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Yoshioka J, Nagano T, Sekiya R, Yano E, Hatano N, Katsurada N, Yamamoto M, Tachihara M, Uno Y, Moriyama T, Nishimura Y, Kobayashi K. Identification of a 17 kDa protein that is a potentially novel antigen of lettuce-associated respiratory allergy in farmers. Immun Inflamm Dis 2023; 11:e1093. [PMID: 38018588 PMCID: PMC10659754 DOI: 10.1002/iid3.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND We have identified and reported a novel antigen, nonprotein-specific secreted EP1-like glycoprotein (51 kDa), for lettuce-related respiratory allergy. OBJECTIVE We aimed to identify a novel antigen for lettuce-related respiratory allergy that is different from epidermis-specific secreted EP1-like glycoprotein. METHODS Immunoblotting was performed using an immunoglobulin E-specific antibody. The antigen-antibody reaction was confirmed by means of enzyme-linked immunosorbent assaying. LC-MS/MS analysis was carried out to detect a novel protein found in sera from 3 of 13 patients with lettuce-related respiratory allergy. Finally, we purified a novel protein from Escherichia coli. RESULTS Immunoblotting assays showed common bands of 17 kDa in the sera of 3 of 13 patients. An enzyme-linked immunosorbent assay confirmed that the patient sera reacted with lettuce latex juice. A 17 kDa protein band that showed antigenic reactivity in 3 of 13 patient sera was identified as a kirola-like protein by LC-MS/MS. In addition, although we purified this protein, we failed to show the inhibitory effect. CONCLUSION A 17 kDa protein that is a potentially novel antigen of lettuce-associated respiratory allergy was identified. In further studies, we will focus on purifying this novel protein to diagnose lettuce allergy.
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Affiliation(s)
- Junya Yoshioka
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Tatsuya Nagano
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Reina Sekiya
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Erika Yano
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Kindai University, Nara City, Nara, Japan
| | - Naoya Hatano
- Department of Internal Medicine, Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Naoko Katsurada
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Masatsugu Yamamoto
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Yuichi Uno
- Department of Plant Resource Science, Graduate School of Agricultural Science, Kobe University, Rokko, Kobe, Hyogo, Japan
| | - Tatsuya Moriyama
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Kindai University, Nara City, Nara, Japan
| | - Yoshihiro Nishimura
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kazuyuki Kobayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Fernandes-Beraldo KR, Santos de Freitas-Xavier R, Pardini-Vicentini A. Fast and cost-effective protocol to produce Paracoccidioides spp. antigens. Biomedica 2023; 43:170-180. [PMID: 37721912 PMCID: PMC10594581 DOI: 10.7705/biomedica.6874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/10/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION The existing methods for Paracoccidioides spp. antigen production are problematic in terms of standardization, specificity, stability, repeatability, and reproducibility. OBJECTIVE To optimize the methodology for Paracoccidioides spp. antigen production and evaluate its applicability in paracoccidioidomycosis immunodiagnosis. MATERIALS AND METHODS The antigens were obtained from Paracoccidioides lutzii isolates (01, 66, and 8334), Paracoccidioides brasiliensis sensu stricto (113), and Paracoccidioides restripiensis (B-339). These fungi were grown at 36 °C ± 1 °C, on modified Fava-Netto agar, according to Freitas et al. (2018). Paracoccidioides lutzii antigens were obtained after , 10, and 20 days of culture, whereas P. brasiliensis and P. restripiensis antigens were obtained after 10 days. Antigens were evaluated in natura, 10 and 20 times concentrated. Antigenic capacity was evaluated using a double immunodiffusion assay against serum samples from patients with paracoccidioidomycosis, histoplasmosis, and aspergillosis, and random blood donors. RESULTS Cross-reactivity between Paracoccidioides spp. antigens was observed when P. brasiliensis, P. restrepiensis antigens, and P. lutzii antigens were evaluated with the polyclonal antibodies against P. lutzii and P. brasiliensis, respectively. No cross-reactivity was obtained for polyclonal antibodies against Histoplasma capsulatum, Aspergillus fumigatus, and random blood donors. The proposed protocol allowed stable, repeatable, and reproducible genus-specific antigen production at a low cost and in a short cultivation time. CONCLUSION The proposed protocol allowed us to obtain genus-specific antigens that can be developed and reproduced in all laboratories in Brazil and South America, where paracoccidioidomycosis is a neglected disease, contributing to an early diagnosis, especially in endemic regions, regardless of the species.
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Affiliation(s)
- Karolina Rosa Fernandes-Beraldo
- Laboratório Central, Universidade Federal de São Paulo, São Paulo, Brasil; Programa de Pós-Graduação em Ciências, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brasil.
| | - Roseli Santos de Freitas-Xavier
- Laboratório de Micologia Médica (LIM53), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil.
| | - Adriana Pardini-Vicentini
- Programa de Pós-Graduação em Ciências, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brasil; Laboratório de Imunodiagnóstico das Micoses, Centro de Imunologia, Instituto Adolfo Lutz, São Universidade de São Paulo, São Paulo, Brasil.
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Ioachimescu OC, Cooper MD. An extraordinary story of discovery: an interview with Doctor Max D Cooper. J Investig Med 2022; 70:jim-2022-002505. [PMID: 35820715 PMCID: PMC9554051 DOI: 10.1136/jim-2022-002505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Octavian C Ioachimescu
- Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Sleep Medicine, Atlanta VA Medical Center, Decatur, Georgia, USA
| | - Max D Cooper
- Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Rodríguez-Vázquez V, Armisén M, Gómez-Rial J, Lamas-Vázquez B, Vidal C. Immunotherapy with Vespula venom for Vespa velutina nigrithorax anaphylaxis: Preliminary clinical and immunological results. Clin Exp Allergy 2021; 52:345-347. [PMID: 34735733 DOI: 10.1111/cea.14039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/11/2021] [Accepted: 10/28/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Virginia Rodríguez-Vázquez
- Allergy Department, Faculty of Medicine, Complejo Hospitalario Universitario de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Margarita Armisén
- Allergy Department, Faculty of Medicine, Complejo Hospitalario Universitario de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose Gómez-Rial
- Department of Immunology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Beatriz Lamas-Vázquez
- Department of Immunology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Carmen Vidal
- Allergy Department, Faculty of Medicine, Complejo Hospitalario Universitario de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain
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Glynne P, Tahmasebi N, Gant V, Gupta R. Long COVID following mild SARS-CoV-2 infection: characteristic T cell alterations and response to antihistamines. J Investig Med 2021; 70:61-67. [PMID: 34611034 PMCID: PMC8494538 DOI: 10.1136/jim-2021-002051] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [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] [Accepted: 08/25/2021] [Indexed: 01/23/2023]
Abstract
Long COVID is characterized by the emergence of multiple debilitating symptoms following SARS-CoV-2 infection. Its etiology is unclear and it often follows a mild acute illness. Anecdotal reports of gradual clinical responses to histamine receptor antagonists (HRAs) suggest a histamine-dependent mechanism that is distinct from anaphylaxis, possibly mediated by T cells, which are also regulated by histamine. T cell perturbations have been previously reported in post-viral syndromes, but the T cell landscape in patients who have recovered from mild COVID-19 and its relationship to both long COVID symptoms and any symptomatic response to HRA remain underexplored. We addressed these questions in an observational study of 65 individuals who had recovered from mild COVID-19. Participants were surveyed between 87 and 408 days after the onset of acute symptoms; none had required hospitalization, 16 had recovered uneventfully, and 49 had developed long COVID. Symptoms were quantified using a structured questionnaire and T cell subsets enumerated in a standard diagnostic assay. Patients with long-COVID had reduced CD4+ and CD8+ effector memory (EM) cell numbers and increased PD-1 (programmed cell death protein 1) expression on central memory (CM) cells, whereas the asymptomatic participants had reduced CD8+ EM cells only and increased CD28 expression on CM cells. 72% of patients with long COVID who received HRA reported clinical improvement, although T cell profiling did not clearly distinguish those who responded to HRA. This study demonstrates that T cell perturbations persist for several months after mild COVID-19 and are associated with long COVID symptoms.
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Affiliation(s)
| | | | - Vanya Gant
- Departments of Infection and Microbiology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Rajeev Gupta
- Stem Cell Laboratory, UCL Cancer Institute, London, UK .,Manual Blood Sciences, Health Services Laboratories, London, UK
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6
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Crane CR, Shayan K, Ingulli E. An Unexpected Kidney Biopsy Finding in a Patient with Newly Diagnosed SLE. Kidney360 2021; 2:1544-1545. [PMID: 35373102 PMCID: PMC8786139 DOI: 10.34067/kid.0003192021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/07/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Clarkson R. Crane
- Division of Pediatric Nephrology, Department of Pediatrics, University of California at San Diego and Rady Children’s Hospital, San Diego, California
| | - Katayoon Shayan
- Department of Pathology, Rady Children’s Hospital, San Diego, California
| | - Elizabeth Ingulli
- Division of Pediatric Nephrology, Department of Pediatrics, University of California at San Diego and Rady Children’s Hospital, San Diego, California
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Murillo-Zamora E, Trujillo X, Huerta M, Ríos-Silva M, Mendoza-Cano O. Performance of Antigen-Based Testing as Frontline Diagnosis of Symptomatic COVID-19. Medicina (Kaunas) 2021; 57:medicina57080852. [PMID: 34441058 PMCID: PMC8399338 DOI: 10.3390/medicina57080852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/15/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: To evaluate the performance of antigen-based detection tests as the frontline diagnosis of coronavirus disease 2019 (COVID-19). Materials and Methods: We conducted a nationwide retrospective cohort study in Mexico. A cross-sectional analysis of a cohort study was conducted in Mexico and data from 15,408 suspected (all of them symptomatic) cases of COVID-19 were analyzed. The results of antigen-based tests were compared with those obtained by molecular (polymerase chain reaction-based) assays. Results: The antigen-based tests showed sensitivity below 50% and high specificity in all the analyzed age groups. The highest Youden index (J) was observed among adults aged 25-44 years old (45.5, 95% CI 43.7-47.3). Conclusions: We documented the poor performance of serologic techniques as frontline diagnosis of symptomatic COVID-19 and inaccurate results may impact negatively on pandemic progression.
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Affiliation(s)
- Efrén Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Av. Javier Mina 301, Col. Centro, Colima C.P. 28000, Mexico;
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. Las Víboras, Colima C.P. 28040, Mexico
| | - Xóchitl Trujillo
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de julio 965, Col. Villas San Sebastián, Colima C.P. 28045, Mexico; (X.T.); (M.H.)
| | - Miguel Huerta
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de julio 965, Col. Villas San Sebastián, Colima C.P. 28045, Mexico; (X.T.); (M.H.)
| | - Mónica Ríos-Silva
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima-Cátedras CONACyT, Av. 25 de julio 965, Col. Villas San Sebastián, Colima C.P. 28045, Mexico;
| | - Oliver Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Coquimatlán, Colima C.P. 28400, Mexico
- Correspondence: ; Tel.: +52-(312)-3161167
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Huber S, Lang R, Asam C, Ferreira F, Hawranek T, Gadermaier G. High-affinity Bet v 1-specific secretory IgA antibodies in nasal fluids protect against birch pollen allergy. Allergy 2021; 76:2267-2270. [PMID: 33594667 PMCID: PMC8359210 DOI: 10.1111/all.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Sara Huber
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Roland Lang
- Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University Salzburg Salzburg Austria
| | - Claudia Asam
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Fatima Ferreira
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Thomas Hawranek
- Department of Dermatology and Allergology University Hospital of the Paracelsus Medical University Salzburg Salzburg Austria
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Zhang H, Liu R, Li Q, Hu X, Wu L, Zhou Y, Qing G, Yuan R, Huang J, Gu W, Ye Y, Qi C, Han M, Chen X, Zhu X, Deng Y, Zhang L, Chen H, Zhang H, Gao W, Liu Y, Luo Y. Flipped Quick-Response Code Enables Reliable Blood Grouping. ACS Nano 2021; 15:7649-7658. [PMID: 33871962 DOI: 10.1021/acsnano.1c01215] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Accurate and rapid blood typing plays a vital role in a variety of biomedical and forensic scenarios, but recognizing weak agglutination remains challenging. Herein, we demonstrated a flipping identification with a prompt error-discrimination (FLIPPED) platform for automatic blood group readouts. Bromocresol green dye was exploited as a characteristic chromatography indicator for the differentiation of plasma from whole blood by presenting a teal color against a brown color. After integrating these color changes into a quick-response (QR) code, prompt typing of ABO and Rhesus groups was automatically achieved and data could be uploaded wirelessly within 30 s using a commercially available smartphone to facilitate blood cross-matching. We further designed a color correction model and algorithm to remove potential errors from scanning angles and ambient light intensities, by which weak agglutination could be accurately recognized. With comparable accuracy and repeatability to classical column assay in grouping 450 blood samples, the proposed approach further demonstrates to be a versatile sample-to-result platform for clinical diagnostics, food safety, and environmental monitoring.
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Affiliation(s)
- Hong Zhang
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Ruining Liu
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
| | - Qingmei Li
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Xiaolin Hu
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Lixiang Wu
- Chongqing University Cancer Hospital, Chongqing 400044, People's Republic of China
| | - Ye Zhou
- College of Biomedical Engineering, Chongqing Medical University, Chongqing 400042, People's Republic of China
| | - Guangchao Qing
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Rui Yuan
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Junjie Huang
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Wei Gu
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
| | - Yanyao Ye
- Department of Laboratory Medicine, Chongqing High-tech Zone People's Hospital, Chongqing 400039, People's Republic of China
| | - Chao Qi
- Department of Blood Transfusion, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, People's Republic of China
| | - Mei Han
- Chongqing Public Health Medical Center, Chongqing 400030, People's Republic of China
| | - Xiaohui Chen
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Xun Zhu
- School of Energy and Power Engineering, Institute of Engineering Thermophysics, Chongqing University, Chongqing 400044, People's Republic of China
| | - Yun Deng
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Liangliang Zhang
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
- College of Bioengineering, Chongqing University, Chongqing 400044, People's Republic of China
| | - Hengyi Chen
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
| | - Haoran Zhang
- School of Energy and Power Engineering, Institute of Engineering Thermophysics, Chongqing University, Chongqing 400044, People's Republic of China
| | - Weiyin Gao
- Department of Emergency, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, People's Republic of China
| | - Yao Liu
- Chongqing University Cancer Hospital, Chongqing 400044, People's Republic of China
| | - Yang Luo
- Center of Smart Laboratory and Molecular Medicine, School of Medicine, Chongqing University, Chongqing 400044, People's Republic of China
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Affiliation(s)
- Maria J. Torres
- Allergy Clinical Unit Hospital Regional Universitario de Málaga‐UMA‐ARADyAL Málaga Spain
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11
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Perelló MI, de Maria Castro A, Nogueira Arraes AC, Caracciolo Costa S, Lacerda Pedrazzi D, Andrade Coelho Dias G, Morette Hanhoerster L, Porto LC, Chigres Kuschnir F, Costa E. Severe cutaneous adverse drug reactions: diagnostic approach and genetic study in a Brazilian case series. Eur Ann Allergy Clin Immunol 2021; 54:207-217. [PMID: 33728835 DOI: 10.23822/eurannaci.1764-1489.193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background. Severe cutaneous adverse reactions (SCAR) are potentially fatal reactions. Genetic predisposition is involved in their pathogenesis related to drugs and ethnicities, however in a mixed population these relationships are still unknown. The aim of this study was to describe phenotypes, suspect drugs and HLA-alleles related to SCAR, identified by a systematized approach in a Brazilian case series. Methods. Patients who were diagnosed with SCAR between March 2011 and July 2019 at our university hospital were included. European Network for Drug Allergy (ENDA) questionnaire was used to collect clinical and laboratory data and algorithms for assessment of drug causality were applied. Socio-demographic variables included age, gender and skin color/ethnicity. Drug patch tests (DPT) and HLA-A, -B, -DRB1 typing were carried out. Results. A total of 74 patients were included: 36 (48.64%) with SJS/TEN, 32 (43.24%) DRESS/DIHS, 3 (4.05%) AGEP, 2 (2.70%) overlap(DRESS/SJS and DRESS/AGEP) and 1 (1.35%) GBFDE. The median age was31.5 years (IQR = 14-52.25), most were female (n = 44/59.46%) and brown (n = 38/51.35%). Anticonvulsants (n = 32/43.24%) were the largest group involved and antibiotics (n = 26/35.13%) were the second most common. Two patients with DRESS died during the acute phase. Positive DPT were shown only in anticonvulsant associated DRESS. HLA related to abacavir, allopurinol and carbamazepine were identified. Conclusions. A systematized approach allowed the phenotypic characterization of SCAR. The HLA-A*31:01, B*57:01 and B*58:01 alleles were identified, reinforcing the causality in SCAR by CBZ, ABC and ALLO in the Brazilian population.
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Affiliation(s)
- M I Perelló
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - A de Maria Castro
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - A C Nogueira Arraes
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - S Caracciolo Costa
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - D Lacerda Pedrazzi
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - G Andrade Coelho Dias
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - L Morette Hanhoerster
- Histocompatibility and Cryopreservation Laboratory, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - L C Porto
- Histocompatibility and Cryopreservation Laboratory, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - F Chigres Kuschnir
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - E Costa
- Allergy and Immunology Service, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Al Hawi Y, Nagao M, Furuya K, Sato Y, Ito S, Hori H, Hirayama M, Fujisawa T. Agreement Between Predictive, Allergen-Specific IgE Values Assessed by ImmunoCAP and IMMULITE 2000 3gAllergy™ Assay Systems for Milk and Wheat Allergies. Allergy Asthma Immunol Res 2021; 13:141-153. [PMID: 33191682 PMCID: PMC7680830 DOI: 10.4168/aair.2021.13.1.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 12/05/2022]
Abstract
Purpose ImmunoCAP® (ImmunoCAP) and IMMULITE® 2000 3gAllergy™ (3gAllergy) systems are major quantitative allergen-specific immunoglobulin E (sIgE) assay methods. Due to the heterogeneous nature of allergenic extracts and differences in the assay format, quantitation of allergen-sIgEs is not expected to correlate well between different methods. However, we have recently reported good agreement between the methods in the diagnosis of egg allergy. This study aimed to determine and correlate the predictive values of sIgE by the two systems in the diagnosis of milk and wheat allergies. Methods Children who had undergone oral food challenge (OFC) for the diagnosis of milk and wheat allergies were enrolled. The OFCs were performed to diagnose either true allergy in the 1-year-old group (A) or tolerance in the 2- to 6-year-old group (B). Milk, casein and β-lactoglobulin, and wheat and ω-5 gliadin sIgE values were measured using the 2 systems. The predictive accuracy of each sIgE for the OFC outcome was assessed using receiver operating characteristic (ROC) curves. The probability of a positive OFC outcome was estimated by logistic regression analysis. Results A total of 395 patients were recruited from 7 primary care clinics and 19 hospitals in Japan. Milk and wheat OFCs were performed for 87 and 102 group A patients, and 124 and 82 group B patients, respectively. ROC analysis yielded similar areas under the curve for the 2 assays (0.7–0.9). The log-transformed sIgE data showed a strong linear correlation with the estimated probabilities (R > 0.9). Conclusions The 2 systems may be interchangeable for diagnosis of milk and wheat allergies in young children.
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Affiliation(s)
- Yasmeen Al Hawi
- Allergy Center and Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan.,Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan.,Cairo University School of Medicine, Cairo, Egypt
| | - Mizuho Nagao
- Allergy Center and Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan.,Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kanae Furuya
- Allergy Center and Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan.,Aichi Konan College, Konan, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Setsuko Ito
- Department of Food Science and Nutrition, Faculty of Human Life and Science, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Hiroki Hori
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Takao Fujisawa
- Allergy Center and Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan.,Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan.
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13
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Goncu B, Salepcioglu Kaya H, Yucesan E, Ersoy YE, Akcakaya A. Graft survival effect of HLA-A allele matching parathyroid allotransplantation. J Investig Med 2020; 69:785-788. [PMID: 33443056 DOI: 10.1136/jim-2020-001648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/04/2022]
Abstract
Permanent hypoparathyroidism is an endocrine disease that is mostly associated with the disruption of the parathyroid glands during surgery. Allotransplantation is the most promising approach for treatment particularly for its cost-effective and exact curative potential. Herein our aim was to evaluate human leukocyte antigen (HLA)-A allele matching effect on clinical improvement and graft survival after parathyroid transplantation. We performed parathyroid transplantation between ABO/Rh compatible recipient and an unrelated donor who has chronic kidney disease. Preoperative immunological tests include panel reactive antibody, T-flow cytometry crossmatch, B-flow cytometry crossmatch, autoflow cytometry crossmatch, and complement-dependent cytotoxicity crossmatch tests were performed. After histopathological evaluation, half of the resected parathyroid gland cells were isolated and transplanted to the omentum surface by laparoscopy. The transplantation outcome was followed up throughout 382 days. The recipient discharged 2 days after transplantation without any complication. During follow-up, calcium and vitamin D supplementation reduced to a one-third dose; even the intact PTH levels remained low. However, clinical improvement was observed by serum calcium levels. The recipient still continues with low-dose supplementation after 382 days of post-transplantation. Parathyroid cell transplantation to the omental tissue is the most promising option even with only one allele matching for patients with using lifelong high-dose supplementation. Clinical improvements and long-term effect of HLA-A allele matching should be evaluated with more studies and in larger cohorts as well.
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Affiliation(s)
- Beyza Goncu
- Experimental Research Center, Bezmialem Vakif University, Istanbul, Turkey .,Parathyroid Transplantation Laboratory, Bezmialem Vakif University, Istanbul, Turkey
| | - Harika Salepcioglu Kaya
- Faculty of Medicine, Department of General Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - Emrah Yucesan
- Faculty of Medicine, Department of Medical Biology, Bezmialem Vakif University, Istanbul, Turkey
| | - Yeliz Emine Ersoy
- Faculty of Medicine, Department of General Surgery, Bezmialem Vakif University, Istanbul, Turkey.,Parathyroid Transplantation Laboratory, Bezmialem Vakif University, Istanbul, Turkey
| | - Adem Akcakaya
- Faculty of Medicine, Department of General Surgery, Bezmialem Vakif University, Istanbul, Turkey.,Organ Transplantation Unit, Bezmialem Vakif University, Istanbul, Turkey
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14
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Copaescu A, Rose M, Mouhtouris E, Chua KY, Holmes NE, Phillips EJ, Trubiano JA. Delayed hypersensitivity associated with amoxicillin-clavulanate. Allergy 2020; 75:2700-2702. [PMID: 32390163 DOI: 10.1111/all.14359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/21/2020] [Accepted: 05/04/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Ana Copaescu
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases Austin Health Heidelberg Vic Australia
| | - Morgan Rose
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases Austin Health Heidelberg Vic Australia
- The National Centre for Infections in Cancer Peter MacCallum Cancer Centre Melbourne Vic Australia
- Department of Oncology, Sir Peter MacCallum Cancer Centre The University of Melbourne Parkville Vic Australia
| | - Effie Mouhtouris
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases Austin Health Heidelberg Vic Australia
| | - Kyra Y. Chua
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases Austin Health Heidelberg Vic Australia
| | - Natasha E. Holmes
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases Austin Health Heidelberg Vic Australia
| | - Elizabeth J. Phillips
- Institute for Immunology and Infectious Diseases Murdoch University Murdoch WA Australia
- Department of Infectious Diseases Vanderbilt University Medical Centre Nashville TN USA
| | - Jason A. Trubiano
- Centre for Antibiotic Allergy and Research, Department of Infectious Diseases Austin Health Heidelberg Vic Australia
- The National Centre for Infections in Cancer Peter MacCallum Cancer Centre Melbourne Vic Australia
- Department of Oncology, Sir Peter MacCallum Cancer Centre The University of Melbourne Parkville Vic Australia
- Department of Medicine (Austin Health) The University of Melbourne Melbourne, Heidelberg Australia
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15
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Sekiya R, Nagano T, Moriyama T, Kishi T, Shinke H, Yano E, Hatano N, Katsurada M, Umezawa K, Katsurada N, Hori S, Hazeki N, Fukunaga A, Yamamoto M, Kamiryo H, Shinohara M, Kobayashi K, Kotani Y, Nishimura Y. Occupational respiratory allergy to lettuce in lettuce farmers. Clin Exp Allergy 2020; 50:932-941. [PMID: 32542808 DOI: 10.1111/cea.13682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/19/2019] [Revised: 04/23/2020] [Accepted: 05/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Lettuce-associated respiratory allergy has never been reported before. The aim of this study was to clarify the clinical condition of lettuce-associated respiratory allergy and to identify the lettuce antigen which induces allergic symptoms. METHODS We distributed questionnaires to 1168 lettuce farmers and performed medical examinations in those who exhibited respiratory symptoms related to occupational exposure to lettuce. We analysed specific IgE-binding proteins in the sera of patients through immunoblotting analysis and determined molecular characterization of the IgE-binding bands using liquid chromatography-mass spectrometry. RESULTS A total of 932 farmers (80%) responded to the questionnaire. Of those, 7% exhibited lettuce-associated respiratory symptoms, during harvesting and packaging. Thirteen patients were diagnosed with allergy to lettuce and agreed to undergo further examinations. The percentage of activated basophils in these patients was significantly higher compared with that reported in negative controls (P < .05). Lettuce-specific IgE (ImmunoCAP® ) and skin prick testing was positive in 46% and 62% of patients, respectively. Notably, occupational lettuce-allergic asthma was detected in one patient through specific bronchial provocation testing. The IgE-binding bands recognized in the sera of >50% of patients were identified as epidermis-specific secreted glycoprotein EP1-like (51 kDa). CONCLUSION The present analysis identified a novel lettuce allergen. This allergen may have clinically useful applications, such as specific IgE testing and allergen-specific immunotherapy.
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Affiliation(s)
- Reina Sekiya
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Nagano
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Moriyama
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Kindai University, Nara City, Japan
| | - Toshiyuki Kishi
- Department of Respiratory Medicine, Takinomiya General Hospital, Ayauta-gun, Japan
| | - Haruko Shinke
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Erika Yano
- Department of Applied Biological Chemistry, Graduate School of Agriculture, Kindai University, Nara City, Japan
| | - Naoya Hatano
- The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiro Katsurada
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kanoko Umezawa
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoko Katsurada
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Suya Hori
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuko Hazeki
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsushi Fukunaga
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masatsugu Yamamoto
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Kamiryo
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masakazu Shinohara
- The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuyuki Kobayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshikazu Kotani
- Department of Respiratory Medicine, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan
| | - Yoshihiro Nishimura
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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16
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Azkur AK, Akdis M, Azkur D, Sokolowska M, Veen W, Brüggen M, O’Mahony L, Gao Y, Nadeau K, Akdis CA. Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19. Allergy 2020; 75:1564-1581. [PMID: 32396996 PMCID: PMC7272948 DOI: 10.1111/all.14364] [Citation(s) in RCA: 669] [Impact Index Per Article: 167.3] [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: 04/22/2020] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 02/06/2023]
Abstract
As a zoonotic disease that has already spread globally to several million human beings and possibly to domestic and wild animals, eradication of coronavirus disease 2019 (COVID-19) appears practically impossible. There is a pressing need to improve our understanding of the immunology of this disease to contain the pandemic by developing vaccines and medicines for the prevention and treatment of patients. In this review, we aim to improve our understanding on the immune response and immunopathological changes in patients linked to deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute-phase reactants, and serum biochemistry in COVID-19. Similar to many other viral infections, asymptomatic disease is present in a significant but currently unknown fraction of the affected individuals. In the majority of the patients, a 1-week, self-limiting viral respiratory disease typically occurs, which ends with the development of neutralizing antiviral T cell and antibody immunity. The IgM-, IgA-, and IgG-type virus-specific antibodies levels are important measurements to predict population immunity against this disease and whether cross-reactivity with other coronaviruses is taking place. High viral load during the first infection and repeated exposure to virus especially in healthcare workers can be an important factor for severity of disease. It should be noted that many aspects of severe patients are unique to COVID-19 and are rarely observed in other respiratory viral infections, such as severe lymphopenia and eosinopenia, extensive pneumonia and lung tissue damage, a cytokine storm leading to acute respiratory distress syndrome, and multiorgan failure. Lymphopenia causes a defect in antiviral and immune regulatory immunity. At the same time, a cytokine storm starts with extensive activation of cytokine-secreting cells with innate and adaptive immune mechanisms both of which contribute to a poor prognosis. Elevated levels of acute-phase reactants and lymphopenia are early predictors of high disease severity. Prevention of development to severe disease, cytokine storm, acute respiratory distress syndrome, and novel approaches to prevent their development will be main routes for future research areas. As we learn to live amidst the virus, understanding the immunology of the disease can assist in containing the pandemic and in developing vaccines and medicines to prevent and treat individual patients.
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Affiliation(s)
- Ahmet Kursat Azkur
- Department of Virology Faculty of Veterinary Medicine University of Kirikkale Kirikkale Turkey
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Dilek Azkur
- Division of Pediatric Allergy and Immunology Department of Pediatrics Faculty of Medicine University of Kirikkale Kirikkale Turkey
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Willem Veen
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Marie‐Charlotte Brüggen
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University Zurich Zurich Switzerland
- Hochgebirgsklinik Davos Davos Switzerland
| | - Liam O’Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
| | - Yadong Gao
- Department of Allergology Zhongnan Hospital of Wuhan University Wuhan China
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research Stanford University Stanford CA USA
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
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17
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Shiroshita A, Jin Z, Tanaka Y, Kataoka Y. Diagnostic accuracy and safety of inhalation challenge tests for bird fancier's lung-Systematic review and meta-analysis. Clin Exp Allergy 2020; 50:1007-1016. [PMID: 32557934 DOI: 10.1111/cea.13685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/04/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To assess the diagnostic accuracy of inhalation challenge tests for bird fancier's lung and related adverse reactions. DESIGN We performed a systematic review and meta-analysis for the diagnostic test accuracy of inhalation challenge tests and a systematic review for adverse events of the tests. We evaluated the risk of bias and applicability of the included articles for diagnostic test accuracy with the modified Quality Assessment of Diagnostic Accuracy Studies-2 tool. We used hierarchical summary receiver operating characteristic (HSROC) curve analysis to evaluate the sensitivity and specificity of challenge tests and assessed subjective adverse reactions and steroid treatment use. Sensitivity was calculated by fixing specificity at 99% from the HSROC curve. DATA SOURCES We searched for articles evaluating the diagnostic accuracy of inhalation challenge tests or describing adverse reactions in Medline, Embase, the Cochrane Library, the International Clinical Trials Registry Platform, and Web of Science. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomized control trials, prospective or retrospective cohort studies, or case-control studies assessing the diagnostic test accuracy of inhalation challenge tests for bird fancier's lung. For adverse effects review, we included the same articles, and case series or case reports reporting adverse reactions of inhalation challenge tests. RESULTS In our review of 12 articles, the diagnostic accuracy of inhalation challenge tests was substantially high. Point estimate of sensitivity when calculated with a fixed specificity of 99% was 99%. Among 873 patients, 6 needed steroid treatment for adverse reactions; however, no death occurred due to acute exacerbation following a challenge test. CONCLUSIONS Inhalation challenges for bird fancier's lung could be accurate and safe diagnostic procedures and may be considered both as rule-in and rule-out tests in tertiary care centres. However, caution is required regarding overestimation of diagnostic yield due to risk of bias. Systematic review registration: University hospital Medical Information Network Clinical Trials Registry (UMIN000038799).
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Affiliation(s)
| | - Zhuan Jin
- Post Graduate Education Center, Kameda Medical Center, Kamogawa, Japan
| | - Yu Tanaka
- Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan
| | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.,Department of Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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18
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Gauderon A, Roux-Lombard P, Spoerl D. Antinuclear Antibodies With a Homogeneous and Speckled Immunofluorescence Pattern Are Associated With Lack of Cancer While Those With a Nucleolar Pattern With the Presence of Cancer. Front Med (Lausanne) 2020; 7:165. [PMID: 32426359 PMCID: PMC7204906 DOI: 10.3389/fmed.2020.00165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 11/26/2019] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Different antinuclear antibody (ANA) patterns have been associated with the presence of cancer, while other are typically seen in autoimmune diseases. This study aims to investigate the association between ANA and cancer, focusing on patients with ANA with a nucleolar indirect immunofluorescence (IIF) pattern. Materials and Methods: ANA patterns and positivity of antibodies against nuclear antigens (NA), in particular those responsible for a nucleolar ANA pattern and/or associated with systemic sclerosis (CENP-A/B, fibrillarin, Ku, NOR-90, PM/Scl-100, PM/Scl-75, RNAP-III, Scl-70, Ro52/TRIM21, and Th/To) were analyzed and correlated to an internal database of patients with cancer. Results: The study included 15,728 patients who had an ANA analysis, 386 patients who had immunodot analysis for antibody/ies against/to specific NA and 15,701 patients diagnosed with cancer. The presence of ANA with a nucleolar pattern showed an increased relative risk (RR 1.5, 95%CI 1.03-2.3) for an associated cancer. Anti-Scl70 and anti-RNAP-III were associated with cancer in 15 and 14%, respectively. The presence of ANA with a homogeneous & speckled (HS) pattern was significantly associated with the absence of cancer (p < 0.01). Patients with a HS pattern were found to have a lower relative risk (RR 0.7, 95%CI 0.5-0.9) of having cancer compared to those with other patterns. Conclusions: Larger studies are needed to investigate which particular antibody/ies against/to specific NA is responsible for the association between nucleolar ANA and cancer, but anti-Scl70 and anti-RNAP-III, which is frequently associated with the presence of anti-RNAP-I, are good candidates to explain this association. Patients with a nucleolar pattern might be considered for cancer screening, in particular if they have anti-Scl70 and anti-RNAP-III antibodies.
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Affiliation(s)
- Amandine Gauderon
- Division of Immunology and Allergy, Department of Medical Specialties, University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - Pascale Roux-Lombard
- Division of Immunology and Allergy, Department of Medical Specialties, University Hospital and Faculty of Medicine, Geneva, Switzerland.,Division of Laboratory Medicine, Department of Diagnostic, Geneva University Hospitals, Geneva, Switzerland
| | - David Spoerl
- Division of Immunology and Allergy, Department of Medical Specialties, University Hospital and Faculty of Medicine, Geneva, Switzerland.,Division of Laboratory Medicine, Department of Diagnostic, Geneva University Hospitals, Geneva, Switzerland
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19
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de Graaf NPJ, Bontkes HJ, Roffel S, Kleverlaan CJ, Rustemeyer T, Gibbs S, Feilzer AJ. Non-heat inactivated autologous serum increases accuracy of in vitro CFSE lymphocyte proliferation test (LPT) for nickel. Clin Exp Allergy 2020; 50:722-732. [PMID: 32215995 PMCID: PMC7317482 DOI: 10.1111/cea.13603] [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: 03/20/2019] [Revised: 02/08/2020] [Accepted: 03/04/2020] [Indexed: 01/08/2023]
Abstract
Background Skin patch testing is still seen as the gold standard for the diagnosis of allergic hypersensitivity. For several metals and for patients with a suspected adverse reaction to their medical device implant material, patch testing can be unreliable. The current alternative to metal allergy patch testing is the in vitro lymphocyte proliferation test (LPT) using tritiated thymidine. This method is well‐established but requires handling of radioactive material, often uses heat‐inactivated allogenic human pooled serum and cannot determine T cell subsets. Objective To develop a radioactive free LPT by using carboxyfluorescein succinimidyl ester (CFSE) and to evaluate the influence of serum source (heat‐inactivated human pooled serum [HI HPS] vs autologous serum) on the sensitivity and specificity of the nickel‐specific LPT. Methods Peripheral blood mononuclear cells derived from nickel‐allergic patients and healthy controls were collected, labelled with CFSE and cultured in medium containing 10% HI HPS or 10% autologous serum with or without additional T cell skewing cytokine cocktails (Th1: IL‐7/IL‐12, Th2: IL‐7/IL‐4 or Th17: IL‐7/IL‐23/IL‐1β) in the absence or presence of NiSO4. The stimulation index (SI) was calculated as the ratio of divided cells, that is the percentage of CFSElow/neg CD3+CD4+ T‐lymphocytes upon nickel stimulation compared to the percentage of CFSElow/neg CD3+CD4+ T‐lymphocytes without antigen. These results were compared with the history of Ni allergy, patch test results and the MELISA test. Results Autologous serum positively influenced Ni‐specific proliferation while HI HPS negatively influenced Ni‐specific proliferation. The test protocol analysing CD4+ cells and autologous serum without skewing cytokines scored the best diagnostic values (sensitivity 95%; specificity 93%; and overall accuracy 94%) compared to the parallel test using HI HPS (accuracy 60%). Cytokine supplements did not further improve the test protocol which used autologous serum. The protocol using HI HPS could be further improved by addition of the cytokine skewing cocktails. Conclusions Here, we describe an optimized and highly accurate flow cytometric LPT which comprises of CFSE‐labelled cells cultured in autologous serum (not heat inactivated) and without the presence of T cell skewing cytokines. Clinical relevance The sensitivity and specificity of LPT is enhanced, compared to HI HPS, when autologous serum without skewing cytokines is used.
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Affiliation(s)
- Niels P J de Graaf
- Department of Dermatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hetty J Bontkes
- Department of Clinical Chemistry, Medical Immunology Laboratory, Amsterdam Infection & Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sanne Roffel
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam, MOVE Research Institute Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelis J Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sue Gibbs
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam, MOVE Research Institute Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam Infection & Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Albert J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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20
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Aalberse RC, Mueller GA, Derksen NIL, Aalberse JA, Edwards LL, Pomés A, Lidholm J, Rispens T, Briza P. Identification of the amino-terminal fragment of Ara h 1 as a major target of the IgE-binding activity in the basic peanut protein fraction. Clin Exp Allergy 2020; 50:401-405. [PMID: 31880850 DOI: 10.1111/cea.13554] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 10/03/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Small, basic peanut proteins are often poorly extracted in pH-neutral buffers that are optimal for the extraction of peanut storage proteins such as Ara h 1. As a result, such proteins are easily missed as potential allergens. OBJECTIVE To analyse the allergenic composition of the basic peanut protein (BPP) fraction. METHODS A peanut extract prepared at pH 4 was fractionated by physicochemical procedures. Chemical analysis was performed by SDS-PAGE and mass spectrometry. Because immunoblotting was found to be inefficient for most of these small basic proteins, IgE-binding activity was measured by coupling the fractions to CNBr-activated Sepharose, followed by incubation with sera from 55 Dutch peanut-allergic children and 125 I-labelled anti-IgE. RESULTS Most IgE reactivity of the BPP fraction was due to the 5-7 kDa amino-terminal fragment of Ara h 1. This finding was confirmed by the use of the fragment in recombinant form, to which 25/55 of the sera was IgE-positive. CONCLUSION The amino-terminal fragment of Ara h 1, a member of a family of small anti-microbial proteins, is an allergen independent of the carboxy-terminal fragment of Ara h 1.
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Affiliation(s)
- Rob C Aalberse
- Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Geoffrey A Mueller
- Genome Integrity and Structural Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Ninotska I L Derksen
- Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Lori L Edwards
- Genome Integrity and Structural Biology Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Anna Pomés
- Indoor Biotechnologies, Inc, Charlottesville, VA, USA
| | | | - Theo Rispens
- Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Briza
- Department of Biosciences, University of Salzburg, Salzburg, Austria
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21
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Liederman Z, Van Cott EM, Smock K, Meijer P, Selby R. Heparin-induced thrombocytopenia: An international assessment of the quality of laboratory testing. J Thromb Haemost 2019; 17:2123-2130. [PMID: 31420903 DOI: 10.1111/jth.14611] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 08/12/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Accurate diagnosis of heparin-induced thrombocytopenia (HIT) is essential to ensure timely treatment and prevent complications. Current diagnostic assays include enzyme-linked immunosorbent assays (ELISAs) and rapid immunoassays (RIs). RIs offer fast turnaround times but were not significantly represented in previous external proficiency testing challenges. OBJECTIVES To use external proficiency testing to assess qualitative concordance for heparin/PF4 antibody detection. METHODS From 2013 to 2017, the External Quality Control for Assays and Tests (ECAT) Foundation distributed 10 samples internationally. RESULTS In total, 437 laboratories submitted 3149 results. ELISAs accounted for 1484 (47%) responses with RIs accounting for 1665 (53%) responses. RI use increased over the 5-year period. ELISAs classified 96% of both consensus positive and consensus negative samples concordantly. The coefficient of variation (CV) for positive sample optical densities (ODs) ranged from 35% to 50% when combining ELISA assay methods together. Quantitative RIs classified 97% of consensus-positive and 98% of consensus-negative samples concordantly. Qualitative RIs had a higher proportion of discordant responses and classified 88% of consensus-positive samples and 73% of consensus-negative samples concordantly. Of RIs only latex immunoassays and IgG specific chemiluminescent assays identified > 95% of samples concordantly with consensus. CONCLUSION Quantitative RIs and ELISAs classify > 95% of samples concordantly. The ODs from different ELISA methods vary considerably and are not interchangeable. Qualitative RI use is increasing despite a greater proportion of discordant classifications. This includes a higher than expected number of negative classifications for consensus-positive samples among many RIs, challenging their use as "rule out" tests.
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Affiliation(s)
| | - Elizabeth M Van Cott
- Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Kristi Smock
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
- ARUP Laboratories, Hemostasis/Thrombosis Laboratory, Salt Lake City, UT, USA
| | - Piet Meijer
- ECAT Foundation, External Quality Control for Assays and Tests, Voorschoten, the Netherlands
| | - Rita Selby
- Department of Laboratory Medicine and Medicine, University of Toronto, Toronto, ON, Canada
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22
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Starshinova A, Zhuravlev V, Dovgaluk I, Panteleev A, Manina V, Zinchenko U, Istomina E, Pavlova M, Yablonskiy P. A comparison of intradermal test with recombinant tuberculosis allergen (diaskintest) with other immunologic tests in the diagnosis of tuberculosis infection. Int J Mycobacteriol 2019. [PMID: 29516883 DOI: 10.4103/ijmy.ijmy_17_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The WHO strategy for eradication of tuberculosis (TB) by 2035 (The End TB Strategy) is aimed at an early and precise diagnosis and subsequent effective treatment of TB patients. Currently, there is no gold standard for the diagnosis of latent TB infection. This study evaluated the diagnostic capabilities of a new intradermal test using recombinant TB allergen (Diaskintest) compared with tuberculin skin test (TST) and commercial TB interferon-gamma release assays (IGRAs). Methods A post-hoc data analysis that involved examining 860 HIV-negative, bacillus Calmette-Guérin (BCG)-vaccinated persons aged 1-65 years who visited the TB health-care institutions of Saint Petersburg to rule out or confirm an active TB was conducted from 2011 to 2016. Results A high degree of consistency of the Diaskintest results with the enzyme-linked immunospot and QuantiFERON-TB Gold In-Tube test (ELISPOT and QFT) results was observed in the examined pediatric population (n = 696), with a Diaskintest cutoff ≥5 mm: the kappa consistency indices were 1.000 and 0.937, for ELISPOT and QFT, respectively. A high sensitivity of Diaskintest, comparable with the IGRA tests, was observed in patients with a confirmed TB diagnosis in all age groups. The sensitivity of Diaskintest in patients of the TB/MTB + group aged 18 years and older was 88.7%; of ELISPOT, 90.6%; of QFT, 87.0%. The conducted analysis has shown a high concordance of results of the commercial TB tests in adult HIV-negative patients (n = 164) with a Diaskintest cutoff ≥5 mm: the kappa indices were 0.805 and 0.636 (Diaskintest vs. ELISPOT and QFT, respectively) among BCG-vaccinated people. Conclusion According to the WHO recommendations, replacing the TST by IGRAs is not recommended as a public health intervention in resource-constrained settings because the IGRA tests are more costly and technically complex to conduct than the TST. Diaskintest has comparable complexity to the TST and its performance is close to that of IGRA in a BCG-vaccinated population. Thus, our study demonstrates that replacing the TST by Diaskintest can be recommended as a public health intervention in resource-constrained and universal BCG vaccination settings.
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Affiliation(s)
- Anna Starshinova
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Federal State Institution of Higher Education Saint Petersburg State University, Petersburg, Russia
| | - Viacheslav Zhuravlev
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Petersburg, Russia
| | - Irina Dovgaluk
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Petersburg, Russia
| | - Alexandr Panteleev
- Department of Social Infection, First Pavlov State Medical University of Saint Petersburg, Ministry of Health, Petersburg, Russia
| | - Vera Manina
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Petersburg, Russia
| | - Ulia Zinchenko
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Federal State Institution of Higher Education Saint Petersburg State University, Petersburg, Russia
| | - Evgenia Istomina
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Petersburg, Russia
| | - Maria Pavlova
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Petersburg, Russia
| | - Piotr Yablonskiy
- Federal State Saint Petersburg Research Institute of Phthisiopulmonology of Ministry of Health Russian Federation, Federal State Institution of Higher Education Saint Petersburg State University, Petersburg, Russia
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Manyelo CM, Solomons RS, Snyders CI, Mutavhatsindi H, Manngo PM, Stanley K, Walzl G, Chegou NN. Potential of Host Serum Protein Biomarkers in the Diagnosis of Tuberculous Meningitis in Children. Front Pediatr 2019; 7:376. [PMID: 31612118 PMCID: PMC6773834 DOI: 10.3389/fped.2019.00376] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/02/2019] [Indexed: 01/22/2023] Open
Abstract
Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis and results in high morbidity and mortality in children. Diagnostic delay contributes to the poor outcome. There is an urgent need for new tools for the rapid diagnosis of TBM, especially in children. Methods: We collected serum samples from children in whom TBM was suspected at a tertiary hospital in Cape Town, South Africa. Children were subsequently classified as having TBM or no TBM using a published uniform research case-definition. Using a multiplex cytokine array platform, we investigated the concentrations of serum biomarkers comprising biomarkers that were previously found to be of value in the diagnosis of adult pulmonary TB (CRP, SAA, CFH, IFN-γ, IP-10, Apo-AI, and transthyretin) plus other potentially useful host biomarkers as diagnostic candidates for TBM. Findings: Out of 47 children included in the study, 23 (48.9%) had a final diagnosis of TBM and six were HIV infected. A modified version of the adult 7-marker biosignature in which transthyretin was replaced by NCAM1, diagnosed TBM in children with AUC of 0.80 (95% CI, 0.67-0.92), sensitivity of 73.9% (95% CI, 51.6-89.8%) and specificity of 66.7% (95% CI, 44.7-84.4%), with the other six proteins in the signature (CRP, IFN-γ, IP-10, CFH, Apo-A1, and SAA) only achieving and AUC of 0.75 (95% CI, 0.61-0.90) when used in combination. A new childhood TBM specific 3-marker biosignature (adipsin, Aβ42, and IL-10) showed potential in the diagnosis of TBM, with AUC of 0.84 (95% CI, 0.73-0.96), sensitivity of 82.6% (95 CI, 61.2-95.0%) and specificity of 75.0% (95% CI, 53.3-90.2%) after leave-one-out cross validation. Conclusion: A previously described adult 7-marker serum protein biosignature showed potential in the diagnosis of TBM in children. However, a smaller childhood TBM-specific 3-marker signature demonstrated improved performance characteristics. Our data indicates that blood-based biomarkers may be useful in the diagnosis of childhood TBM and requires further validation in larger cohort studies.
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Affiliation(s)
- Charles M Manyelo
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Regan S Solomons
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Candice I Snyders
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Hygon Mutavhatsindi
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Portia M Manngo
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kim Stanley
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Gerhard Walzl
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Novel N Chegou
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Tsolakis N, Malinovschi A, Nordvall L, Mattsson L, Lidholm J, Pedroletti C, Janson C, Borres MP, Alving K. Sensitization to minor cat allergen components is associated with type-2 biomarkers in young asthmatics. Clin Exp Allergy 2018; 48:1186-1194. [PMID: 29575179 DOI: 10.1111/cea.13135] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/10/2018] [Accepted: 03/03/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cat allergy is a major trigger of asthma world-wide. Molecular patterns of cat sensitization vary between individuals, but their relationship to inflammation in asthmatics has not been extensively studied. OBJECTIVE To investigate the prevalence and levels of IgE antibodies against different cat allergen components and their relationship to type-2 inflammation and total IgE among young asthmatic subjects sensitized to furry animals. METHODS Patients with asthma (age 10-35 years; n = 266) and IgE sensitization to cat, dog or horse extract (ImmunoCAP), were analysed for IgE to the cat allergen components Fel d 1 (secretoglobin), Fel d 2 (serum albumin), Fel d 4 and Fel d 7 (lipocalins). Independent associations between IgE-antibody concentrations, and fraction of exhaled nitric oxide (FeNO), blood eosinophil (B-Eos) count, and total IgE were analysed by multiple linear regression after adjustment for possible confounders. RESULTS The level of IgE against Fel d 2 was independently related to FeNO (P = .012) and total IgE (P < .001), and IgE against Fel d 4 associated with Β-Eos count (P = .009) and total IgE (P < .001). IgE antibodies against Fel d 1 or cat extract did not independently relate to these inflammatory markers (P = .23-.51). CONCLUSIONS Levels of IgE to lipocalin (Fel d 4) and serum albumin (Fel d 2), but not to secretoglobin (Fel d 1) or cat extract, were independently associated with type-2 biomarkers and total IgE in young asthmatics. CLINICAL RELEVANCE We suggest that measurement of IgE to minor cat allergen components may be useful when investigating asthma morbidity in cat allergic subjects.
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Affiliation(s)
- N Tsolakis
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - A Malinovschi
- Medical Sciences, Uppsala University, Uppsala, Sweden
| | - L Nordvall
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - L Mattsson
- Thermo Fisher Scientific, Uppsala, Sweden
| | - J Lidholm
- Thermo Fisher Scientific, Uppsala, Sweden
| | - C Pedroletti
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - C Janson
- Medical Sciences, Uppsala University, Uppsala, Sweden
| | - M P Borres
- Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Thermo Fisher Scientific, Uppsala, Sweden
| | - K Alving
- Women's and Children's Health, Uppsala University, Uppsala, Sweden
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25
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Gargiulo MDLÁ, Khoury M, Gómez G, Grimaudo S, Suárez L, Collado MV, Sarano J. Cut-off values of immunological tests to identify patients at high risk of severe lupus nephritis. Medicina (B Aires) 2018; 78:329-335. [PMID: 30285925] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Cut-off values for anti-dsDNA, anti-nucleosome and anti-C1q antibodies tests and for complementmediated hemolytic activity (CH50) were explored to identify patients with high risk of developing severe lupus nephritis (LN). Forty-one patients with confirmed systemic lupus erythematosus (SLE) were identified; their levels for the three antibodies and complement had been measured on a same serum sample. These patients were classified based on the presence of renal involvem ent; sixteen had active proliferative LN. With the cut-off values accepted in the laboratory for SLE diagnosis (anti-dsDNA > 100 UI/ml, anti-nucleosome > 50 U/ml or CH50 < 190 UCH50%) no significant differences were found between patients with and without LN. Anti-C1q > 40 U/ml showed a statistically significant association with LN and had 80% of specificity. Cut-off values for LN identified by Receiver Operating Characteristic curves (ROC) were higher for anti-dsDNA (> 455 IU/ml) and antinucleosome (>107 U/ml), lower for CH50 (< 150 UCH50%) and, for anti-C1q (> 41 U/ml) coincided with the cut-off values accepted for SLE. Anti-C1q > 134 U/ml had a 92% of specificity, 56% of sensibility and was associated with a fifteen-fold increased risk of LN. The simultaneous presence of anti-nucleosome > 107 U/ml and anti-C1q > 134 U/ml was associated with a 27-fold higher probability for LN. According to these results, the cut-off values used to detect SLE activity could be inadequate to identify patients at high risk of severe LN.
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Affiliation(s)
- María De Los Ángeles Gargiulo
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Marina Khoury
- Estadística y Metodología de la Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Graciela Gómez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Sebastián Grimaudo
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Lorena Suárez
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - María Victoria Collado
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | - Judith Sarano
- Servicio de Inmunología, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires, Argentina
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Gornowicz-Porowska J, Seraszek-Jaros A, Bowszyc-Dmochowska M, Bartkiewicz P, Kaczmarek E, Dmochowski M. Clinical evaluation of a multiparametric ELISA as a rapid tool for routinely diagnosing IgG-mediated autoimmune blistering dermatoses in ethnic Slavs. J Clin Lab Anal 2017; 32:e22336. [PMID: 28948640 DOI: 10.1002/jcla.22336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/07/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Technical innovation of autoimmune blistering dermatoses (ABDs) diagnosis aimed at multiplex approach. Two multiparametric ELISA tests are commercially available for ABDs serology. The aim was to compare diagnostic accuracy of multiparametric and monospecific ELISAs and to examine the diagnostic value/agreement of multivariant ELISA in compliance with traditional diagnostic setup for ABDs. METHODS In total, 128 sera from suspected ABDs patients were studied (27 sera in order to compare ELISAs). Multivariant ELISA (detection of IgG against desmoglein 1 and 3 - DSG1/3; BP180, BP230, envoplakin, type VII collagen), monovariant ELISA, and statistical analysis were performed. RESULTS With the use of sera from patients with suspected ABDs, the multiparametric ELISA yield an agreement of 84% with traditional stepwise diagnostics. Multivariant ELISA with BP180 and BP230 showed 87.5% and 80% sensitivity, 87.5% and 91% specificity, 87.5% reliability as well as 87.5% and 80% positive predictive value, 87.5% and 91% negative predictive value, respectively, in relation to monospecific ELISA. Multivariant ELISA with DSG1 and DSG3 showed 50% and 80% sensitivity, 100% and 80% specificity, 85% and 80% reliability as well as 100% and 57% positive predictive value, 82% and 92% negative predictive value, respectively, in relation to monospecific ELISA. A better rate of agreement was observed among ELISA systems with BP180 and BP230, than with ELISA systems with DSG1 and DSG3. CONCLUSION Multivariant ELISA test combined with clinical examinations and DIF is recommended as a minimal approach to diagnosing ABDs in ethnic Slavs.
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Affiliation(s)
- Justyna Gornowicz-Porowska
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Seraszek-Jaros
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Bowszyc-Dmochowska
- Cutaneous Histopathology and Immunopathology Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Bartkiewicz
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Kaczmarek
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marian Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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Mothes-Luksch N, Raith M, Stingl G, Focke-Tejkl M, Razzazi-Fazeli E, Zieglmayer R, Wöhrl S, Swoboda I. Pru p 3, a marker allergen for lipid transfer protein sensitization also in Central Europe. Allergy 2017; 72:1415-1418. [PMID: 28252802 PMCID: PMC5573991 DOI: 10.1111/all.13151] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [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] [Accepted: 02/24/2017] [Indexed: 01/01/2023]
Abstract
In the Mediterranean area, lipid transfer proteins (LTPs) are important causes of plant‐food allergies often associated with severe allergic reactions. There, peach LTP (Pru p 3) seems to be the primary sensitizer, whereas in Central Europe, little is known about the importance of LTP sensitization. In this region, allergen extract‐based diagnosis is often complicated by co‐sensitization to Bet v 1, the major birch pollen allergen, its cross‐reactive food allergens, and profilins. We investigated the role of LTP sensitization in Central European patients displaying strong allergic reactions to plant‐derived food. Analysis of IgE reactivity revealed that ten of thirteen patients were sensitized to Pru p 3, nine to Bet v 1, and two to profilin. Our results showed that LTP sensitization represents a risk factor for severe allergic symptoms in Central Europe. Furthermore, the strong IgE reactivity detected in immunoblots of plant‐food extracts indicated that Pru p 3 can be used as a marker allergen for LTP sensitization also in Central European patients.
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Affiliation(s)
- N. Mothes-Luksch
- Comparative Immunology and Oncology; Department of Pathophysiology and Allergy Research; Center of Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - M. Raith
- Molecular Biotechnology Section; FH Campus Wien; University of Applied Sciences, Campus Vienna Biocenter; Vienna Austria
| | - G. Stingl
- Department of Dermatology; Division of Immunology, Allergy and Infectious Diseases; Medical University of Vienna; Vienna Austria
| | - M. Focke-Tejkl
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - E. Razzazi-Fazeli
- VetCore Facility for Research; University of Veterinary Medicine Vienna; Vienna Austria
| | | | - S. Wöhrl
- FAZ - Floridsdorf Allergy Center; Vienna Austria
| | - I. Swoboda
- Molecular Biotechnology Section; FH Campus Wien; University of Applied Sciences, Campus Vienna Biocenter; Vienna Austria
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Gornowicz-Porowska J, Seraszek-Jaros A, Bowszyc-Dmochowska M, Kaczmarek E, Pietkiewicz P, Bartkiewicz P, Dmochowski M. Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays. Postepy Dermatol Alergol 2017; 34:21-7. [PMID: 28261028 DOI: 10.5114/ada.2017.65617] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/29/2015] [Indexed: 12/24/2022] Open
Abstract
Introduction Pemphigus and bullous pemphigoid (BP) are identified by autoantibodies (abs) against desmoglein 1, 3 (DSG1/3) and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF) using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection) and modified (IgG4 detection) mosaic for indirect immunofluorescence (IIFc – IIF commercial, IIFm – IIF modified) and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP) molecular diagnostics. Aim To compare diagnostic accuracy of commercial (IgG detection) and modified (IgG4 detection) mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP. Material and methods Sera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher’s exact test. Results There are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1)/desmoglein3 (DSG3)/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc. Conclusions The IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.
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29
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Cetica V, Sieni E, Pende D, Danesino C, De Fusco C, Locatelli F, Micalizzi C, Putti MC, Biondi A, Fagioli F, Moretta L, Griffiths GM, Luzzatto L, Aricò M. Genetic predisposition to hemophagocytic lymphohistiocytosis: Report on 500 patients from the Italian registry. J Allergy Clin Immunol 2015; 137:188-196.e4. [PMID: 26342526 PMCID: PMC4699615 DOI: 10.1016/j.jaci.2015.06.048] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 06/04/2015] [Accepted: 06/10/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a rare life-threatening disease affecting mostly children but also adults and characterized by hyperinflammatory features. A subset of patients, referred to as having familial hemophagocytic lymphohistiocytosis (FHL), have various underlying genetic abnormalities, the frequencies of which have not been systematically determined previously. OBJECTIVE This work aims to further our understanding of the pathogenic bases of this rare condition based on an analysis of our 25 years of experience. METHODS From our registry, we have analyzed a total of 500 unselected patients with HLH. RESULTS Biallelic pathogenic mutations defining FHL were found in 171 (34%) patients; the proportion of FHL was much higher (64%) in patients given a diagnosis during the first year of life. Taken together, mutations of the genes PRF1 (FHL2) and UNC13D (FHL3) accounted for 70% of cases of FHL. Overall, a genetic diagnosis was possible in more than 90% of our patients with FHL. Perforin expression and the extent of degranulation have been more useful for diagnosing FHL than hemophagocytosis and the cytotoxicity assay. Of 281 (56%) patients classified as having "sporadic" HLH, 43 had monoallelic mutations in one of the FHL-defining genes. Given this gene dosage effect, FHL is not strictly recessive. CONCLUSION We suggest that the clinical syndrome HLH generally results from the combined effects of an exogenous trigger and genetic predisposition. Within this combination, different weights of exogenous and genetic factors account for the wide disease spectrum that ranges from HLH secondary to severe infection to FHL.
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Affiliation(s)
- Valentina Cetica
- Department Pediatric Hematology Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Florence, Italy
| | - Elena Sieni
- Department Pediatric Hematology Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Florence, Italy
| | - Daniela Pende
- Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Cesare Danesino
- Medical Genetics, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carmen De Fusco
- Pediatric Hematology and Oncology, Pausilipon Hospital, Naples, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, and the University of Pavia, Pavia, Italy
| | | | | | - Andrea Biondi
- Pediatric Clinic, University of Milan Bicocca, San Gerardo Hospital/Fondazione MBBM, Monza, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Turin, Italy
| | | | - Gillian M Griffiths
- Cambridge Institute for Medical Research, University of Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | - Maurizio Aricò
- Istituto Toscano Tumori (I.T.T.), Florence, Italy; Azienda Sanitaria Provinciale, Ragusa, Italy.
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Van Hemelen D, Mahler V, Fischer G, Fae I, Reichl-Leb V, Pickl W, Jutel M, Smolinska S, Ebner C, Bohle B, Jahn-Schmid B. HLA class II peptide tetramers vs allergen-induced proliferation for identification of allergen-specific CD4 T cells. Allergy 2015; 70:49-58. [PMID: 25236500 DOI: 10.1111/all.12524] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 09/12/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Fluorescence-labeled MHC class II/peptide tetramer complexes are considered as optimal tools to characterize allergen-specific CD4(+) T cells, but this technique is restricted to frequently expressed HLA class II molecules and knowledge of immunodominant epitopes. In contrast, allergen-stimulated proliferation assessed by CFSE dilution is less sophisticated and widely applicable. The major mugwort allergen, Art v 1, contains only one single, immunodominant, HLA-DR1-restricted epitope (Art v 125-36 ). Thus, essentially all Art v 1-reactive cells should be identified by a HLA-DRB1*01:01/Art v 119-36 tetramer. METHODS We compared specificity and sensitivity of tetramer(+) and allergen-induced proliferating (CFSE(lo) ) CD4(+) T cells by flow cytometry. RESULTS The frequency of tetramer(+) CD4(+) T cells determined ex vivo in PBMC of mugwort-allergic individuals ranged from 0 to 0.029%. After 2-3 weeks of in vitro expansion, sufficient tetramer(+) T cells for phenotyping were detected in 83% of Art v 125-36 -reactive T-cell lines (TCL) from mugwort-allergic individuals, but not in TCL from healthy individuals. The tetramers defined bona fide Th2 cells. Notably, Art v 125-36 -reactive TCL depleted of tetramer(+) T cells still reacted to the peptide, and only 44% of Art v 125-36 -specific T-cell clones were detected by the tetramer. CFSE(lo) CD4(+) T cells contained only 0.3-10.7% of tetramer(+) T cells and very low proportions of Th2 cells. CONCLUSION Allergen-specific T cells can be identified by HLA class II tetramers with high specificity, but unexpected low sensitivity. In contrast, allergen-stimulated CFSE(lo) CD4(+) T cells contain extremely high fractions of bystander cells. Therefore, for T-cell monitoring, either method should be interpreted with caution.
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Affiliation(s)
- D. Van Hemelen
- Department of Pathophysiology and Allergy Research; Center for Pathophysiology; Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - V. Mahler
- Department of Dermatology; University of Erlangen; Erlangen Germany
| | - G. Fischer
- Department of Blood Group Serology; Medical University of Vienna; Vienna Austria
| | - I. Fae
- Department of Blood Group Serology; Medical University of Vienna; Vienna Austria
| | - V. Reichl-Leb
- Institute of Immunology; Medical University of Vienna; Vienna Austria
- Christian Doppler Laboratory for Immunomodulation; Medical University of Vienna; Vienna Austria
| | - W. Pickl
- Institute of Immunology; Medical University of Vienna; Vienna Austria
- Christian Doppler Laboratory for Immunomodulation; Medical University of Vienna; Vienna Austria
| | - M. Jutel
- Department of Clinical Immunology; Wroclaw Medical University and ‘ALL-MED’ Medical Research Institute; Wroclaw Poland
| | - S. Smolinska
- Department of Clinical Immunology; Wroclaw Medical University and ‘ALL-MED’ Medical Research Institute; Wroclaw Poland
| | - C. Ebner
- Allergieambulatorium Reumannplatz; Vienna Austria
| | - B. Bohle
- Department of Pathophysiology and Allergy Research; Center for Pathophysiology; Infectiology and Immunology; Medical University of Vienna; Vienna Austria
- Christian Doppler Laboratory for Immunomodulation; Medical University of Vienna; Vienna Austria
| | - B. Jahn-Schmid
- Department of Pathophysiology and Allergy Research; Center for Pathophysiology; Infectiology and Immunology; Medical University of Vienna; Vienna Austria
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Opstrup MS, Malling HJ, Krøigaard M, Mosbech H, Skov PS, Poulsen LK, Garvey LH. Standardized testing with chlorhexidine in perioperative allergy--a large single-centre evaluation. Allergy 2014; 69:1390-6. [PMID: 24957973 DOI: 10.1111/all.12466] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [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: 06/17/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Perioperative allergic reactions to chlorhexidine are often severe and easily overlooked. Although rare, the prevalence remains unknown. Correct diagnosis is crucial, but no validated provocation model exists, and other diagnostic tests have never been evaluated. The aims were to estimate (i) the prevalence of chlorhexidine allergy in perioperative allergy and (ii) the specificity and sensitivity for diagnostic tests for chlorhexidine allergy. METHODS We included all patients investigated for suspected perioperative allergic reactions in the Danish Anaesthesia Allergy Centre during 2004-2012. The following tests were performed: specific IgE (Immunocap® ; Phadia AB, Sweden), histamine release test (HR) (RefLab ApS, Denmark), skin prick test (SPT) and intradermal test (IDT). Positivity criteria were as follows: specific IgE >0.35 kUA/l; HR class 1-12; SPT mean wheal diameter ≥3 mm; IDT mean wheal diameter ≥ twice the diameter of negative control. Chlorhexidine allergy was post hoc defined as a relevant clinical reaction to chlorhexidine combined with two or more positive tests. Based on this definition, sensitivity and specificity were estimated for each test. RESULTS In total, 22 of 228 patients (9.6%) met the definition of allergy to chlorhexidine. Estimated sensitivity and specificity were as follows: specific IgE (sensitivity 100% and specificity 97%), HR (sensitivity 55% and specificity 99%), SPT (sensitivity 95% and specificity 97%) and IDT (sensitivity 68% and specificity 100%). CONCLUSIONS In patients investigated for suspected perioperative allergic reactions, 9.6% were diagnosed with allergy to chlorhexidine. Using our definition of chlorhexidine allergy, the highest combined estimated sensitivity and specificity was found for specific IgE and SPT.
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Affiliation(s)
- M. S. Opstrup
- National Allergy Research Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - H.-J. Malling
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - M. Krøigaard
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - H. Mosbech
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - P. S. Skov
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - L. K. Poulsen
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
| | - L. H. Garvey
- Allergy Clinic; Danish Anaesthesia Allergy Centre; Copenhagen University Hospital Gentofte; Gentofte Denmark
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Moreno C, Justicia JL, Quiralte J, Moreno-Ancillo Á, Iglesias-Cadarso A, Torrecillas M, Labarta N, García MA, Dávila I. Olive, grass or both? Molecular diagnosis for the allergen immunotherapy selection in polysensitized pollinic patients. Allergy 2014; 69:1357-63. [PMID: 24988991 DOI: 10.1111/all.12474] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [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: 06/28/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Grass and olive are the most frequently pollens that induce seasonal allergic rhinitis in Spain. Cross-reactivity due to panallergens shared by them and overlapping pollination complicates the recognition of allergy-causing agents, making it difficult to identify the most appropriate allergen immunotherapy (AIT) to use. The aim of this study was to determine the sensitization pattern to major grass and olive pollen allergens using component-resolved diagnostics in patients with seasonal allergic rhinitis (SAR) and positive skin prick test to grass and olive pollens and evaluate how knowledge of the sensitization patterns might influence AIT prescription. METHODS After informed written consent, a total of 1263 patients were recruited. A serum determination of specific IgE levels to Ole e 1 and Phl p 1 + 5 was performed to all patients. A comparison was made before and after obtaining the specific IgE results, and differences in diagnosis were stated. RESULTS At the 0.35 kU/l cut-off point, 71.2% of patients were positive to Ole e 1 and Phl p 1 + 5, 14% were positive only to Phl p 1 + 5 and 12% were positive only to Ole e 1. Based on available clinical data and skin prick test results, 922 (73%) patients would have been indicated for a mixture of grass and olive pollens for AIT. In 56.8% of patients, there was non-coincidence in the composition of AIT that would be selected before and after investigators received the in vitro data. CONCLUSION The diagnostic accuracy of the recombinant allergen-specific IgE test could help to improve the selection of specific-allergen immunotherapy in polysensitized patients.
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Affiliation(s)
- C. Moreno
- Hospital Universitario Reina Sofía; Cordoba Spain
| | | | | | | | | | - M. Torrecillas
- Complejo Universitario Hospitalario de Albacete; Albacete Spain
| | - N. Labarta
- Policlínica Alto Aragón; Hospital San Jorge; Huesca Spain
| | | | - I. Dávila
- Instituto Biosanitario de Salamanca (IBSAL); Hospital Universitario de Salamanca; Salamanca Spain
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Stennis NL, Trieu L, Ahuja SD, Harris TG. Estimated Prevalence of Tuberculosis Infection Among a New York City Clinic Population Using Interferon-gamma Release Assays. Open Forum Infect Dis 2014; 1:ofu047. [PMID: 25734119 PMCID: PMC4281800 DOI: 10.1093/ofid/ofu047] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022] Open
Abstract
Using QuantiFERON®-Gold In-Tube (QFT-GIT) data, the prevalence of tuberculosis infection in New York City was estimated. Patient characteristics associated with a positive result were consistent with known tuberculosis risk factors. Results suggest that blood-based tests for tuberculosis infection are reliable. Background Elimination of tuberculosis (TB) in the United States requires treating not only persons with active disease but also those infected with TB. Achieving this goal requires understanding local TB infection prevalence and identifying subgroups at increased risk for infection and disease. Methods The study population included all patients tested with an interferon-gamma release assay (IGRA) test at New York City (NYC) public TB clinics from October 1, 2006 to December 31, 2011. Patients who were not a case or contact at testing (general clinic patients) and who had a positive QuantiFERON-Gold In-Tube (QFT-GIT) test result were compared with those with indeterminate or negative results to identify characteristics associated with positive results. New York City TB surveillance data were used to identify clinic patients later diagnosed with active TB disease. Results A total of 69 273 IGRA tests were conducted. Among 20 066 patients tested with QFT-GIT, 16% tested positive, 83% tested negative, and <1% were indeterminate. Of 18 481 general clinic patients, 14% had a positive QFT-GIT result. Nine percent of United States-born patients compared with 19% of foreign-born patients had a positive result. Increasing age and birth in a high-incidence country were associated with a higher likelihood of having a positive result. One patient with a negative QFT-GIT result was identified as a TB case 2 years later. Conclusions Using QFT-GIT data, the background prevalence of TB infection in NYC was estimated. Patient characteristics associated with a positive QFT-GIT result were consistent with known TB risk factors. Results suggest that IGRAs are reliable tests for TB infection.
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Affiliation(s)
- Natalie L Stennis
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Lisa Trieu
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Shama D Ahuja
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Tiffany G Harris
- New York City Department of Health and Mental Hygiene, Long Island City, New York
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