 failed to detect a transcript from the mutated allele, analysis of transcripts spanning exons 11 and 12 revealed a minor mRNA species. Sequencing confirmed the mutation created a new RNA acceptor site introducing 8 nucleotides of intronic sequence into the mature mRNA. Haplotype analysis of the defective PROS1 alleles in six families revealed the same haplotype in all affected individuals suggesting the presence of a common ancestor. Six of the fourteen relatives with the mutation experienced at least one venous thrombotic event strongly supporting the association of the mutation with venous thrombosis.
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19
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Menegatti M, Palla R, Boscarino M, Bucciarelli P, Muszbek L, Katona E, Makris M, Peyvandi F. Minimal factor XIII activity level to prevent major spontaneous bleeds. J Thromb Haemost 2017; 15:1728-1736. [PMID: 28688221 DOI: 10.1111/jth.13772] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 11/25/2016] [Indexed: 11/30/2022]
Abstract
Essentials A strong association between bleeding severity and FXIII activity level (FXIII:C) was shown. The range 5-30 IU dL-1 of FXIII:C was associated with a high variability of bleeding severity. The PROspective study confirmed the association between FXIII:C activity and bleeding severity. A FXIII C of 15 IU dL-1 is a proposed target to start prophylaxis for prevention of major bleeding. SUMMARY Background Congenital factor XIII (FXIII) deficiency is a rare bleeding disorder associated with significant bleeding manifestations. The European Network of Rare Bleeding Disorders (EN-RBD) study, performed from 2007 to 2010, showed a strong association between bleeding severity and FXIII activity in plasma of patients with FXIII deficiency. Among these patients, variable levels of FXIII activity, from undetectable to 30%, were associated with a wide range of bleeding severity. Objectives and patients The present cross-sectional study, in the frame of the PRO-RBDD project, a prospective cohort study, analyzed data of 64 patients with FXIII deficiency and different types of clinical and laboratory severity. Results The results of this analysis confirmed that FXIII coagulant activity in plasma is well associated with clinical severity of patients. In addition, 15 IU dL-1 of FXIII activity was identified to be the level under which the probability of spontaneous major bleeding sharply increases (from 50% for levels of 15 IU dL-1 to more than 90% for levels of 5 IU dL-1 or lower). Conclusion The PRO-RBDD study suggests a FXIII coagulant activity level of 15 IU dL-1 as a target to start prophylaxis in order to prevent major bleedings, such as central nervous system or gastrointestinal tract hemorrhages.
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Affiliation(s)
- M Menegatti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano and Luigi Villa Foundation, Milan, Italy
| | - R Palla
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano and Luigi Villa Foundation, Milan, Italy
| | - M Boscarino
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Bucciarelli
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Muszbek
- Division of Clinical Laboratory Science, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - E Katona
- Division of Clinical Laboratory Science, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - M Makris
- Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK
| | - F Peyvandi
- Angelo Bianchi Bonomi Haemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Itlay
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20
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Peyvandi F, Makris M, Collins P, Lillicrap D, Pipe SW, Iorio A, Rosendaal FR. Minimal dataset for post-registration surveillance of new drugs in hemophilia: communication from the SSC of the ISTH. J Thromb Haemost 2017; 15:1878-1881. [PMID: 28767195 DOI: 10.1111/jth.13762] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Indexed: 11/27/2022]
Affiliation(s)
- F Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Luigi Villa Foundation, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
| | - P Collins
- Arthur Bloom Haemophilia Centre, School of Medicine, Cardiff University, Cardiff, UK
| | - D Lillicrap
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Canada
| | - S W Pipe
- Pediatrics and Pathology, University of Michigan, Ann Arbor, MI, USA
| | - A Iorio
- Department of Health Research Methods, Evidence, and Impact, and Department of Medicine, McMaster University, Hamilton, Canada
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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21
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Collins PW, Quon DVK, Makris M, Chowdary P, Kempton CL, Apte SJ, Ramanan MV, Hay CRM, Drobic B, Hua Y, Babinchak TJ, Gomperts ED. Pharmacokinetics, safety and efficacy of a recombinant factor IX product, trenonacog alfa in previously treated haemophilia B patients. Haemophilia 2017; 24:104-112. [DOI: 10.1111/hae.13324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 01/01/2023]
Affiliation(s)
- P. W. Collins
- Arthur Bloom Haemophilia Centre; School of Medicine Cardiff University; Cardiff UK
| | - D. V. K. Quon
- Hemophilia Treatment Center; Orthopaedic Hospital; Los Angeles CA USA
| | - M. Makris
- Department of Haematology; Royal Hallamshire Hospital; Sheffield UK
| | - P. Chowdary
- Katharine Dormandy Haemophilia Care and Thrombosis Unit; Royal Free Hospital NHS Trust; London UK
| | - C. L. Kempton
- Department of Hematology and Medical Oncology; Emory University; Atlanta GA USA
| | | | - M. V. Ramanan
- Jehangir Clinical Development Centre; Jehangir Hospital; Pune India
| | - C. R. M. Hay
- Manchester Haemophilia Comprehensive Care Centre; Manchester UK
| | - B. Drobic
- Clinical Research; Emergent BioSolutions Canada Inc.; Winnipeg MB Canada
| | - Y. Hua
- Clinical Research; Emergent BioSolutions Canada Inc.; Winnipeg MB Canada
| | - T. J. Babinchak
- Clinical Development and Medical Affairs; Emergent BioSolutions Inc.; Berwyn IL USA
| | - E. D. Gomperts
- Consultant for Emergent BioSolutions Inc.; Montrose CO USA
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22
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Jennings I, Kitchen S, Menegatti M, Palla R, Walker I, Peyvandi F, Makris M. Potential misdiagnosis of dysfibrinogenaemia: Data from multicentre studies amongst UK NEQAS and PRO-RBDD project laboratories. Int J Lab Hematol 2017; 39:653-662. [DOI: 10.1111/ijlh.12721] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/16/2017] [Indexed: 12/17/2022]
Affiliation(s)
| | - S. Kitchen
- UK NEQAS (Blood Coagulation); Sheffield UK
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. Menegatti
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation; Università degli Studi di Milano and Fondazione Luigi Villa; Milan Italy
| | - R. Palla
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation; Università degli Studi di Milano and Fondazione Luigi Villa; Milan Italy
| | - I. Walker
- UK NEQAS (Blood Coagulation); Sheffield UK
| | - F. Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation; Università degli Studi di Milano and Fondazione Luigi Villa; Milan Italy
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
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23
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Bowyer A, Key N, Dalton D, Kitchen S, Makris M. The coagulation laboratory monitoring of Afstyla single-chain FVIII concentrate. Haemophilia 2017; 23:e469-e470. [DOI: 10.1111/hae.13290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2017] [Indexed: 01/24/2023]
Affiliation(s)
- A. Bowyer
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - N. Key
- Division of Hematology/Oncology; Department of Medicine; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - D. Dalton
- Division of Hematology/Oncology; Department of Medicine; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - S. Kitchen
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Department of Infection, Immunity and Cardiovascular Disease; University of Sheffield; Sheffield UK
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24
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Affiliation(s)
- L. F. D. van Vulpen
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht The Netherlands
| | - D. Keeling
- Oxford Haemophilia and Thrombosis Centre; Churchill Hospital; Oxford UK
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
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25
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Collins P, Chalmers E, Alamelu J, Hay C, Liesner R, Makris M, Mathias M, Payne J, Rangarajan S, Richards M, Talks K, Tunstall O, Williams M, Hart DP. First-line immune tolerance induction for children with severe haemophilia A: A protocol from the UK Haemophilia Centre Doctors' Organisation Inhibitor and Paediatric Working Parties. Haemophilia 2017; 23:654-659. [DOI: 10.1111/hae.13264] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/29/2022]
Affiliation(s)
- P. Collins
- Arthur Bloom Haemophilia Centre; University Hospital of Wales; Cardiff UK
| | - E. Chalmers
- Haemophilia Centre; Royal Hospital for Children; Glasgow UK
| | - J. Alamelu
- Haemophilia Centre; Evelina London Children's Hospital; London UK
| | - C. Hay
- Haemophilia Centre; University Departmentt of Haematology; Manchester UK
| | - R. Liesner
- Haemophilia Centre; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. Mathias
- Haemophilia Centre; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - J. Payne
- Departement of Haematology; Sheffield Children's Hospital; Sheffield UK
| | - S. Rangarajan
- Haemophilia Centre; Hampshire Hospitals NHS Foundation Trust; Basingstoke UK
| | - M. Richards
- Haemophilia Centre; Department of Paediatric Haematology; Leeds Children's Hospital; Leeds UK
| | - K. Talks
- Haemophilia Centre; Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH); Newcastle UK
| | - O. Tunstall
- Department of Paediatric Haematology; Bristol Royal Hospital for Children; Bristol UK
| | - M. Williams
- Department of Haematology; Birmingham Children's Hospital; Birmingham UK
| | - D. P. Hart
- Barts and The London School of Medicine & Dentistry, QMUL; London UK
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26
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Affiliation(s)
- M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Department of Infection; Immunity and Cardiovascular disease; University of Sheffield; Sheffield UK
| | - C. M. Kessler
- Georgetown University Medical Center; Washington DC USA
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27
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Riva N, Vella K, Meli S, Hickey K, Zammit D, Calamatta C, Makris M, Kitchen S, Ageno W, Gatt A. A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment. Int J Lab Hematol 2017; 39:482-488. [DOI: 10.1111/ijlh.12668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/24/2017] [Indexed: 11/29/2022]
Affiliation(s)
- N. Riva
- Department of Pathology; University of Malta; Msida Malta
| | - K. Vella
- Coagulation Medicine Laboratory; Department of Pathology; Mater Dei Hospital; Msida Malta
| | - S. Meli
- Point-of-Care Testing Committee; Department of Pathology; Mater Dei Hospital; Msida Malta
| | - K. Hickey
- Sheffield Haemophilia and Thrombosis Centre; University of Sheffield; Sheffield UK
| | - D. Zammit
- Coagulation Medicine Laboratory; Department of Pathology; Mater Dei Hospital; Msida Malta
| | - C. Calamatta
- Point-of-Care Testing Committee; Department of Pathology; Mater Dei Hospital; Msida Malta
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; University of Sheffield; Sheffield UK
| | - S. Kitchen
- Sheffield Haemophilia and Thrombosis Centre; University of Sheffield; Sheffield UK
| | - W. Ageno
- Department of Clinical and Experimental Medicine; University of Insubria; Varese Italy
| | - A. Gatt
- Department of Pathology; University of Malta; Msida Malta
- Coagulation Medicine Laboratory; Department of Pathology; Mater Dei Hospital; Msida Malta
- Point-of-Care Testing Committee; Department of Pathology; Mater Dei Hospital; Msida Malta
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28
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Jennings I, Kitchen S, Menegatti M, Palla R, Walker I, Makris M, Peyvandi F. Detection of Factor XIII deficiency: data from multicentre exercises amongst UK NEQAS and PRO-RBDD project laboratories. Int J Lab Hematol 2017; 39:350-358. [PMID: 28406553 DOI: 10.1111/ijlh.12633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 08/08/2016] [Accepted: 11/25/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION FXIII deficiency is a rare bleeding disorders, and specific FXIII assays are recommended to detect this deficiency. We investigated the performance and accuracy of FXIII investigations in two exercises, comparing centres enrolled in the PRO-RBDD project (prospective data collection on patients with fibrinogen and Factor XIII deficiencies), and UK NEQAS BC centres. METHODS Samples from a FXIII deficient subject and a normal donor were sent to participating centres, to investigate for FXIII deficiency, and interpret their results. Median, coefficient of variation and range were determined. RESULTS Results were returned from 98 UK NEQAS BC and 28 PRO-RBDD centres. Up to 40% of UK NEQAS BC and 52% of PRO-RBDD centres reported clot solubility results - with diagnostic errors by two NEQAS BC centres (false negatives for the FXIII deficient sample) and one PRO-RBDD centre (false positive for the normal sample). Over 70% of UK NEQAS BC centres and PRO-RBDD centres performed FXIII assays. Median results were similar between the two groups, with the exception of sample 3 in survey 2 (5.5 vs. 14.0 μ/dl for UK NEQAS BC and PRO-RBDD centres respectively, P < 0.001). Diagnostic errors were made by 2 UK NEQAS BC centres. CONCLUSION Approximately 70% of centres now employ FXIII assays, complying with international recommendations. However, solubility tests continue to be used. Our data show this can be successful, depending on the sensitivity of the method in use. Diagnostic errors are made by centres using both solubility screens and FXIII assays, and laboratories should ensure good quality assurance procedures to improve diagnostic accuracy.
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Affiliation(s)
- I Jennings
- UK NEQAS (Blood Coagulation), Sheffield, UK
| | - S Kitchen
- UK NEQAS (Blood Coagulation), Sheffield, UK.,Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
| | - M Menegatti
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano and Fondazione Luigi Villa, Milan, Italy
| | - R Palla
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano and Fondazione Luigi Villa, Milan, Italy
| | - I Walker
- UK NEQAS (Blood Coagulation), Sheffield, UK
| | - M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
| | - F Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano and Fondazione Luigi Villa, Milan, Italy
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Affiliation(s)
- M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Department of Infection, Immunity and Cardiovascular Disease; University of Sheffield; Sheffield UK
| | - B. A. Konkle
- Bloodworks North West and Department of Medicine; Division of Hematology; University of Washington; Seattle WA USA
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Peyvandi F, Ettingshausen CE, Goudemand J, Jiménez-Yuste V, Santagostino E, Makris M. New findings on inhibitor development: from registries to clinical studies. Haemophilia 2017; 23 Suppl 1:4-13. [PMID: 27990784 DOI: 10.1111/hae.13137] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 10/28/2016] [Indexed: 02/06/2023]
Abstract
The high incidence of inhibitors against factor VIII (FVIII) concentrates in patients with haemophilia A has encouraged debate as to whether product-type plays a role. There is debate in the literature as to whether rFVIII concentrates are associated with a higher incidence of inhibitors compared to pdFVIII products. The management of haemophilia in patients with inhibitors includes on-demand/prophylaxis treatment with bypassing agents, and/or immune tolerance induction (ITI). However, these options create an economic and emotional burden on patients, their families and healthcare practitioners. Although ITI eliminates inhibitors successfully in 60-80% of cases, it is costly. Despite high costs, preliminary data from a decision analytical model have indicated that ITI is economically advantageous compared with on-demand/prophylactic treatment with bypassing agents. In patients with persistent inhibitors and those who are not candidates for ITI or have failed ITI, bleeding-related mortality and morbidity increase and quality of life decreases, compared with non-inhibitor patients. This article provides an update on the risk of inhibitor development and discusses best management approaches for patients with high-risk factors for inhibitor development.
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Affiliation(s)
- F Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | | | - J Goudemand
- School of Medicine, University of Lille, Lille, France
| | - V Jiménez-Yuste
- Department of Haematology, Autónoma University Madrid and La Paz University Hospital, Madrid, Spain
| | - E Santagostino
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, United Kingdom
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Yeung CHT, Santesso N, Pai M, Kessler C, Key NS, Makris M, Navarro-Ruan T, Soucie JM, Schünemann HJ, Iorio A. Care models in the management of haemophilia: a systematic review. Haemophilia 2017; 22 Suppl 3:31-40. [PMID: 27348399 DOI: 10.1111/hae.13000] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 05/05/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Haemophilia care is commonly provided via multidisciplinary specialized management. To date, there has been no systematic assessment of the impact of haemophilia care delivery models on patient-important outcomes. OBJECTIVE To conduct a systematic review of published studies assessing the effects of the integrated care model for persons with haemophilia (PWH). SEARCH METHODS We searched MEDLINE, EMBASE and CINAHL up to April 22, 2015, contacted experts in the field, and reviewed reference lists. SELECTION CRITERIA Randomized and non-randomized studies of PWH or carriers, focusing mainly on the assessment of care models on delivery. DATA COLLECTION AND ANALYSIS Two investigators independently screened title, abstract, and full text of retrieved articles for inclusion. Risk of bias and overall quality of evidence was assessed using Cochrane's ACROBAT-NRSI tool and GRADE respectively. Relative risks, mean differences, proportions, and means and their variability were calculated as appropriate. RESULTS 27 non-randomized studies were included: eight comparative and 19 non-comparative studies. We found low- to very low-quality evidence that in comparison to other models of care, integrated care may reduce mortality, hospitalizations and emergency room visits, may lead to fewer missed days of school and work, and may increase knowledge seeking. CONCLUSION Our comprehensive review found low- to very low-quality evidence from a limited number of non-randomized studies assessing the impact of haemophilia care models on some patient-important outcomes. While the available evidence suggests that adoption of the integrated care model may provide benefit to PWH, further high-quality research in the field is needed.
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Affiliation(s)
- C H T Yeung
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - N Santesso
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - M Pai
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - C Kessler
- Georgetown University, Washington, DC, USA
| | - N S Key
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - M Makris
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - T Navarro-Ruan
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - J M Soucie
- Centers for Disease Control and Prevention, Division of Blood Disorders, National Center for Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - H J Schünemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - A Iorio
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
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Iorio A, Barbara AM, Makris M, Fischer K, Castaman G, Catarino C, Gilman E, Kavakli K, Lambert T, Lassila R, Lissitchkov T, Mauser-Bunschoten E, Mingot-Castellano ME, Ozdemir N, Pabinger I, Parra R, Pasi J, Peerlinck K, Rauch A, Roussel-Robert V, Serban M, Tagliaferri A, Windyga J, Zanon E. Natural history and clinical characteristics of inhibitors in previously treated haemophilia A patients: a case series. Haemophilia 2017; 23:255-263. [PMID: 28205285 DOI: 10.1111/hae.13167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 12/01/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Development of inhibitors is the most serious complication in haemophilia A treatment. The assessment of risk for inhibitor formation in new or modified factor concentrates is traditionally performed in previously treated patients (PTPs). However, evidence on risk factors for and natural history of inhibitors has been generated mostly in previously untreated patients (PUPs). The purpose of this study was to examine cases of de novo inhibitors in PTPs reported in the scientific literature and to the EUropean HAemophilia Safety Surveillance (EUHASS) programme, and explore determinants and course of inhibitor development. METHODS We used a case series study design and developed a case report form to collect patient level data; including detection, inhibitor course, treatment, factor VIII products used and events that may trigger inhibitor development (surgery, vaccination, immune disorders, malignancy, product switch). RESULTS We identified 19 publications that reported 38 inhibitor cases and 45 cases from 31 EUHASS centres. Individual patient data were collected for 55/83 (66%) inhibitor cases out of 12 330 patients. The median (range) peak inhibitor titre was 4.4 (0.5-135.0), the proportion of transient inhibitors was 33% and only two cases of 12 undergoing immune tolerance induction failed this treatment. In the two months before inhibitor development, surgery was reported in nine (22%) cases, and high intensity treatment periods reported in seven (17%) cases. CONCLUSIONS By studying the largest cohort of inhibitor development in PTPs assembled to date, we showed that inhibitor development in PTPs, is on average, a milder event than in PUPs.
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Affiliation(s)
- A Iorio
- Department of Clinical Epidemiology and Biostastics, McMaster University, Hamilton, ON, Canada
| | - A M Barbara
- Department of Clinical Epidemiology and Biostastics, McMaster University, Hamilton, ON, Canada
| | - M Makris
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - K Fischer
- Van Creveldkliniek University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - C Catarino
- Congenital Coagulopathies Centre, Santa Maria Hospital, Lisbon, Portugal
| | - E Gilman
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - K Kavakli
- Department of Pediatric Hematology, Ege University Children's Hospital, Izmir, Turkey
| | - T Lambert
- Centre de traitement des Hemophiles de Bicetre, Paris, France
| | - R Lassila
- Department of Hematology, Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | | | - E Mauser-Bunschoten
- Van Creveldkliniek University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - N Ozdemir
- Istanbul University Haemophilia Centre, Istanbul, Turkey
| | - I Pabinger
- Department of Medicine I, Haemophilia Centre, Medical University of Vienna, Vienna, Austria
| | - R Parra
- Hospital Vall d'Hebron, Barcelona, Spain
| | - J Pasi
- Barts and the London School of Medicine, London, UK
| | - K Peerlinck
- Haemophilia Center, Universitaire Ziekenhuis Gasthuisberg, Leuven, Belgium
| | - A Rauch
- Département d'Hématologie Transfusion, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - V Roussel-Robert
- Regional Reference Centre for Inherited Bleeding Disorders, University Hospital of Parma, Parma, Italy
| | | | - A Tagliaferri
- European Haemophilia Center, Paediatric Clinical Emergency Hospital Louis Turcanu, Timisoara, Romania
| | - J Windyga
- Department of Disorders of Haemostasis and Internal Medicine, Institute of Haematology & Transfusion Medicine, Warsaw, Poland
| | - E Zanon
- Haemophilia Centre, Azienda Universitaria Ospedaliera di Padova, Padova, Italy
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Affiliation(s)
- F. Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and Department of Pathophysiology and Transplantation; Università degli Studi di Milano; Milan Italy
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield United Kingdom
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Iorio A, Barbara AM, Bernardi F, Lillicrap D, Makris M, Peyvandi F, Rosendaal F. Recommendations for authors of manuscripts reporting inhibitor cases developed in previously treated patients with hemophilia: communication from the SSC of the ISTH. J Thromb Haemost 2016; 14:1668-72. [PMID: 27496160 DOI: 10.1111/jth.13382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Indexed: 11/30/2022]
Abstract
Aim The scope of this recommendation is to provide guidance for reporting of inhibitor cases in previously treated patients (PTPs) with hemophilia A. This guidance is intended to improve transparency and completeness of reporting of observed events; it does not cover planning, executing or analyzing original studies aimed at the assessment of inhibitor rates. Recommendation We recommend that for each case of inhibitor development reported in a published paper, a paragraph or a table is included in the main publication reporting as a minimum the underlined data fields in Table . We recommend transparent reporting when any of the suggested information is not available. We recommend that particular care is used in reporting the timeline of events by clearly identifying a reference time-point. We suggest that journals in the field adopt this guidance as instructions for the authors and as a guide for reviewers. Conclusion Development of inhibitors in PTPs is a very rare event. Standardized reporting of inhibitor characteristics will contribute to generating a body of evidence otherwise not available. Case by case reporting of the recommended data elements may shed light on the natural history and risk factors of inhibitor development in PTPs and be useful for tailoring care in similar future cases.
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Affiliation(s)
- A Iorio
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - A M Barbara
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - F Bernardi
- Department of Biochemistry and Molecular Biology, University of Ferrara, Ferrara, Italy
| | - D Lillicrap
- Pathology, Queens University, Kingston, ON, Canada
| | - M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
| | - F Peyvandi
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation Università degli Studi di Milano, Milan, Italy
| | - F Rosendaal
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
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Maurer M, Metz M, Bindslev-Jensen C, Bousquet J, Canonica GW, Church MK, Godse KV, Grattan CE, Hide M, Kocatürk E, Magerl M, Makris M, Meshkova R, Saini SS, Sussman G, Toubi E, Zhao Z, Zuberbier T, Gimenez-Arnau A. Definition, aims, and implementation of GA(2) LEN Urticaria Centers of Reference and Excellence. Allergy 2016; 71:1210-8. [PMID: 27038243 DOI: 10.1111/all.12901] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [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: 03/26/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND GA²LEN, the Global Allergy and Asthma European Network, has recently launched a program for the development, interaction, and accreditation of centers of reference and excellence in special areas of allergy embedded in its overall quality management of allergy centers of excellence. The first area chosen is urticaria. Urticaria is a common and debilitating condition and can be a challenge for both patients and treating physicians, especially when chronic. Centers of reference and excellence in urticaria (UCAREs) can help to improve the management of hard-to-treat conditions such as urticaria. AIMS Here, we describe the aims, the requirements and deliverables, the application process, and the audit and accreditation protocol for GA²LEN UCAREs. RESULTS The main aims of GA²LEN UCAREs are to provide excellence in urticaria management, to increase the knowledge of urticaria by research and education, and to promote the awareness of urticaria by advocacy activities. To become a certified GA²LEN UCARE, urticaria centers have to apply and fulfill 32 requirements, defined by specific deliverables that are assessed during an audit visit. DISCUSSION AND CONCLUSION The GA²LEN UCARE program will result in a strong network of urticaria specialists, promote urticaria research, and harmonize and improve urticaria management globally.
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Affiliation(s)
- M. Maurer
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Metz
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Center; Odense Research Center for Anaphylaxis; Odense University Hospital; Odense Denmark
| | - J. Bousquet
- University Hospital; Montpellier France
- VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches; INSERM; Paris France
- UVSQ; UMR-S 1168; Université Versailles St-Quentin-en-Yvelines; St-Quentin-en-Yvelines France
| | - G. W. Canonica
- IRCCS AOU San Martino-IST; University of Genoa; Genoa Italy
| | - M. K. Church
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. V. Godse
- Department of Dermatology; D.Y. Patil School of Medicine; Nerul Navi Mumbai India
| | | | - M. Hide
- Department of Dermatology; Institute of Biomedical and Health Sciences; Hiroshima University; Hiroshima Japan
| | - E. Kocatürk
- Department of Dermatology; Okmeydani Training and Research Hospital; Istanbul Turkey
| | - M. Magerl
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Makris
- 2nd Department of Dermatology and Venereology; Attikon University Hospital; Athens Greece
| | - R. Meshkova
- Department of Clinical Immunology and Allergy; Smolensk State Medical University; Smolensk Russia
| | - S. S. Saini
- Department of Medicine; Johns Hopkins University; Baltimore MD USA
| | - G. Sussman
- Division Allergy and Immunology; University of Toronto; Toronto ON Canada
| | - E. Toubi
- Allergy and Clinical Immunology; Bnai-Zion Medical Center; The Technion; Haifa Israel
| | - Z. Zhao
- Department of Dermatology and Venereology; Peking University, First Hospital; Beijing China
| | - T. Zuberbier
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Gimenez-Arnau
- Department of Dermatology; Hospital del Mar, IMIM; Universitat Autònoma; Barcelona Spain
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Pai M, Key NS, Skinner M, Curtis R, Feinstein M, Kessler C, Lane SJ, Makris M, Riker E, Santesso N, Soucie JM, Yeung CHT, Iorio A, Schünemann HJ. NHF-McMaster Guideline on Care Models for Haemophilia Management. Haemophilia 2016; 22 Suppl 3:6-16. [DOI: 10.1111/hae.13008] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2016] [Indexed: 02/05/2023]
Affiliation(s)
- M. Pai
- Department of Medicine; McMaster University; Hamilton ON Canada
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
- McMaster Centre for Transfusion Research McMaster University; Hamilton ON Canada
| | - N. S. Key
- Department of Medicine; University of North Carolina; Chapel Hill NC USA
| | - M. Skinner
- Institute for Policy Advancement Ltd.; Washington DC USA
| | - R. Curtis
- Factor VIII Computing; Berkeley CA USA
| | | | - C. Kessler
- Georgetown University; Washington DC USA
| | - S. J. Lane
- McMaster Centre for Transfusion Research McMaster University; Hamilton ON Canada
| | - M. Makris
- Department of Infection, Immunity and Cardiovascular Disease; University of Sheffield; Sheffield UK
| | - E. Riker
- National Hemophilia Foundation; New York NY USA
| | - N. Santesso
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
| | - J. M. Soucie
- Centers for Disease Control and Prevention; National Center for Birth Defects and Developmental Disabilities; Division of Blood Disorders; Atlanta GA USA
| | - C. H. T. Yeung
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
| | - A. Iorio
- Department of Medicine; McMaster University; Hamilton ON Canada
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
| | - H. J. Schünemann
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
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Ali S, Ghosh K, Daly ME, Hampshire DJ, Makris M, Ghosh M, Mukherjee L, Bhattacharya M, Shetty S. Congenital macrothrombocytopenia is a heterogeneous disorder in India. Haemophilia 2016; 22:570-82. [DOI: 10.1111/hae.12917] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- S. Ali
- Department of Haemostasis and Thrombosis; National Institute of Immunohaematology; Parel, Mumbai
| | - K. Ghosh
- Surat Raktadan Kendra; Surat; Gujarat India
| | - M. E. Daly
- Department of Cardiovascular Science; Medical School; University of Sheffield; Sheffield UK
| | - D. J. Hampshire
- Department of Cardiovascular Science; Medical School; University of Sheffield; Sheffield UK
| | - M. Makris
- Department of Cardiovascular Science; Medical School; University of Sheffield; Sheffield UK
| | - M. Ghosh
- Department of Haematology; NRS Medical College and Hospital; Kolkata India
| | - L. Mukherjee
- Department of Haematology; NRS Medical College and Hospital; Kolkata India
| | - M. Bhattacharya
- Department of Haematology; NRS Medical College and Hospital; Kolkata India
| | - S. Shetty
- Department of Haemostasis and Thrombosis; National Institute of Immunohaematology; Parel, Mumbai
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Abstract
The introduction of clotting factor concentrates has transformed the lives of persons with inherited bleeding disorders. With the use of prophylactic treatment, it is now possible to prevent bleeding in these individuals. The early concentrates were contaminated with the HIV and hepatitis C viruses (HCV) and resulted in major morbidity and mortality in the recipients. Current products are much safer, especially in terms of infectious agents, but other adverse events such as alloantibodies (inhibitors), allergic reactions and thrombotic risks remain of concern. Approximately 30% of previously untreated patients with severe haemophilia A develop inhibitors, making this the most important issue in haemophilia care today. Recently, it was suggested that one of the most commonly used concentrates was associated with a higher inhibitor risk, but this was not supported by the evidence from all studies. Good safety surveillance systems are essential for all diseases and products but are particularly so in the group of individuals with inherited bleeding disorders treated with clotting factor concentrates who have suffered disproportionately from the adverse effects of their treatment. National and multinational systems are now in place to allow reporting of adverse events in patients with inherited bleeding disorders. All clinicians treating individuals with inherited bleeding disorders should prospectively report adverse events to treatment even if they are believed to be common and well recognized.
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Affiliation(s)
- R Lassila
- Helsinki University Hospital, Coagulation Disorders, Hematology and Comprehensive Cancer Center, University of Helsinki, Helsinki, Finland
| | - M Makris
- Department of Cardiovascular Science, Medical School, University of Sheffield, Sheffield, UK.,Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
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Kitchen S, Jennings I, Makris M, Kitchen DP, Woods TAL, Walker ID. Factor VIII assay variability in postinfusion samples containing full length and B-domain deleted FVIII. Haemophilia 2016; 22:806-12. [PMID: 27217329 DOI: 10.1111/hae.12962] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 03/14/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although the variability in factor VIII (FVIII):C measurement is well recognized, this has not been widely reported for post-FVIII infusion samples. AIM/METHODS Three samples from haemophilia A patients were distributed in a UK National External Quality Assessment Scheme survey, each after treatment with either ReFacto AF, Kogenate FS or Advate. Fifty-two UK haemophilia centres performed FVIII assays using one-stage (n = 46) and chromogenic (n = 10) assays. Centres calibrated assays with the local plasma standard and with ReFacto AF laboratory standard for the ReFacto AF sample. RESULTS/CONCLUSIONS Chromogenic assays gave significantly higher results than one-stage assays (P < 0.0001, 32% difference) in the post-Kogenate sample but not in the post-ReFacto AF (11% higher by chromogenic assay, ns) or post-Advate samples (3% lower by chromogenic, ns) when assays were calibrated with plasma standards. Twenty centres used all Instrumentation Laboratory (IL)-activated partial thromboplastin time reagents (Synthasil)/IL deficient plasma/reference plasma) in the one-stage assay and 15 used all Siemens reagents (Actin FS/Siemens deficient plasma/reference plasma); this made a significant difference to results post-ReFacto AF (41% higher by IL reagents, P < 0.0001) and Advate (39% higher by IL reagents, P < 0.0001), but not Kogenate (7% higher by IL, ns) when calibrated with plasma standards. Differences between results obtained with different one-stage assay reagents for monitoring Advate have implications for dosing patients. Furthermore, there was considerable inter-laboratory variation as indicated by CVs in the range 15-26% for chromogenic assay and 12-19% for one-stage assay results. This study suggests that external quality assessment schemes should offer participation in post-FVIII infusion schemes where haemophilic patients are monitored.
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Affiliation(s)
- S Kitchen
- UK NEQAS Blood Coagulation, Sheffield, UK. .,Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK.
| | - I Jennings
- UK NEQAS Blood Coagulation, Sheffield, UK
| | - M Makris
- UK NEQAS Blood Coagulation, Sheffield, UK.,Department of Cardiovascular Science, University of Sheffield, Sheffield, UK
| | | | | | - I D Walker
- UK NEQAS Blood Coagulation, Sheffield, UK
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Affiliation(s)
- D P Kitchen
- UK NEQAS for Blood Coagulation, Pegasus House, Sheffield S10 2QD, UK
| | - S Kitchen
- UK NEQAS for Blood Coagulation, Pegasus House, Sheffield S10 2QD, UK
| | - I Jennings
- UK NEQAS for Blood Coagulation, Pegasus House, Sheffield S10 2QD, UK
| | - T A L Woods
- UK NEQAS for Blood Coagulation, Pegasus House, Sheffield S10 2QD, UK
| | - M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
| | - I D Walker
- UK NEQAS for Blood Coagulation, Pegasus House, Sheffield S10 2QD, UK
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41
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Bucko A, Makris M. Pre-operative PCC for non-bleeding patients on warfarin. Thromb Res 2016; 139:158-9. [DOI: 10.1016/j.thromres.2015.12.017] [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] [Received: 11/30/2015] [Revised: 12/19/2015] [Accepted: 12/22/2015] [Indexed: 10/22/2022]
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Bowyer AE, Guy S, Shepherd MF, Sampson BM, Kitchen S, Makris M. Von Willebrand factor activity assay errors. Haemophilia 2015; 22:e74-6. [DOI: 10.1111/hae.12862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2015] [Indexed: 01/16/2023]
Affiliation(s)
- A. E. Bowyer
- Coagulation laboratory; Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - S. Guy
- Coagulation laboratory; Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. F. Shepherd
- Coagulation laboratory; Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - B. M. Sampson
- Coagulation laboratory; Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - S. Kitchen
- Coagulation laboratory; Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. Makris
- Coagulation laboratory; Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Department of Cardiovascular Science; University Sheffield; Sheffield UK
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Affiliation(s)
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
- Department of Cardiovascular Science; University of Sheffield; Sheffield UK
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Fischer K, Iorio A, Hollingsworth R, Makris M. FVIII inhibitor development according to concentrate: data from the EUHASS registry excluding overlap with other studies. Haemophilia 2015. [DOI: 10.1111/hae.12764] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K. Fischer
- Julius Center for Health Sciences and Primary Care; Utrecht The Netherlands
- Van Creveldkliniek; University Medical Centre Utrecht; Utrecht The Netherlands
| | - A. Iorio
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Toronto ON Canada
| | | | - M. Makris
- Department of Cardiovascular Science; University of Sheffield; Sheffield UK
- Sheffield Haemophilia and Thrombosis Centre; University of Sheffield; Sheffield UK
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Chliva C, Aggelides X, Makris M, Katoulis A, Rigopoulos D, Tiligada E. Comparable profiles of serum histamine and IgG4 levels in allergic beekeepers. Allergy 2015; 70:457-60. [PMID: 25639973 DOI: 10.1111/all.12568] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Accepted: 12/25/2014] [Indexed: 11/30/2022]
Abstract
Growing evidence identifies histamine as a key player in allergic responses, but the reports relating serum histamine to tolerance are scarce and inconclusive. This study investigated the relationship of circulating histamine to the tolerant phenotype in allergic beekeepers. The results showed a positive correlation between the serum levels of histamine and specific immunoglobulin G4 (sIgG4) to honeybee venom, but not with total IgE or sIgE. Interestingly, both sIgG4 and histamine levels were negatively correlated with the time since the last bee sting. In contrast to total IgE and sIgE, serum sIgG4 and histamine levels followed comparable patterns, being higher in tolerant/recently stung individuals and lower in the least frequently stung subgroup. The data obtained in this pilot study associated, for the first time, serum histamine levels with allergen tolerance in allergic individuals and provided the lead for further considering the putative immunomodulatory properties of histamine in allergic responses.
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Affiliation(s)
- C. Chliva
- Allergy Unit ‘D. Kalogeromitros’; 2nd Department of Dermatology and Venereology; ‘Attikon’ General University Hospital; Medical School; University of Athens; Athens Greece
| | - X. Aggelides
- Allergy Unit ‘D. Kalogeromitros’; 2nd Department of Dermatology and Venereology; ‘Attikon’ General University Hospital; Medical School; University of Athens; Athens Greece
| | - M. Makris
- Allergy Unit ‘D. Kalogeromitros’; 2nd Department of Dermatology and Venereology; ‘Attikon’ General University Hospital; Medical School; University of Athens; Athens Greece
| | - A. Katoulis
- 2nd Department of Dermatology and Venereology; ‘Attikon’ General University Hospital; Medical School; University of Athens; Athens Greece
| | - D. Rigopoulos
- 2nd Department of Dermatology and Venereology; ‘Attikon’ General University Hospital; Medical School; University of Athens; Athens Greece
| | - E. Tiligada
- Allergy Unit ‘D. Kalogeromitros’; 2nd Department of Dermatology and Venereology; ‘Attikon’ General University Hospital; Medical School; University of Athens; Athens Greece
- Department of Pharmacology; Medical School; University of Athens; Athens Greece
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Affiliation(s)
- M Makris
- Department of Cardiovascular Science, University of Sheffield, Sheffield, UK; Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
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Abstract
Clinical registries or databases have an increasing role in the management of inherited bleeding disorders. Initially, research-based registries provided valuable data and now national databases are increasingly being developed with multiple stakeholders, including persons with haemophilia (PWH) and payers, to enable improvements and efficiencies in care. Registries are extending to international collaborations to collect adverse event data and comparisons of national approaches to the management of haemophilia to improve the availability of product to PWH.
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Affiliation(s)
- G Dolan
- Nottingham University Hospitals, Nottingham, UK
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Affiliation(s)
- J. J. van Veen
- Department of Haematology, Sheffield Haemophilia and Thrombosis; Royal Hallamshire Hospital; Sheffield UK
| | - M. Makris
- Department of Haematology, Sheffield Haemophilia and Thrombosis; Royal Hallamshire Hospital; Sheffield UK
- Department of Cardiovascular Science; Royal Hallamshire Hospital; Sheffield UK
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Makris M, Federici AB, Mannucci PM, Bolton-Maggs PHB, Yee TT, Abshire T, Berntorp E. The natural history of occult or angiodysplastic gastrointestinal bleeding in von Willebrand disease. Haemophilia 2014; 21:338-342. [PMID: 25381842 DOI: 10.1111/hae.12571] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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: 09/29/2014] [Indexed: 01/15/2023]
Abstract
Recurrent gastrointestinal bleeding is one of the most challenging complications encountered in the management of patients with von Willebrand disease (VWD). The commonest cause is angiodysplasia, but often no cause is identified due to the difficulty in making the diagnosis. The optimal treatment to prevent recurrences remains unknown. We performed a retrospective study of VWD patients with occult or angiodysplastic bleeding within the setting of the von Willebrand Disease Prophylaxis Network (VWD PN) to describe diagnostic and treatment strategies. Centres participating in the VWD PN recruited subjects under their care with a history of congenital VWD and gastrointestinal (GI) bleeding due to angiodysplasia, or cases in which the cause was not identified despite investigation. Patients with acquired von Willebrand syndrome or those for whom the GI bleeding was due to another cause were excluded. Forty-eight patients from 18 centres in 10 countries were recruited. Seven individuals had a family history of GI bleeding and all VWD types except 2N were represented. Angiodysplasia was confirmed in 38%, with video capsule endoscopy and GI tract endoscopies being the most common methods of making the diagnosis. Recurrent GI bleeding in VWD is associated with significant morbidity and required hospital admission on up to 30 occasions. Patients were treated with multiple pharmacological agents with prophylactic von Willebrand factor concentrate being the most efficient in preventing recurrence of the GI bleeding. The diagnosis and treatment of recurrent GI bleeding in congenital VWD remains challenging and is associated with significant morbidity. Prophylactic treatment with von Willebrand factor concentrate was the most effective method of preventing recurrent bleeding but its efficacy remains to be confirmed in a prospective study.
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Affiliation(s)
- M Makris
- Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK; Department of Cardiovascular Science, University of Sheffield, Sheffield, UK
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Makris M. Prothrombin complex concentrate for non-vitamin K oral anticoagulant reversal: good enough for now? J Thromb Haemost 2014; 12:1425-7. [PMID: 25039898 DOI: 10.1111/jth.12667] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 07/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M Makris
- Department of Cardiovascular Science, University of Sheffield, Sheffield, UK; Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital Sheffield, UK
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