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Xie E, Chen Y, Yang W, Pan Q, Zheng Shen J, Zhou F, Shen J, Li T, Li Q, Li X. Long-term exposure to dietary emulsifier Tween 80 promotes liver lipid accumulation and induces different-grade inflammation in young and aged mice. Food Res Int 2024; 184:114205. [PMID: 38609253 DOI: 10.1016/j.foodres.2024.114205] [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: 12/17/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024]
Abstract
With the advent of industrialization, there has been a substantial increase in the production and consumption of ultra-processed foods (UPFs). These processed foods often contain artificially synthesized additives, such as emulsifiers. Emulsifiers constitute approximately half of the total amount of food additives, with Tween 80 being a commonly used emulsifier in the food industry. Concurrently, China is undergoing significant demographic changes, transitioning into an aging society. Despite this demographic shift, there is insufficient research on the health implications of food emulsifiers, particularly on the elderly population. In this study, we present novel findings indicating that even at low concentrations, Tween 80 suppressed the viability of multiple cell types. Prolonged in vivo exposure to 1 % Tween 80 in drinking water induced liver lipid accumulation and insulin resistance in young adult mice under a regular chow diet. Intriguingly, in mice with high-fat diet (HFD) induced metabolic dysfunction-associated steatotic liver disease (MASLD), this inductive effect was masked. In aged mice, liver lipid accumulation was replicated under prolonged Tween 80 exposure. We further revealed that Tween 80 induced inflammation in both adult and aged mice, with a more pronounced inflammation in aged mice. In conclusion, our study provides compelling evidence that Tween 80 could contribute to a low-grade inflammation and liver lipid accumulation. These findings underscore the need for increasing attention regarding the consumption of UPFs with Tween 80 as the emulsifier, particularly in the elderly consumers.
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Affiliation(s)
- Enjun Xie
- Zhejiang University School of Medicine, Hangzhou, China
| | - Yunmei Chen
- School of Pharmacy, Xi'an Medical University, Xi'an, China
| | - Wanbao Yang
- Department of Nutrition, Texas A&M University, College Station, United States
| | - Quan Pan
- Department of Nutrition, Texas A&M University, College Station, United States
| | - James Zheng Shen
- Department of Nutrition, Texas A&M University, College Station, United States
| | - Fenghua Zhou
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Jie Shen
- Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Li
- Food Science and Nutrition Center, Hunan Agricultural Products Processing Institute, Hunan Academy of Agricultural Science, Changsha, China
| | - Qili Li
- Food Science and Nutrition Center, Hunan Agricultural Products Processing Institute, Hunan Academy of Agricultural Science, Changsha, China
| | - Xiaopeng Li
- Food Science and Nutrition Center, Hunan Agricultural Products Processing Institute, Hunan Academy of Agricultural Science, Changsha, China.
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2
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Kanukollu S, Spatz K, Lavery JA, Bender JG, Mauguen A, Mathew S. Safety and tolerability of intravenous aprepitant and fosaprepitant in children with cancer: A retrospective, single-center review. Pediatr Blood Cancer 2024; 71:e30882. [PMID: 38267822 DOI: 10.1002/pbc.30882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/14/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
NK-1 receptor antagonists (NK1-RA) are key agents for chemotherapy-induced nausea and vomiting (CINV) prevention in patients receiving highly emetogenic chemotherapy. Current pediatric practice guidelines recommend the use of intravenous fosaprepitant or oral aprepitant. However, there are reports of hypersensitivity reactions with fosaprepitant due to polysorbate 80. Intravenous aprepitant does not contain polysorbate 80, but its use in pediatric patients has not been described. In this retrospective, single-center study, 106 pediatric patients received either fosaprepitant or intravenous aprepitant as part of their antiemetic regimen. Intravenous aprepitant was well tolerated and did not lead to any instances of hypersensitivity reactions requiring discontinuation.
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Affiliation(s)
- Srivarshini Kanukollu
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Krisoula Spatz
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jessica A Lavery
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Julia Glade Bender
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Audrey Mauguen
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sherry Mathew
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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3
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Gonza I, Goya-Jorge E, Douny C, Boutaleb S, Taminiau B, Daube G, Scippo ML, Louis E, Delcenserie V. Food additives impair gut microbiota from healthy individuals and IBD patients in a colonic in vitro fermentation model. Food Res Int 2024; 182:114157. [PMID: 38519184 DOI: 10.1016/j.foodres.2024.114157] [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: 11/06/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/24/2024]
Abstract
Intestinal fibrosis is a long-term complication of inflammatory bowel diseases (IBD). Changes in microbial populations have been linked with the onset of fibrosis and some food additives are known to promote intestinal inflammation facilitating fibrosis induction. In this study, we investigated how polysorbate 80, sucralose, titanium dioxide, sodium nitrite and maltodextrin affect the gut microbiota and the metabolic activity in healthy and IBD donors (patients in remission and with a flare of IBD). The Simulator of the Human Intestinal Microbial Ecosystem (SHIME®) with a static (batch) configuration was used to evaluate the effects of food additives on the human intestinal microbiota. Polysorbate 80 and sucralose decreased butyrate-producing bacteria such as Roseburia and Faecalibacterium prausnitzii. Both compounds, also increased bacterial species positively correlated with intestinal inflammation and fibrosis (i.e.: Enterococcus, Veillonella and Mucispirillum schaedleri), especially in donors in remission of IBD. Additionally, polysorbate 80 induced a lower activity of the aryl hydrocarbon receptor (AhR) in the three groups of donors, which can affect the intestinal homeostasis. Maltodextrin, despite increasing short-chain fatty acids production, promoted the growth of Ruminococcus genus, correlated with higher risk of fibrosis, and decreased Oscillospira which is negatively associated with fibrosis. Our findings unveil crucial insights into the potential deleterious effects of polysorbate 80, sucralose and maltodextrin on human gut microbiota in healthy and, to a greater extent, in IBD patients.
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Affiliation(s)
- Irma Gonza
- Laboratory of Food Quality Management, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Elizabeth Goya-Jorge
- Laboratory of Food Quality Management, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Caroline Douny
- Laboratory of Food Analysis, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Samiha Boutaleb
- Laboratory of Food Analysis, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Bernard Taminiau
- Laboratory of Microbiology, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Georges Daube
- Laboratory of Microbiology, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Marie-Louise Scippo
- Laboratory of Food Analysis, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
| | - Edouard Louis
- Hepato - Gastroenterology and Digestive Oncology Department, CHU of Liège, Liège, Belgium.
| | - Véronique Delcenserie
- Laboratory of Food Quality Management, Department of Food Sciences, FARAH - Veterinary Public Health, University of Liège, B43b, 4000 Liège, Belgium.
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Saito J, Nakamura H, Akabane M, Yamatani A. Quantitative Investigation on Exposure to Potentially Harmful Excipients by Injection Drug Administration in Children Under 2 Years of Age and Analysis of Association with Adverse Events: A Single-Center, Retrospective Observational Study. Ther Innov Regul Sci 2024; 58:316-335. [PMID: 38055156 DOI: 10.1007/s43441-023-00596-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Potentially harmful excipients (PHEs) for children have been reported and the need for information collection has been advocated. However, studies on the actual occurrence of adverse events are limited. This study investigated the quantitative exposure of PHEs via injection and their association with adverse events in children under 2 years of age. MATERIALS AND METHODS As a single-center observational study, children aged 0-23 months received injectable drugs from April 1, 2018, to March 31, 2023 were included. Information on PHE exposure and adverse events after administration were extracted from medical records. Sodium benzoate, benzyl alcohol, ethanol, glycerol, lactose, polyethylene glycol paraben, polysorbate, propylene glycol, sorbitol, sucrose, sulfite, and thimerosal were selected as PHEs. RESULTS AND DISCUSSION 6265 cases, 333,694 prescriptions, and 368 drugs (264 ingredients) were analyzed. The median age was 0.63 years (interquartile range [IQR] 0.1-1.1). 72,133 prescriptions, 132 drugs and 99 ingredients contained PHE; 2,961 cases exposed to PHE and 1825 cases exceeding permitted daily exposure. The drug with the highest number of exposure cases was hydroxyzine, and the highest number of prescriptions was heparin (both drugs contain benzyl alcohol). In association between adverse events and PHE exposure, higher doses in cases of adverse event occurrence were found in benzyl alcohol, glycerol, polyethylene glycol, and polysorbate exposed cases. Among thimerosal-exposed cases, "developmental delay" was more frequent in exposed cases, but the causal relationship was unknown. Further investigation is needed to clarify the relationship between adverse events and PHE exposure. Additionally, more precise information on PDE for pediatrics including neonates is necessary.
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Affiliation(s)
- Jumpei Saito
- Department of Pharmacy, National Center for Child Health and Development, 2-10-1, Okura, Setagayaku, Tokyo, 157-8535, Japan.
| | - Hidefumi Nakamura
- Department of Research and Development Supervision, National Center for Child Health and Development, 2-10-1, Okura, Setagayaku, Tokyo, 157-8535, Japan
| | - Miki Akabane
- Department of Pharmacy, National Center for Child Health and Development, 2-10-1, Okura, Setagayaku, Tokyo, 157-8535, Japan
| | - Akimasa Yamatani
- Department of Pharmacy, National Center for Child Health and Development, 2-10-1, Okura, Setagayaku, Tokyo, 157-8535, Japan
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Mombelli M, Neofytos D, Huynh-Do U, Sánchez-Céspedes J, Stampf S, Golshayan D, Dahdal S, Stirnimann G, Schnyder A, Garzoni C, Venzin RM, Magenta L, Schönenberger M, Walti L, Hirzel C, Munting A, Dickenmann M, Koller M, Aubert JD, Steiger J, Pascual M, Mueller TF, Schuurmans M, Berger C, Binet I, Villard J, Mueller NJ, Egli A, Cordero E, van Delden C, Manuel O. Immunogenicity of High-Dose Versus MF59-Adjuvanted Versus Standard Influenza Vaccine in Solid Organ Transplant Recipients: The Swiss/Spanish Trial in Solid Organ Transplantation on Prevention of Influenza (STOP-FLU Trial). Clin Infect Dis 2024; 78:48-56. [PMID: 37584344 PMCID: PMC10810716 DOI: 10.1093/cid/ciad477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The immunogenicity of the standard influenza vaccine is reduced in solid-organ transplant (SOT) recipients, so new vaccination strategies are needed in this population. METHODS Adult SOT recipients from 9 transplant clinics in Switzerland and Spain were enrolled if they were >3 months after transplantation. Patients were randomized (1:1:1) to a MF59-adjuvanted or a high-dose vaccine (intervention), or a standard vaccine (control), with stratification by organ and time from transplant. The primary outcome was vaccine response rate, defined as a ≥4-fold increase of hemagglutination-inhibition titers to at least 1 vaccine strain at 28 days postvaccination. Secondary outcomes included polymerase chain reaction-confirmed influenza and vaccine reactogenicity. RESULTS A total of 619 patients were randomized, 616 received the assigned vaccines, and 598 had serum available for analysis of the primary endpoint (standard, n = 198; MF59-adjuvanted, n = 205; high-dose, n = 195 patients). Vaccine response rates were 42% (84/198) in the standard vaccine group, 60% (122/205) in the MF59-adjuvanted vaccine group, and 66% (129/195) in the high-dose vaccine group (difference in intervention vaccines vs standard vaccine, 0.20; 97.5% confidence interval [CI], .12-1); P < .001; difference in high-dose vs standard vaccine, 0.24 [95% CI, .16-1]; P < .001; difference in MF59-adjuvanted vs standard vaccine, 0.17 [97.5% CI, .08-1]; P < .001). Influenza occurred in 6% of the standard, 5% in the MF59-adjuvanted, and 7% in the high-dose vaccine groups. Vaccine-related adverse events occurred more frequently in the intervention vaccine groups, but most of the events were mild. CONCLUSIONS In SOT recipients, use of an MF59-adjuvanted or a high-dose influenza vaccine was safe and resulted in a higher vaccine response rate. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov NCT03699839.
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Affiliation(s)
- Matteo Mombelli
- Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - Uyen Huynh-Do
- Department of Nephrology and Hypertension, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Javier Sánchez-Céspedes
- Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Department of Medicine, Virgen del Rocío University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío and Virgen Macarena, University of Seville, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Susanne Stampf
- Clinic for Transplantation Immunology and Nephrology, Swiss Transplant Cohort Study (STCS), University Hospital of Basel, Basel, Switzerland
| | - Dela Golshayan
- Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Suzan Dahdal
- Department of Nephrology and Hypertension, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Guido Stirnimann
- University Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - Aurelia Schnyder
- Division of Nephrology and Transplantation Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, Lugano, Switzerland
| | - Reto M Venzin
- Division of Nephrology, Cantonal Hospital Graubuenden, Chur, Switzerland
| | | | - Melanie Schönenberger
- Clinic for Transplantation Immunology and Nephrology, Swiss Transplant Cohort Study (STCS), University Hospital of Basel, Basel, Switzerland
| | - Laura Walti
- Department of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland
| | - Cédric Hirzel
- Department of Infectious Diseases, University Hospital and University of Bern, Bern, Switzerland
| | - Aline Munting
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Michael Dickenmann
- Clinic for Transplantation Immunology and Nephrology, Swiss Transplant Cohort Study (STCS), University Hospital of Basel, Basel, Switzerland
| | - Michael Koller
- Clinic for Transplantation Immunology and Nephrology, Swiss Transplant Cohort Study (STCS), University Hospital of Basel, Basel, Switzerland
| | - John-David Aubert
- Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Division of Pulmonology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jürg Steiger
- Clinic for Transplantation Immunology and Nephrology, Swiss Transplant Cohort Study (STCS), University Hospital of Basel, Basel, Switzerland
| | - Manuel Pascual
- Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas F Mueller
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Macé Schuurmans
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology and Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Isabelle Binet
- Division of Nephrology and Transplantation Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Jean Villard
- Transplantation Immunology Unit and National Reference Laboratory for Histocompatibility, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas J Mueller
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Adrian Egli
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Elisa Cordero
- Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Department of Medicine, Virgen del Rocío University Hospital, Seville, Spain
- Institute of Biomedicine of Seville (IBiS), Virgen del Rocío and Virgen Macarena, University of Seville, Seville, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Christian van Delden
- Transplant Infectious Diseases Unit, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - Oriol Manuel
- Transplantation Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Montera MC, Giordano A, Asperti C, Aruanno A, Barzaghi CE, Bignardi D, Borrelli P, Bommarito L, Busa M, Calafiore P, Carusi V, Cinquini M, Cortellini G, Cocchi R, D'Auria F, De Caro F, Demonte A, Di Leo E, Di Lizia M, Di Rienzo A, Fumagalli F, Kihlgren P, Lodi Rizzini F, Macchia D, Manzotti G, Marra AM, Mileto P, Mietta S, Montagni M, Nettis E, Nucera E, Peveri S, Pivetta D, Pirisi M, Ramirez GA, Rivolta F, Rizzi A, Savoia A, Pedicini A, Scarpa A, Zambito M, Zisa G, Yacoub MR. The role of skin tests with polyethylene glycol and polysorbate 80 in the vaccination campaign for COVID-19: results from an Italian multicenter survey. Eur Ann Allergy Clin Immunol 2024; 56:17-25. [PMID: 36927838 DOI: 10.23822/eurannaci.1764-1489.291] [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] [Indexed: 03/18/2023]
Abstract
Summary Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.
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Affiliation(s)
- M C Montera
- University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - A Giordano
- UO University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - C Asperti
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - A Aruanno
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - D Bignardi
- Allergology Unit, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - P Borrelli
- SSD Dermatology, Beauregard Hospital, Valle d'Aosta, Italy
| | - L Bommarito
- Turin Local Health Authority 4, Turin, Italy
| | - M Busa
- UOS Dermatology Hospital of Mirano, Venice, Italy
| | | | - V Carusi
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - M Cinquini
- SSVD Allergology, Spedali Civili, Brescia, Italy
| | - G Cortellini
- SSI Allergology Romagna Health Authority, Rimini Hospital, Italy
| | - R Cocchi
- Pneumology Unit, Busto Arsizio Hospital, Varese, Italy
| | | | - F De Caro
- UO University Hospital "O.O.R.R. San Giovanni di Dio and Ruggi d'Aragona", Salerno, Italy
| | - A Demonte
- Simple Operating Unit of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - E Di Leo
- Section of Allergy and Clinical Immunology, Unit of Internal Medicine- "F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
| | - M Di Lizia
- UOSD. Allergology Giulianova, Teramo, Italy
| | - A Di Rienzo
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | | | | | - F Lodi Rizzini
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - D Macchia
- SOS Allergology Clinical Immunology, San Giovanni di Dio Hospital, Florence, Italy
| | - G Manzotti
- Allergology Clinic, Casa di Cura Palazzolo, Bergamo, Italy
| | - A M Marra
- ASST Rhodense, Rho Hospital, Milan, Italy
| | - P Mileto
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - S Mietta
- Turin Local Health Authority 4, Turin, Italy
| | | | - E Nettis
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
| | - E Nucera
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Peveri
- ASST Bergamo Ovest, Bergamo, Italy
| | - D Pivetta
- SSVD Allergology, Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences (DSCS), University of Brescia, Brescia, Italy
| | - M Pirisi
- Division of Internal Medicine, Ospedale Maggiore della Carità, Novara, Italy
| | - G A Ramirez
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - F Rivolta
- UOC General Medicine, Immunology and Allergology, IRCCS Cà Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
| | - A Rizzi
- Agostino Gemelli University Hospital Foundation IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Savoia
- Ospedale del Sacro Cuore di Gesù - Fatebenefratelli, Benevento, Italy
| | - A Pedicini
- Ospedale del Sacro Cuore di Gesù - Fatebenefratelli, Benevento, Italy
| | - A Scarpa
- UOS Dermatology Hospital of Mirano, Venice, Italy
| | - M Zambito
- Specialist Outpatient Allergy Unit, ASP 6 Palermo, Palermo, Italy
| | - G Zisa
- SS Allergology and Clinical Immunology, Maggiore della Carità Hospital, Novara, Italy
| | - M-R Yacoub
- Unit of Immunology, Rheumatology, Allergology and Rare Diseases, IRCCS San Raffaele Hospital, Milan, Italy
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7
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Tang C, Zhao Y, Liu J, Zheng X, Guo X, Liu H, Chen L, Shi Y. Polysorbate 80 as a possible allergenic component in cross-allergy to docetaxel and fosaprepitant: A literature review. J Oncol Pharm Pract 2023; 29:1998-2006. [PMID: 37817680 DOI: 10.1177/10781552231203186] [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] [Indexed: 10/12/2023]
Abstract
OBJECTIVE Patients had allergies to both fosaprepitant and docetaxel with similar signs and symptoms. To explore the possible causes of allergy and whether there is cross-allergy between fosaprepitant and docetaxel, we conducted a literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS A systematic search of the following databases was performed: Pubmed, Embase, Cochrane Library, CINAHL, Scopus, Web of Science and Taylor & Francis. The final search was on 12 November 2022. Two investigators independently selected eligible studies and extracted data according to inclusion and exclusion criteria and assessed the methodological quality of included studies. Any disagreement was resolved by a third researcher. RESULTS The main cause of fosaprepitant and docetaxel allergy is polysorbate 80. Fosaprepitant and docetaxel have similar allergic symptoms, mainly facial flushing (19.0%, 18.5%); erythema/dermatitis (17.2%, 1.9%); fluid retention (17.2%, 22.2%); and dyspnea, bronchospasm, shortness of breath and coughing (15.5%, 16.7%). Hypotension (1.7%, 7.4%) and decreased oxygen saturation (1.7%, 1.9%) are rare. The treatments for both allergies are similar: stop injection, oxygen, glucocorticoid, antihistamines and symptomatic treatments. CONCLUSION Polysorbate 80 is the same allergenic component of docetaxel and fosaprepitant. The symptoms and treatments caused by the two drugs are similar. Most allergic reactions are not serious. Medications containing the same allergy ingredient need to be used with caution for patients with severe allergies to polysorbate 80.
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Affiliation(s)
- Caihong Tang
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yueqiu Zhao
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jing Liu
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaoqing Zheng
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xi Guo
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Haoying Liu
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Licong Chen
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yulan Shi
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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8
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Pasali M, Taka S, Chliva C, Katoulis A, Makris M. Case of Polyethylene Glycol Allergy Confirmed with Basophil Activation Test and Oral Challenge Successfully Immunized with SARS-CoV-2 Vaccine. Iran J Allergy Asthma Immunol 2023; 22:409-412. [PMID: 37767684 DOI: 10.18502/ijaai.v22i4.13615] [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: 05/04/2022] [Accepted: 07/15/2023] [Indexed: 09/29/2023]
Abstract
Polyethylene glycols (PEG) or macrogols are polymers of ethylene oxide widely used in drugs either as active substances or, more commonly, as excipients. We report a Caucasian 32-year-old woman with referred anaphylaxis almost instantly after oral intake of a macrogol-containing laxative. Despite an anaphylactic reaction, the patient showed negative results for both the skin test and specific IgE to monomer, while the basophil activation test and oral challenge were positive. The patient was later successfully vaccinated with a polysorbate 80-containing SARS-CoV-2 vaccine following an additional work-up. As a result, the inactive form of PEG cannot be fully diagnosed, and it is considered a "hidden" allergen. Allergens like polysorbates need special consideration due to their possible cross-reactivity by their specific derivatives.
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Affiliation(s)
- Maria Pasali
- Allergy Unit "D. Kalogeromitros", 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, ATTIKON University General Hospital, Athens, Greece.
| | - Styliani Taka
- Allergy and Clinical Immunology Unit, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece 3 StArtBioP.C., Molecular Allergy Diagnostics, Athens, Greece.
| | - Caterina Chliva
- Allergy Unit "D. Kalogeromitros", 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, ATTIKON University General Hospital, Athens, Greece.
| | - Alexandros Katoulis
- 2nd Dpt. of Dermatology and Venereology, National and Kapodistrian University of Athens, ATTIKON University General Hospital, Athens, Greece.
| | - Michael Makris
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, ATTIKON University General Hospital, Athens, Greece.
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9
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Ogulur I, Yazici D, Pat Y, Bingöl EN, Babayev H, Ardicli S, Heider A, Rückert B, Sampath V, Dhir R, Akdis M, Nadeau K, Akdis CA. Mechanisms of gut epithelial barrier impairment caused by food emulsifiers polysorbate 20 and polysorbate 80. Allergy 2023; 78:2441-2455. [PMID: 37530764 DOI: 10.1111/all.15825] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/19/2023] [Accepted: 07/05/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The rising prevalence of many chronic diseases related to gut barrier dysfunction coincides with the increased global usage of dietary emulsifiers in recent decades. We therefore investigated the effect of the frequently used food emulsifiers on cytotoxicity, barrier function, transcriptome alterations, and protein expression in gastrointestinal epithelial cells. METHODS Human intestinal organoids originating from induced pluripotent stem cells, colon organoid organ-on-a-chip, and liquid-liquid interface cells were cultured in the presence of two common emulsifiers: polysorbate 20 (P20) and polysorbate 80 (P80). The cytotoxicity, transepithelial electrical resistance (TEER), and paracellular-flux were measured. Immunofluorescence staining of epithelial tight-junctions (TJ), RNA-seq transcriptome, and targeted proteomics were performed. RESULTS Cells showed lysis in response to P20 and P80 exposure starting at a 0.1% (v/v) concentration across all models. Epithelial barrier disruption correlated with decreased TEER, increased paracellular-flux and irregular TJ immunostaining. RNA-seq and targeted proteomics analyses demonstrated upregulation of cell development, signaling, proliferation, apoptosis, inflammatory response, and response to stress at 0.05%, a concentration lower than direct cell toxicity. A proinflammatory response was characterized by the secretion of several cytokines and chemokines, interaction with their receptors, and PI3K-Akt and MAPK signaling pathways. CXCL5, CXCL10, and VEGFA were upregulated in response to P20 and CXCL1, CXCL8 (IL-8), CXCL10, LIF in response to P80. CONCLUSIONS The present study provides direct evidence on the detrimental effects of food emulsifiers P20 and P80 on intestinal epithelial integrity. The underlying mechanism of epithelial barrier disruption was cell death at concentrations between 1% and 0.1%. Even at concentrations lower than 0.1%, these polysorbates induced a proinflammatory response suggesting a detrimental effect on gastrointestinal health.
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Affiliation(s)
- Ismail Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Duygu Yazici
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yagiz Pat
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Elif Naz Bingöl
- Department of Bioengineering, Institute of Pure and Applied Sciences, Marmara University, Istanbul, Turkey
| | - Huseyn Babayev
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Sena Ardicli
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Anja Heider
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Beate Rückert
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California, USA
| | - Raja Dhir
- SEED Inc. Co., Los Angeles, California, USA
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Kari Nadeau
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, 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 (CK-CARE), Davos, Switzerland
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10
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Nin-Valencia A, Fiandor A, Lluch M, Quirce S, Caballero T, Heredia Revuelto R, González-Muñoz M, Caballero ML, Cabañas R. Safe administration of SARS-CoV-2 vaccine after desensitization to a biologic containing polysorbate 80 in a patient with polyethylene glycol-induced severe anaphylaxis and sensitization to polysorbate 80. J Investig Allergol Clin Immunol 2022; 33:151-153. [PMID: 35638393 DOI: 10.18176/jiaci.0830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Nin-Valencia
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
| | - A Fiandor
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- PIELenRed Consortium
| | - M Lluch
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- PIELenRed Consortium
| | - S Quirce
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES)
| | - T Caballero
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER, U754)
| | | | - M González-Muñoz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Immunology, Hospital Universitario La Paz, Madrid, Spain
| | - M L Caballero
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - R Cabañas
- Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- PIELenRed Consortium
- Centro de Investigación en Red de Enfermedades Raras (CIBERER, U754)
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11
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Pillet S, Arunachalam PS, Andreani G, Golden N, Fontenot J, Aye PP, Röltgen K, Lehmicke G, Gobeil P, Dubé C, Trépanier S, Charland N, D'Aoust MA, Russell-Lodrigue K, Monjure C, Blair RV, Boyd SD, Bohm RP, Rappaport J, Villinger F, Landry N, Pulendran B, Ward BJ. Safety, immunogenicity, and protection provided by unadjuvanted and adjuvanted formulations of a recombinant plant-derived virus-like particle vaccine candidate for COVID-19 in nonhuman primates. Cell Mol Immunol 2022; 19:222-233. [PMID: 34983950 PMCID: PMC8727235 DOI: 10.1038/s41423-021-00809-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 08/30/2021] [Accepted: 11/15/2021] [Indexed: 12/11/2022] Open
Abstract
Although antivirals are important tools to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, effective vaccines are essential to control the current coronavirus disease 2019 (COVID-19) pandemic. Plant-derived virus-like particle (VLP) vaccine candidates have previously demonstrated immunogenicity and efficacy against influenza. Here, we report the immunogenicity and protection induced in rhesus macaques by intramuscular injections of a VLP bearing a SARS-CoV-2 spike protein (CoVLP) vaccine candidate formulated with or without Adjuvant System 03 (AS03) or cytidine-phospho-guanosine (CpG) 1018. Although a single dose of the unadjuvanted CoVLP vaccine candidate stimulated humoral and cell-mediated immune responses, booster immunization (at 28 days after priming) and adjuvant administration significantly improved both responses, with higher immunogenicity and protection provided by the AS03-adjuvanted CoVLP. Fifteen micrograms of CoVLP adjuvanted with AS03 induced a polyfunctional interleukin-2 (IL-2)-driven response and IL-4 expression in CD4 T cells. Animals were challenged by multiple routes (i.e., intratracheal, intranasal, and ocular) with a total viral dose of 106 plaque-forming units of SARS-CoV-2. Lower viral replication in nasal swabs and bronchoalveolar lavage fluid (BALF) as well as fewer SARS-CoV-2-infected cells and immune cell infiltrates in the lungs concomitant with reduced levels of proinflammatory cytokines and chemotactic factors in the BALF were observed in animals immunized with the CoVLP adjuvanted with AS03. No clinical, pathologic, or virologic evidence of vaccine-associated enhanced disease was observed in vaccinated animals. The CoVLP adjuvanted with AS03 was therefore selected for vaccine development and clinical trials.
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MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Adjuvants, Immunologic/adverse effects
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- COVID-19/epidemiology
- COVID-19/immunology
- COVID-19/prevention & control
- COVID-19/virology
- COVID-19 Vaccines/administration & dosage
- COVID-19 Vaccines/adverse effects
- Disease Models, Animal
- Drug Combinations
- Drug Compounding/methods
- Immunity, Humoral
- Immunogenicity, Vaccine/immunology
- Macaca mulatta
- Male
- Pandemics/prevention & control
- Polysorbates/administration & dosage
- Polysorbates/adverse effects
- Recombinant Proteins/immunology
- Recombinant Proteins/metabolism
- SARS-CoV-2/immunology
- Spike Glycoprotein, Coronavirus/immunology
- Spike Glycoprotein, Coronavirus/metabolism
- Squalene/administration & dosage
- Squalene/adverse effects
- Nicotiana/metabolism
- Treatment Outcome
- Vaccination/methods
- Vaccines, Virus-Like Particle/administration & dosage
- Vaccines, Virus-Like Particle/adverse effects
- alpha-Tocopherol/administration & dosage
- alpha-Tocopherol/adverse effects
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Affiliation(s)
| | - Prabhu S Arunachalam
- Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Nadia Golden
- Tulane National Primate Research Center, Covington, LA, USA
| | - Jane Fontenot
- New Iberia Research Center, University of Louisiana at Lafayette, New Iberia, LA, USA
| | | | - Katharina Röltgen
- Department of Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | | | | | | | | | | | | | | | | | - Robert V Blair
- Tulane National Primate Research Center, Covington, LA, USA
| | - Scott D Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Rudolf P Bohm
- Tulane National Primate Research Center, Covington, LA, USA
| | - Jay Rappaport
- Tulane National Primate Research Center, Covington, LA, USA
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA
| | - François Villinger
- New Iberia Research Center, University of Louisiana at Lafayette, New Iberia, LA, USA
| | | | - Bali Pulendran
- Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
- Department of Pathology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
- Institute for Immunity, Transplantation & Infection, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Brian J Ward
- Medicago Inc., Québec, QC, Canada.
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
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12
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Rousta E, Oka A, Liu B, Herzog J, Bhatt AP, Wang J, Habibi Najafi MB, Sartor RB. The Emulsifier Carboxymethylcellulose Induces More Aggressive Colitis in Humanized Mice with Inflammatory Bowel Disease Microbiota Than Polysorbate-80. Nutrients 2021; 13:3565. [PMID: 34684567 PMCID: PMC8540676 DOI: 10.3390/nu13103565] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 09/01/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 12/11/2022] Open
Abstract
Commonly used synthetic dietary emulsifiers, including carboxymethylcellulose (CMC) and polysorbate-80 (P80), promote intestinal inflammation. We compared abilities of CMC vs. P80 to potentiate colitis and impact human microbiota in an inflammatory environment using a novel colitis model of ex-germ-free (GF) IL10-/- mice colonized by pooled fecal transplant from three patients with active inflammatory bowel diseases. After three days, mice received 1% CMC or P80 in drinking water or water alone for four weeks. Inflammation was quantified by serial fecal lipocalin 2 (Lcn-2) and after four weeks by blinded colonic histologic scores and colonic inflammatory cytokine gene expression. Microbiota profiles in cecal contents were determined by shotgun metagenomic sequencing. CMC treatment significantly increased fecal Lcn-2 levels compared to P80 and water treatment by one week and throughout the experiment. Likewise, CMC treatment increased histologic inflammatory scores and colonic inflammatory cytokine gene expression compared with P80 and water controls. The two emulsifiers differentially affected specific intestinal microbiota. CMC did not impact bacterial composition but significantly decreased Caudoviricetes (bacteriophages), while P80 exposure non-significantly increased the abundance of both Actinobacteria and Proteobacteria. Commonly used dietary emulsifiers have different abilities to induce colitis in humanized mice. CMC promotes more aggressive inflammation without changing bacterial composition.
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Affiliation(s)
- Esmat Rousta
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA; (E.R.); (A.O.); (B.L.); (J.H.); (A.P.B.)
- Department of Food Science and Technology, Faculty of Agriculture, Ferdowsi University of Mashhad, Mashhad 9177948974, Iran
| | - Akihiko Oka
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA; (E.R.); (A.O.); (B.L.); (J.H.); (A.P.B.)
- Department of Internal Medicine II, Faculty of Medicine, Shimane University, 89-1, Enya, Izumo, Shimane 693-8501, Japan
| | - Bo Liu
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA; (E.R.); (A.O.); (B.L.); (J.H.); (A.P.B.)
| | - Jeremy Herzog
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA; (E.R.); (A.O.); (B.L.); (J.H.); (A.P.B.)
| | - Aadra P. Bhatt
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA; (E.R.); (A.O.); (B.L.); (J.H.); (A.P.B.)
- Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA;
| | - Jeremy Wang
- Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA;
- Department of Genetics, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA
| | - Mohammad B. Habibi Najafi
- Department of Food Science and Technology, Faculty of Agriculture, Ferdowsi University of Mashhad, Mashhad 9177948974, Iran
| | - Ryan Balfour Sartor
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA; (E.R.); (A.O.); (B.L.); (J.H.); (A.P.B.)
- Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA;
- Department of Microbiology and Immunology, School of Medicine, University of North Carolina at Chapel Hill, 111 Mason Farm Road, Chapel Hill, NC 27599, USA
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13
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Pitlick MM, Park MA, Gonzalez-Estrada A, Chiarella SE. Biphasic anaphylaxis after first dose of messenger RNA coronavirus disease 2019 vaccine with positive polysorbate 80 skin testing result. Ann Allergy Asthma Immunol 2021; 127:498-499. [PMID: 34343674 PMCID: PMC8325373 DOI: 10.1016/j.anai.2021.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 12/26/2022]
Affiliation(s)
| | - Miguel A Park
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minnesota
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14
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Kim J, Kwak S, Park MS, Rhee CH, Yang GH, Lee J, Son WC, Kang WH. Safety verification for polysorbate 20, pharmaceutical excipient for intramuscular administration, in Sprague-Dawley rats and New Zealand White rabbits. PLoS One 2021; 16:e0256869. [PMID: 34449810 PMCID: PMC8396741 DOI: 10.1371/journal.pone.0256869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/17/2021] [Indexed: 11/19/2022] Open
Abstract
Human serum albumin (HSA) has been widely used as a pharmaceutical excipient in Botulinum toxin serotype A (BoNT/A) products that are indicated for use in therapeutics and cosmetics. However, HSA as a human-derived material has some concerns, such as the potential risk of transmission of infectious agents, an insufficient supply, and difficulty in maintaining a certain quality. For those reasons, newly developed BoNT/A products (CORETOX®, Medytox, Inc., Republic of Korea) contained polysorbate 20, a non-human-derived excipient, to replace the HSA. However, most safety studies of polysorbate 20 have been conducted with non-invasive routes of administration, and thus there are a few studies on the safety of polysorbate 20 when administered intramuscularly. To secure the in vivo safety profile of polysorbate 20, a four-week repeated intramuscular dose toxicity study (0.02, 0.1, and 0.4 mg/kg, one injection every two weeks for a total of three injections) was conducted in 66 Sprague-Dawley (SD) rats. An intradermal irritation study was further conducted with 18 New Zealand White (NZW) rabbits. The toxicological evaluation of HSA (0.06 and 0.12 mg/kg) was also carried out as a comparative substance. Systemic and local toxicities were not observed in any of the SD rats or NZW rabbits based on clinical signs, body weight, hematology, clinical biochemistry, macroscopic findings on necropsy, histopathology of the injection site, and allergic reactions. The current study suggested that intramuscular administration of polysorbate 20 was considered to be safe at a level similar to that of HSA, which has an in vivo safety profile accumulated over the years. This provided the basis for the in vivo safety profile of polysorbate 20 administered intramuscularly and the scientific reliability of the use of polysorbate 20 as an alternative to HSA, which is used as an excipient for various pharmaceuticals in terms of its safety.
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Affiliation(s)
- Junhyung Kim
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Gyeonggi-do, Korea
| | - Seongsung Kwak
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Gyeonggi-do, Korea
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Mi-Sun Park
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Gyeonggi-do, Korea
| | - Chang-Hoon Rhee
- Osong R&D Center, Medytox Inc., Cheongju-si, Chungcheongbuk-do, Korea
| | - Gi-Hyeok Yang
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Gyeonggi-do, Korea
| | - Jangmi Lee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
| | - Woo-Chan Son
- Department of Pathology, Asan Medical Center, Songpa-gu, Seoul, Korea
- * E-mail: (WhK); (WCS)
| | - Won-ho Kang
- Gwanggyo R&D Center, Medytox Inc., Suwon-si, Gyeonggi-do, Korea
- * E-mail: (WhK); (WCS)
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15
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Ganapathy Pillay S, Mohd Amin SDW, Masri SN, Joseph NM, Amran F, Van Belkum A, Amin Nordin S. Evaluation of Tween 80 incorporated media to increase pathogen isolation from peritoneal fluid of CAPD patients at Hospital Kuala Lumpur. Malays J Pathol 2021; 43:261-268. [PMID: 34448790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis remains a major complication in patients on CAPD leading to increased morbidity and mortality. Successful therapy of peritonitis is highly dependent on a positive microbiological culture because narrow spectrum antibiotics are essential to efficiently combat infection. Therefore, this study evaluated the performance of Tween 80 containing media at three different concentrations (0.1%, 1.0% and 2.0%) to increase the pathogen yield from peritoneal fluid in comparison with the standard culture media. MATERIALS AND METHODS Peritoneal fluid samples (n=121) obtained from CAPD patients suspected of peritonitis at Hospital Kuala Lumpur were analysed macroscopically and microscopically prior to culture. All samples were cultured on seven different culture media, including sheep blood agar, MacConkey agar, Sabouraud dextrose agar, brain heart infusion agar and Tween 80 incorporated blood agar. All plates were incubated at an optimum temperature up to 48 hours. RESULTS AND CONCLUSION Among all the culture media investigated, 0.1% to 2.0% Tween 80 incorporated blood agar yielded the highest positive culture (23/121) in comparison with all other standard media, thus lowering the negative culture rate among CAPD patients. Statistical analysis by Chi Square revealed significant differences (p <0.001) between the three concentrations of Tween 80 tested in this study. Among the three different concentrations of Tween 80 optimised in this study, blood agar containing 0.1% Tween 80 generated the best results, achieved by optimum growth of all Gram-positive organisms, Gram-negative organisms and yeast cells simultaneously. Using a small amount of detergent at low cost significantly increased the pathogen yield during CAPD-associated peritonitis.
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Affiliation(s)
- S Ganapathy Pillay
- Hospital Kuala Lumpur, Department of Pathology, Microbiology Unit, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - S D W Mohd Amin
- Hospital Kuala Lumpur, Department of Pathology, Microbiology Unit, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - S N Masri
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medical Microbiology, 43400, Serdang, Selangor, Malaysia
| | - N M Joseph
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medical Microbiology, 43400, Serdang, Selangor, Malaysia
| | - F Amran
- Institute for Medical Research, Infectious Disease Reseach Centre (IDRC), Bacteriology Unit, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - A Van Belkum
- bioMérieux, Open Innovation and Partnerships, 3 Route de Port Michaud, 38390 La Balme Les Grottes, France
| | - S Amin Nordin
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medical Microbiology, 43400, Serdang, Selangor, Malaysia.
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Cruz C, Gaspar Â, Borrego LM. Allergic Reactions to COVID-19 Vaccines: An Allergist's Perspective. ACTA MEDICA PORT 2021; 34:243. [PMID: 33547771 DOI: 10.20344/amp.15803] [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: 01/27/2021] [Revised: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Cíntia Cruz
- Immunoallergy Department. Hospital da Luz Lisboa. Lisbon. Portugal
| | - Ângela Gaspar
- Immunoallergy Department. Hospital da Luz Lisboa. Lisbon. Portugal
| | - Luís Miguel Borrego
- Immunoallergy Department. Hospital da Luz Lisboa. Lisbon. Chronic Diseases Research Center. NOVA Medical School. Nova University of Lisbon. Lisbon. Comprehensive Health Research Centre. NOVA Medical School. Nova University of Lisbon. Lisbon. Portugal
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Nishimura S, Aoi W, Kodani H, Kobayashi Y, Wada S, Kuwahata M, Higashi A. Polysorbate 80-induced leaky gut impairs skeletal muscle metabolism in mice. Physiol Rep 2020; 8:e14629. [PMID: 33113283 PMCID: PMC7592879 DOI: 10.14814/phy2.14629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022] Open
Abstract
Impaired intestinal permeability can induce systemic inflammation and metabolic disturbance. However, the effect of impaired intestinal permeability on metabolic function in the skeletal muscle is unknown. Dietary polysorbate 80 (PS80), a common emulsifier, has been shown to impair intestinal permeability in mice. Here, we investigated the effect of PS80-induced intestinal permeability on glucose tolerance with metabolic signaling in the skeletal muscle. Male ICR mice were divided into control and PS80 groups. In the PS80 group, PS80 was contained in the drinking water at 1% (w/v). After 4 weeks, plasma fluorescein isothiocyanate (FITC) intensity was measured after orally administering FITC-dextran. Half of the mice in each group underwent running exercises. Metabolic and inflammatory parameters were examined in the blood and skeletal muscle. Plasma FITC and lipopolysaccharide levels were higher in the PS80 group than the control group (p < .01, p = .085). The expression of tumor necrosis factor-α in the skeletal muscle was increased upon PS80 administration (p < .05). Although the homeostasis model assessment ratio was higher in the PS80-fed mice (p < .05), insulin-signaling activity in the muscle did not differ between groups. Muscular pH, mitochondrial cytochrome oxidase activity, and glycogen content after exercise were lower in the PS80 group (p < .05) than the control group. There was a negative correlation between plasma FITC and muscle glycogen levels in the exercised groups (r = -.60, p < .05). These results suggest that daily PS80 intake induces intestinal permeability, leading to glucose intolerance and mitochondrial dysfunction in the skeletal muscle.
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Affiliation(s)
- Saho Nishimura
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
- Division of Nutrition ManagementOsaka University HospitalOsakaJapan
| | - Wataru Aoi
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
| | - Hinako Kodani
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
| | - Yukiko Kobayashi
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
| | - Sayori Wada
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
| | - Masashi Kuwahata
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
| | - Akane Higashi
- Division of Applied Life SciencesGraduate School of Life and Environmental SciencesKyoto Prefectural UniversityKyotoJapan
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Sandall AM, Cox SR, Lindsay JO, Gewirtz AT, Chassaing B, Rossi M, Whelan K. Emulsifiers Impact Colonic Length in Mice and Emulsifier Restriction is Feasible in People with Crohn's Disease. Nutrients 2020; 12:nu12092827. [PMID: 32942699 PMCID: PMC7551245 DOI: 10.3390/nu12092827] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/04/2020] [Accepted: 09/11/2020] [Indexed: 12/13/2022] Open
Abstract
There is an association between food additive emulsifiers and the prevalence of Crohn’s disease. This study aimed to investigate: (i) the effect of different classes of emulsifiers on markers of intestinal inflammation in mice and (ii) the feasibility, nutritional adequacy and symptom impact of restricting all emulsifier classes in Crohn’s disease. Mice were exposed to different classes of emulsifiers (carboxymethycellose, polysorbate-80, soy lecithin, gum arabic) in drinking water for 12-weeks, after which markers of inflammation and metabolism were measured. A low emulsifier diet was developed to restrict all classes of emulsifiers and its feasibility measured over 14-days in 20 participants with stable Crohn’s disease. Crohn’s disease-related symptoms, disease control, body weight and composition, nutrient intake and food-related quality of life (QoL) were measured. All emulsifiers resulted in lower murine colonic length compared with control (mean 9.5 cm (SEM 0.20)), but this only reached significance for polysorbate-80 (8.2 cm (0.34), p = 0.024) and carboxymethylcellulose (8.0 cm (0.35), p = 0.013). All 20 participants completed the feasibility study. The frequency of consuming emulsifier-containing foods decreased by 94.6% (SD 10.3%). Food-related QoL improved between habitual (median 81.5 (IQR 25.0)) and low emulsifier diet (90.0 (24.0), p = 0.028). Crohn’s disease-related symptoms reduced (median 3.0 (IQR 5.3) vs. 1.4 (3.9), p = 0.006), and disease control scores improved (13.5 (IQR 6.0) vs. 15.5 (IQR 3.0), p = 0.026). A range of emulsifiers may influence intestinal inflammation in mice, and dietary restriction of emulsifiers is feasible. Trials investigating the efficacy of a low emulsifier diet in Crohn’s disease are warranted.
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Affiliation(s)
- Alicia M. Sandall
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK; (A.M.S.); (S.R.C.); (M.R.)
| | - Selina R. Cox
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK; (A.M.S.); (S.R.C.); (M.R.)
| | - James O. Lindsay
- Department of Gastroenterology, Barts Health NHS Trust, Royal London Hospital, London E1 1BB, UK;
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London E1 2AT, UK
| | - Andrew T. Gewirtz
- Centre for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA; (A.T.G.); (B.C.)
| | - Benoit Chassaing
- Centre for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA; (A.T.G.); (B.C.)
- Neuroscience Institute, Georgia State University, Atlanta, GA 30303, USA
- INSERM, U1016, Team “Mucosal microbiota in chronic inflammatory diseases”, 75006 Paris, France
- Université de Paris, 75006 Paris, France
| | - Megan Rossi
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK; (A.M.S.); (S.R.C.); (M.R.)
| | - Kevin Whelan
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 9NH, UK; (A.M.S.); (S.R.C.); (M.R.)
- Correspondence: ; Tel.: +44-(0)-207-848-3858
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19
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Stowe J, Andrews N, Gringras P, Quinnell T, Zaiwalla Z, Shneerson J, Miller E. Reassessment of the risk of narcolepsy in children in England 8 years after receipt of the AS03-adjuvanted H1N1 pandemic vaccine: A case-coverage study. PLoS Med 2020; 17:e1003225. [PMID: 32926731 PMCID: PMC7489954 DOI: 10.1371/journal.pmed.1003225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Early studies of narcolepsy after AS03-adjuvanted pandemic A/H1N12009 vaccine (Pandemrix) could not define the duration of elevated risk post-vaccination nor the risk in children aged under 5 years who may not present until much older. METHODS/FINDINGS Clinical information and sleep test results, extracted from hospital notes at 3 large pediatric sleep centers in England between September 2017 and June 2018 for narcolepsy cases aged 4-19 years with symptom onset since January 2009, were reviewed by an expert panel to confirm the diagnosis. Vaccination histories were independently obtained from general practitioners (GPs). The odds of vaccination in narcolepsy cases compared with the age-matched English population was calculated after adjustment for clinical conditions that were indications for vaccination. GP questionnaires were returned for 242 of the 244 children with confirmed narcolepsy. Of these 5 were under 5 years, 118 were 5-11 years, and 119 were 12-19 years old at diagnosis; 39 were vaccinated with Pandemrix before onset. The odds ratio (OR) for onset at any time after vaccination was 1.94 (95% confidence interval [CI] 1.30-2.89), The elevated risk period was restricted to onsets within 12 months of vaccination (OR 6.65 [3.44-12.85]) and was highest within the first 6 months. After one year, ORs were not significantly different from 1 up to 8 years after vaccination. The ORs were similar in under five-year-olds and older ages. The estimated attributable risk was 1 in 34,500 doses. Our study is limited by including cases from only 3 sleep centers, who may differ from cases diagnosed in nonparticipating centers, and by imprecision in defining the centers' catchment population. The potential for biased recall of onset shortly after vaccination in cases aware of the association cannot be excluded. CONCLUSIONS In this study, we found that vaccine-attributable cases have onset of narcolepsy within 12 months of Pandemrix vaccination. The attributable risk is higher than previously estimated in England because of identification of vaccine-attributable cases with late diagnoses. Absence of a compensatory drop in risk 1-8 years after vaccination suggests that Pandemrix does not trigger onsets in those in whom narcolepsy would have occurred later.
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Affiliation(s)
- Julia Stowe
- Immunisation and Countermeasures, Public Health England, London, England
- * E-mail:
| | - Nick Andrews
- Statistics and Modelling Economics Department, Public Health England, London, England
| | - Paul Gringras
- Evelina Children’s Hospital, Lambeth, London, England
| | - Timothy Quinnell
- Respiratory Support and Sleep Centre, Royal Papworth Hospital, Cambridge, England
| | | | | | - Elizabeth Miller
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, England
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Abstract
Due to the complexity and fragility of biological drug products, several challenges exist in their formulation development. Excipients are added to increase product stability, maintain tonicity, and facilitate drug delivery. The potential implications of these additive substances merit clinical consideration. We assessed the safety risk of excipients on the basis of their type and variability through an assessment framework, which quantifies excipient complexity in 230 biological formulations, and identifies excipient-related adverse events through published case reports. A biologic on average contained 4.45 excipients, half of that found in oral medications. The frequency distribution was heavily skewed towards the most commonly occurring excipients: water (40.4%), sodium chloride (38.3%), polysorbate 80 (28.7%), sucrose (24.4%), and mannitol (20.9%), with 44.4% of formulations not listing the concentration of the most commonly occurring inactive ingredients. A literature search revealed only 17 case reports of excipient-related adverse events, suggesting the need for more clarity for clinicians on the safety of chemical additives. These cases included injection site reactions, anaphylaxis, hyperglycemia, and acute renal failure. With the expansion of the biopharmaceutical market, it is important to consider the safety data of biologic excipients, so that therapy can be tailored appropriately for a specific patient.
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Affiliation(s)
- Yelena Ionova
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, California, United States of America
- * E-mail:
| | - Leslie Wilson
- Departments of Medicine and Pharmacy, University of California, San Francisco, California, United States of America
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21
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Panatto D, Haag M, Lai PL, Tomczyk S, Amicizia D, Lino MM. Enhanced Passive Safety Surveillance (EPSS) confirms an optimal safety profile of the use of MF59 ® -adjuvanted influenza vaccine in older adults: Results from three consecutive seasons. Influenza Other Respir Viruses 2020; 14:61-66. [PMID: 31617965 PMCID: PMC6928029 DOI: 10.1111/irv.12685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/06/2019] [Accepted: 09/18/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In Europe, the enhanced safety surveillance (ESS) of seasonal influenza vaccines is mandatory, in order to detect any potential increase in reactogenicity when the vaccine composition is updated. The MF59® -adjuvanted influenza vaccine (Fluad™) is the first and the only licensed adjuvanted seasonal influenza vaccine in Europe. OBJECTIVE Our objective was to summarize the safety data of Fluad™ over three consecutive seasons. METHODS A passive approach to ESS (EPSS) was adopted, in which reporting of spontaneous adverse events (AEs) by vaccinees and vaccine exposure was estimated, in order to generate a near real-time reporting rate. EPSS was conducted in Italy during the 2015, 2016, and 2017 influenza seasons in the primary care setting. All AEs reported within 7 days following immunization were analyzed by season, type and seriousness. Fisher's exact test was used to compare frequencies between seasons. RESULTS Total exposure accounted for approximately 1,000 doses of Fluad™ for each season. A total of 0.5% (2015), 0.7% (2016), and 0.5% (2017) individual case safety reports (ICSRs) were received, corresponding to a total of 9 (2015), 18 (2016), and 12 (2017) spontaneous AEs. The frequencies of AEs of interest were below those expected on the basis of the known safety profile of the vaccine. Most AEs were mild-to-moderate in severity. No between-season difference was found. CONCLUSIONS Our analyses confirmed that the safety data observed were consistent with the known safety profile of Fluad™, which has been amply established over the last 20 years. No significant changes in the safety profile were observed.
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Affiliation(s)
- Donatella Panatto
- Department of Health SciencesUniversity of GenoaGenoaItaly
- Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI‐IT)GenoaItaly
| | - Mendel Haag
- Clinical DevelopmentSeqirus Netherlands B.V.Amsterdamthe Netherlands
| | - Piero Luigi Lai
- Department of Health SciencesUniversity of GenoaGenoaItaly
- Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI‐IT)GenoaItaly
| | | | - Daniela Amicizia
- Department of Health SciencesUniversity of GenoaGenoaItaly
- Interuniversity Research Center on Influenza and other Transmissible Infections (CIRI‐IT)GenoaItaly
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22
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Lock JY, Carlson TL, Wang CM, Chen A, Carrier RL. Acute Exposure to Commonly Ingested Emulsifiers Alters Intestinal Mucus Structure and Transport Properties. Sci Rep 2018; 8:10008. [PMID: 29968743 PMCID: PMC6030187 DOI: 10.1038/s41598-018-27957-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/07/2018] [Indexed: 01/13/2023] Open
Abstract
The consumption of generally regarded as safe emulsifiers has increased, and has been associated with an increased prevalence of inflammatory bowel and metabolic diseases, as well as an altered microbiome. The mucus barrier, which selectively controls the transport of particulates and microorganisms to the underlying epithelial layer, has been previously shown to be altered by dietary salts and lipids. However, the potential impact of emulsifiers on the protective mucus barrier, its permeability, and associated structural changes are not clear. In this study, we analyzed changes in the mucus barrier to both passively diffusing nanoparticles and actively swimming E. coli upon exposure to two emulsifiers, carboxymethylcellulose (CMC) and polysorbate 80 (Tween). When exposed to CMC, mucus pore size decreased, which resulted in significantly slower E. coli speed and particle diffusion rates through mucus. Tween exposure minimally impacted mucus microstructure and particle diffusion, but increased E. coli speed in mucus. Moreover, both emulsifiers appeared to alter mucus amount and thickness in rat intestinal tissue and mucus-producing cell cultures. These results indicate that acute exposure to emulsifiers impacts barrier and structural properties of intestinal mucus, modulating interactions between intestinal lumen contents, microbes, and underlying tissue, which may contribute to development of intestinal inflammation.
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Affiliation(s)
- Jaclyn Y Lock
- Department of Bioengineering, Northeastern University, Boston, Massachusetts, 02115, USA
| | - Taylor L Carlson
- Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, 02115, USA
| | - Chia-Ming Wang
- Department of Bioengineering, Northeastern University, Boston, Massachusetts, 02115, USA
| | - Albert Chen
- Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, 02115, USA
| | - Rebecca L Carrier
- Department of Bioengineering, Northeastern University, Boston, Massachusetts, 02115, USA.
- Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, 02115, USA.
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23
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Yuan Z, Li Y, Hu Y, You J, Higashisaka K, Nagano K, Tsutsumi Y, Gao J. Chitosan nanoparticles and their Tween 80 modified counterparts disrupt the developmental profile of zebrafish embryos. Int J Pharm 2016; 515:644-656. [PMID: 27826026 DOI: 10.1016/j.ijpharm.2016.10.071] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 09/05/2016] [Revised: 10/11/2016] [Accepted: 10/28/2016] [Indexed: 01/14/2023]
Abstract
Chitosan nanoparticles (CS-NPs) and their Tween 80 modified counterparts (TmCS-NPs) are among the most commonly used brain-targeted vehicles. However, their potential developmental toxicity is poorly understood. In this study, zebrafish embryos are introduced as an in vivo platform. Both NPs showed a dose-dependent increase in developmental toxicity (decreased hatching rate, increased mortality and incidences of malformation). Neurobehavioral changes included decreased spontaneous movement in TmCS-NP treated embryos and hyperactive effect in CS-NP treated larvae. Both NPs remarkably inhibited axonal development of primary and secondary motor neurons, and affected the muscle structure. Overall, this study demonstrated that CS-NPs and TmCS-NPs could affect embryonic development, disrupt neurobehavior of zebrafish larvae and affect muscle and neuron development, suggesting more attention on biodegradable chitosan nanoparticles.
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Affiliation(s)
- Zhongyue Yuan
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, PR China, PR China
| | - Ying Li
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, PR China, PR China
| | - Yulan Hu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, PR China, PR China
| | - Jian You
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, PR China, PR China
| | - Kazuma Higashisaka
- Department of Toxicology and Safety Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
| | - Kazuya Nagano
- Department of Toxicology and Safety Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
| | - Yasuo Tsutsumi
- Department of Toxicology and Safety Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
| | - Jianqing Gao
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, PR China, PR China.
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Vaughn DW, Seifert H, Hepburn A, Dewe W, Li P, Drame M, Cohet C, Innis BL, Fries LF. Safety of AS03-adjuvanted inactivated split virion A(H1N1)pdm09 and H5N1 influenza virus vaccines administered to adults: pooled analysis of 28 clinical trials. Hum Vaccin Immunother 2014; 10:2942-57. [PMID: 25483467 PMCID: PMC5443104 DOI: 10.4161/21645515.2014.972149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/15/2014] [Accepted: 07/25/2014] [Indexed: 11/23/2022] Open
Abstract
Clinical trials have shown that AS03-adjuvanted H5N1 and A(H1N1)pdm09 vaccines are highly immunogenic, although with an increased reactogenicity profile relative to non-adjuvanted vaccines in terms of the incidence of common injection site and systemic adverse events (AEs). We evaluated pooled safety data from 22,521 adults who had received an AS03-adjuvanted H5N1 or A(H1N1)pdm09 influenza or control vaccine with the purpose to identify medically-attended AEs (MAEs), including subsets of serious AEs (SAEs), potentially immune-mediated diseases (pIMDs), and AEs of special interest (AESI), and to explore a potential association of these AEs with the administration of an AS03-adjuvanted influenza vaccine. For participants who had received an AS03-adjuvanted vaccine, the relative risks (RRs) for experiencing a MAE or a SAE compared to control group (participants who had received a non-adjuvanted vaccine or saline placebo) were 1.0 (95% confidence interval [CI]: 0.9; 1.1) and 1.1 (95% CI: 0.9; 1.4), respectively. The overall RRs for experiencing an AESI or a pIMD (AS03-adjuvanted vaccine/control) were 1.2 (95% CI: 0.9; 1.6) and 1.7 (95% CI: 0.8; 3.8), respectively. Thirty-8 participants in the AS03-adjuvanted vaccine group had a pIMD reported after vaccine administration, yielding an incidence rate (IR) of 351.9 (95% CI: 249.1; 483.1) per 100,000 person-years. The estimated IRs in the AS03-adjuvanted vaccine group were greater than the literature reported rates for: facial paresis/VIIth nerve paralysis, celiac disease, thrombocytopenia and ulcerative colitis. These results do not support an association between AS03-adjuvanted H5N1 and A(H1N1)pdm09 vaccines and the AEs collected in the trials included in the analysis.
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Affiliation(s)
| | | | | | | | - Ping Li
- GlaxoSmithKline Vaccines; King of Prussia, PA USA
| | | | | | | | - Louis F Fries
- GlaxoSmithKline Biologicals; Columbia, MD USA
- Current affiliation: Novavax, Inc.; Rockville, MD USA
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25
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Montplaisir J, Petit D, Quinn MJ, Ouakki M, Deceuninck G, Desautels A, Mignot E, De Wals P. Risk of narcolepsy associated with inactivated adjuvanted (AS03) A/H1N1 (2009) pandemic influenza vaccine in Quebec. PLoS One 2014; 9:e108489. [PMID: 25264897 PMCID: PMC4180737 DOI: 10.1371/journal.pone.0108489] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 08/11/2014] [Indexed: 11/27/2022] Open
Abstract
Context An association between an adjuvanted (AS03) A/H1N1 pandemic vaccine and narcolepsy has been reported in Europe. Objective To assess narcolepsy risk following administration of a similar vaccine in Quebec. Design Retrospective population-based study. Setting Neurologists and lung specialists in the province were invited to report narcolepsy cases to a single reference centre. Population Patients were interviewed by two sleep experts and standard diagnostic tests were performed. Immunization status was verified in the provincial pandemic influenza vaccination registry. Main Outcome Measures Confirmed narcolepsy with or without cataplexy with onset of excessive daytime sleepiness between January 1st, 2009, and December 31st, 2010. Relative risks (RRs) were calculated using a Poisson model in a cohort analysis, by a self-controlled case series (SCCS) and a case-control method. Results A total of 24 cases were included and overall incidence rate was 1.5 per million person-years. A cluster of 7 cases was observed among vaccinated persons in the winter 2009–2010. In the primary cohort analysis, 16-week post-vaccination RR was 4.32 (95% CI: 1.50–11.12). RR was 2.07 (0.70–6.17) in the SCCS, and 1.48 (0.37–7.03) using the case-control method. Estimates were lower when observation was restricted to the period of pandemic influenza circulation, and tended to be higher in persons <20 years old and for cataplexy cases. Conclusions Results are compatible with an excess risk of approximately one case per million vaccine doses, mainly in persons less than 20 years of age. However, a confounding effect of the influenza infection cannot be ruled out.
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Affiliation(s)
- Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur, and Department of Psychiatry, University of Montreal, Montreal, Canada
| | - Dominique Petit
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur, Montreal, Canada
| | - Marie-Josée Quinn
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur, Montreal, Canada
| | - Manale Ouakki
- Quebec National Public Health Institute (Institut national de santé publique du Québec), Quebec City, Canada
| | | | - Alex Desautels
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur, and Department of Medicine, University of Montreal, Montreal, Canada
| | - Emmanuel Mignot
- Stanford Center for Sleep Sciences and Medicine, Stanford University of Medicine, Palo Alto, CA, United States of America
| | - Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, Quebec City, Canada
- * E-mail:
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26
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Bruun Laursen A. [Catastrophic consequences of Pandemrix swine flu vaccine containing squalene]. Ugeskr Laeger 2013; 175:1447. [PMID: 23833781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Bulcão RP, de Freitas FA, Dallegrave E, Venturini CG, Baierle M, Durgante J, Sauer E, Cassini C, Cerski CT, Zielinsky P, Salvador M, Pohlmann AR, Guterres SS, Garcia SC. In vivo toxicological evaluation of polymeric nanocapsules after intradermal administration. Eur J Pharm Biopharm 2013; 86:167-77. [PMID: 23643792 DOI: 10.1016/j.ejpb.2013.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [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: 09/11/2012] [Revised: 03/14/2013] [Accepted: 04/05/2013] [Indexed: 12/11/2022]
Abstract
Polymeric nanocarriers have shown great promise as delivery systems. An alternative strategy has been to explore new delivery routes, such as intradermal (i.d.), that can be used for vaccines and patch-based drug delivery. Despite their many advantages, there are few toxicity studies, especially in vivo. We report a safety assessment of biodegradable poly(ɛ-caprolactone) lipid-core nanocapsules (LNC) with a mean size of 245±10nm following single and repeated intradermal injections to Wistar rats. Suspensions were prepared by interfacial deposition of polymer. The animals (n=6/group) received a single-dose of saline solution (1.2ml/kg) or LNC (7.2×10(12)LNC/kg), or repeated-doses of two controls, saline solution or Tween 80 (0.9ml/kg), or three different concentrations of LNC (1.8, 3.6, and 5.4×10(12)LNC/kg) for 28 consecutive days. Clinical and physiological signs and mortality were observed. Samples of urine, blood, and tissue were used to perform toxicological evaluation. There were no clinical signs of toxicity or mortality, but there was a slight decrease in the relative body weights in the Tween 80-treated group (p<0.01) after repeated administration. No histopathological alterations were observed in tissues or significant changes in blood and urinary biomarkers for tissue damage. Mild alterations in white blood cells count with increases in granulocytes in the Tween-80 group (p<0.05) were found. Genotoxicity was evaluated through the comet assay, and no statistical difference was observed among the groups. Therefore, we conclude that, under the conditions of these experiments, biodegradable LNC did not present appreciable toxicity after 28 consecutive days of intradermal administration and is promising for its future application in vaccines and patch-based devices for enhancing the delivery of drugs.
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Affiliation(s)
- Rachel P Bulcão
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil; Laboratório de Toxicologia (LATOX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando A de Freitas
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil; Laboratório de Toxicologia (LATOX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Eliane Dallegrave
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Cristina G Venturini
- Departamento de Produção e Controle de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marília Baierle
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil; Laboratório de Toxicologia (LATOX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliano Durgante
- Laboratório de Toxicologia (LATOX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Elisa Sauer
- Laboratório de Toxicologia (LATOX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | - Carina Cassini
- Instituto de Biotecnologia, Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | - Carlos T Cerski
- Departamento de Patologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Paulo Zielinsky
- Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, Brazil
| | - Mirian Salvador
- Instituto de Biotecnologia, Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | - Adriana R Pohlmann
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil; Departamento de Química Orgânica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sílvia S Guterres
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil; Departamento de Produção e Controle de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Solange C Garcia
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Brazil; Laboratório de Toxicologia (LATOX), Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Reynales H, Astudillo P, de Vallière S, Hatz C, Schlagenhauf P, Rath B, Velentgas P, Fariña A, Sales-Carmona V, Groth N. A prospective observational safety study on MF59(®) adjuvanted cell culture-derived vaccine, Celtura(®) during the A/H1N1 (2009) influenza pandemic. Vaccine 2012; 30:6436-43. [PMID: 22902681 DOI: 10.1016/j.vaccine.2012.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 07/27/2012] [Accepted: 08/02/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND The present study was a prospective observational study to evaluate the safety profile of Celtura(®), a monovalent, cell culture-derived, inactivated subunit influenza vaccine prepared from A/California/07/2009(H1N1) with the adjuvant MF59(®). Subjects were enrolled prospectively during the H1N1 2009 influenza pandemic at medical centres in Colombia, Chile, Switzerland, and Germany during the period December 2009 to June 2010. METHODS Subjects ages 18 and older were followed for the occurrence of adverse events (AEs) for six months after vaccination. Adverse events of special interest (AESIs) were neuritis, convulsion (seizure), anaphylaxis, encephalitis, vasculitis, Guillain-Barre syndrome, demyelinating conditions, Bell's palsy, and laboratory-confirmed vaccination failure. RESULTS Overall, 7348 AEs were reported in 2296 of 3989 enrolled subjects (57.6%). Only two AEs were considered related to injection site reactions. No laboratory-confirmed cases of influenza were reported. There were 108 medically confirmed serious adverse events (SAEs) reported among 73 subjects with 6 such SAEs described as possibly or probably related to vaccination. Three fatal cases were reported and assessed as not related to vaccination. Two AESIs classified as convulsion were reported and assessed as not related to vaccination. Both AESIs occurred well outside the pre-specified 7 day risk window representing the likely timeframe of the occurrence of seizure following vaccination. CONCLUSIONS The results of this study support the overall good safety profile of MF59 adjuvanted cell culture-derived influenza vaccine as administered in adults during the 2009-2010 H1N1 influenza pandemic. No concern is raised regarding the occurrence of AESIs.
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Affiliation(s)
- Humberto Reynales
- Centro de Atención e Investigación Médica (CAIMED), Bogotá, Colombia.
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Dell'Era L, Corona F, Daleno C, Scala A, Principi N, Esposito S. Immunogenicity, safety and tolerability of MF59-adjuvanted seasonal influenza vaccine in children with juvenile idiopathic arthritis. Vaccine 2011; 30:936-40. [PMID: 22138210 DOI: 10.1016/j.vaccine.2011.11.083] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Revised: 11/01/2011] [Accepted: 11/21/2011] [Indexed: 12/22/2022]
Abstract
In order to evaluate the immunogenicity, safety, and tolerability of the MF-59 adjuvanted seasonal influenza vaccine in children and adolescents with juvenile idiopathic arthritis (JIA) treated with different anti-rheumatic drugs, 60 pediatric patients with JIA (30 treated with disease-modifying anti-rheumatic drugs [DMARDs] and 30 with etanercept) were compared with 30 healthy controls of similar gender and age. All of the patients received a single dose of the MF59-adjuvanted seasonal influenza vaccine (Fluad, Siena, Italy). Immunogenicity was assessed at baseline, and 1 and 3 months post-vaccination; safety and tolerability were also evaluated during the study period. The JIA patients treated with etanercept showed significantly lower geometric mean titres (GMTs) against the A/H1N1 strain than those treated with DMARDs (p<0.05) and the healthy controls (p<0.05), who had similar GMTs. The etanercept-treated JIA patients also showed a significant reduction in GMTs against the A/H1N1 and A/H3N2 strains from 1 to 3 months after vaccination (p<0.05). Furthermore, their seroconversion and seroprotection rates, and B antigen GMTs, were all significantly lower than those of the subjects in the other two groups (p<0.05). The safety and tolerability of the vaccine were good and similar between the groups. The results of this study indicate a reduced immune response to MF59-adjuvanted seasonal influenza vaccine in JIA children and adolescents treated with etanercept in comparison with those treated with DMARDs and healthy controls. The safety and tolerability of the vaccine appeared to be good in all of the study population.
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Affiliation(s)
- Laura Dell'Era
- Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy
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30
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Zuccotti GV, Pariani E, Scaramuzza A, Santoro L, Giani E, Macedoni M, Gazzarri A, Anselmi G, Amendola A, Zanetti A. Long-lasting immunogenicity and safety of a 2009 pandemic influenza A(H1N1) MF59-adjuvanted vaccine when co-administered with a 2009-2010 seasonal influenza vaccine in young patients with type 1 diabetes mellitus. Diabet Med 2011; 28:1530-6. [PMID: 21916971 DOI: 10.1111/j.1464-5491.2011.03449.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the long-lasting immunogenicity and safety of a pandemic vaccine co-administered with a seasonal influenza vaccine in young subjects with Type 1 diabetes. METHODS Eighty patients (mean age: 16.7 ± 5.5 years, disease duration: 10.2 ± 4.7 years) were randomly assigned to receive a single or a double dose (1 month apart) of MF59-adjuvanted influenza A(H1N1) vaccine, simultaneously with a single dose of a virosome-adjuvanted trivalent influenza vaccine for the 2009-2010 season. RESULTS One month after immunization, the rate of seroconversion to 2009 pandemic A(H1N1) was 92.5% with an overall 100% proportion of vaccinees with protective antibody titres (≥ 1:40). No significant differences were observed between vaccinees who received the one-dose or the two-dose schedule. Seasonal vaccine induced a significant increase of both seroprotection rates and antibody levels. Local adverse events at the injection site of pandemic and seasonal vaccines were reported by 66.3% and 50% of subjects, respectively. Solicited systemic adverse events, mainly mild in intensity, were reported by 26.7% of vaccinees. No subjects had an influenza-like illness during the 6-month follow-up. CONCLUSIONS One injection of 2009 pandemic influenza A(H1N1) MF59-adjuvanted vaccine is immunogenic and safe in young patients with Type 1 diabetes who are at increased risk of influenza morbidities. Pandemic vaccine can be safely co-administered with seasonal influenza vaccine.
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Affiliation(s)
- G V Zuccotti
- Department of Paediatrics, Università degli Studi di Milano, Ospedale Luigi Sacco, Milan, Italy
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Vesikari T, Knuf M, Wutzler P, Karvonen A, Kieninger-Baum D, Schmitt HJ, Baehner F, Borkowski A, Tsai TF, Clemens R. Oil-in-water emulsion adjuvant with influenza vaccine in young children. N Engl J Med 2011; 365:1406-16. [PMID: 21995388 DOI: 10.1056/nejmoa1010331] [Citation(s) in RCA: 223] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The efficacy of inactivated influenza vaccines is known to be poor in infants and young children. METHODS We studied the effect of the adjuvant MF59, an oil-in-water emulsion, on the efficacy of trivalent inactivated influenza vaccine (TIV) in 4707 healthy children 6 to less than 72 months of age who had not previously been vaccinated against influenza. The children were randomly assigned to three study groups, each of which received the assigned vaccines in two doses, 28 days apart, during two consecutive influenza seasons. Two of the groups were given age-appropriate doses of TIV either with or without the MF59 adjuvant, and the third group was given control (noninfluenza) vaccines to assess their absolute and relative efficacy against influenza-like illness, as confirmed by means of polymerase-chain-reaction (PCR) assay. RESULTS Attack rates of influenza-like illness across both influenza seasons were 0.7%, 2.8%, and 4.7% in the adjuvant, nonadjuvant, and control vaccine groups, respectively. The absolute vaccine efficacy rates against all influenza strains (94 of 110 cases were due to vaccine-matched H3N2 viruses) were 86% (95% confidence interval [CI], 74 to 93) for the MF59-adjuvant vaccine (ATIV) and 43% (95% CI, 15 to 61) for the vaccine without the adjuvant (TIV); the relative vaccine efficacy rate for ATIV versus TIV was 75% (95% CI, 55 to 87). The efficacy rates for ATIV were 79% (95% CI, 55 to 90) in children 6 to less than 36 months of age and 92% (95% CI, 77 to 97) in those 36 to less than 72 months of age, as compared with 40% (95% CI, -6 to 66) and 45% (95% CI, 6 to 68), respectively, for TIV. Antibody responses were higher with ATIV and remained so through day 181. The rates of systemic and local reactions to the influenza vaccines with and without the adjuvant were similar in the younger age group (relative risk, 1.04; 95% CI, 0.98 to 1.09), but systemic events in the older age group were more frequent after administration of ATIV (63%) than after administration of TIV (44%) or the control vaccine (50%). Serious adverse events were distributed evenly across the three vaccine groups. CONCLUSIONS Influenza vaccine with the MF59 adjuvant is efficacious against PCR-confirmed influenza in infants and young children. (Funded by Novartis Vaccines and Diagnostics; ClinicalTrials.gov number, NCT00644059.).
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Affiliation(s)
- Timo Vesikari
- University of Tampere Medical School, Tampere, Finland.
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Sun W, Li Y, Wang N, Du F, Hao W, Zhao L. [Anaphylactoid reactions induced by polysorbate 80 on Beagle dogs]. Zhongguo Zhong Yao Za Zhi 2011; 36:1874-1878. [PMID: 22016951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the sensitization effect of polysorbate 80 from different factories on Beagle dogs. METHOD Beagles dogs were randomly divided into 5 groups, 3 in each group, received respectively the intravenous infusion of polysorbate 80 made by four factories in the concentration of 0.5%, with the constant infusing speed of 5 mL x min(-1) and volume of 10 mL x kg(-1). Changes were observed before infusion and in the 24 h after infusion, time of symptom appearance and disappearance was recorded, and the grade of response was determined. Moreover, blood pressure and heart rates were tested by the machine of Bp-98E, blood samples of animals were collected before infusion and at 10 min after ending infusion for measuring histamine content in plasma using ELISA. Then the sensitization effect was comprehensively estimated by combined consideration of the responding grade and histamine level. RESULT Typical symptoms of anaphylactoid reactions were found in sample 3 group, atypical symptoms were found in other polysorbate 80 groups. Different degrees of heart rate speeding and blood pressure downing were found in polysorbate 80 groups. No over 1-fold increase of plasma histamine level was found in all groups. The atypical anaphylactoid reactions and blood pressure of sample 2 group was lighter than other polysorbate 80 groups. Estimation showed that the sample 3 induced the suspicious anaphylactoid reactions, other test solutions did not induce the typical anaphylactoid reactions on Beagle dogs. CONCLUSION For allergies and other special populations, there is still a certain risk to applicate polysorbate 80 in the concentration of 0.5%. Production process of polysorbate 80 have a certain influence on allergenicity, refined polysorbate 80 increase the security, but further reasearchs are needed to confirmed.
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Affiliation(s)
- Weiwei Sun
- Department of Gynecology, Guang' anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
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Guo Y, Li Y, Wu C, Zhao Y, Li Y, Liu X, Wang N, Huang W. [Study on anaphylaxis and hemocytolysis of 6 kinds of tween-80 injection from different souce]. Zhongguo Zhong Yao Za Zhi 2011; 36:1879-1883. [PMID: 22016952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To observe the anaphylaxis and hemocytolysis of 6 kinds of tween-80 injection from different source. METHOD The Hartley albinism guinea pig was used to carry on the active systematic anaphylaxis (ASA) and the passive cutaneous anaphylaxis (PCA). The in vitro hemolytic experiment and the hemocytolysis was observed by means of spectrophotometry on the domestic rabbit. RESULT The result of ASA and PLA of 6 kinds of tween-80 injection from different source assumed the negative. In observation time, the temolysis rate of 3 kinds of tween-80 injection are more than 5%, while the others are also more than 5% only in the highly concentrated test tube. CONCLUSION Six kinds of tween-80 injection from different source have not caused the immune-mediated anaphylaxis, but it may have hematolysis tendency on intravenous injection. The hemocytolysis of tween-80 may not be entirely caused by the impurities. It is worthy of further study that the physical and chemical properties of the product itself and the undeserved concentration is doubtful whether there is also some internal relations with the generation of hemolytic.
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Affiliation(s)
- Yan Guo
- College of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China
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34
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Zhang M. [Advance of polysorbate 80 for injection accessories]. Zhongguo Zhong Yao Za Zhi 2011; 36:1910-1915. [PMID: 22016958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Polysorbate 80 for injection accessories is one of the main reactions of clinical adverse to which may be leaded by a variety of traditional Chinese medicine injection. In this review, on the basis of literature research and experimental studies, polysorbate 80 are summarized in areas which conclude the chemical structure, basic nature,quality standards, pharmacological activity, safety evaluation and toxicity studies. The review aimed to provide theoretical basis for the rational selections of Chinese medicine, safe and efficient usages of injection accessories, and to promote healthy development of traditional Chinese medicine injections.
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Affiliation(s)
- Meiyu Zhang
- Experimental Research Center, China Academy of Chinese Medial Sciences, Beijing 100091, China.
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Pérez-Pérez L, García-Gavín J, Piñeiro B, Zulaica A. Biologic-induced urticaria due to polysorbate 80: usefulness of prick test. Br J Dermatol 2011; 164:1119-20. [PMID: 21219296 DOI: 10.1111/j.1365-2133.2011.10220.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kozlov VG, Viktorova EG. [Evaluation of the efficiency and reactogenicity of emulsion-based adjuvant systems in the manufacture of polyclonal enteroviral diagnostic sera]. Vopr Virusol 2011; 56:41-46. [PMID: 21545042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Whether various adjuvants might be used in the manufacture of commercial enteroviral diagnostic sera (EDS) was studied. The following adjuvants: Ribi, SAF-1, and TiterMax were compared; vaseline-lanoline emulsion used to prepare EDSs, as well as modified Freund's complete adjuvant served as controls. Chinchilla rabbits were intramuscularly injected enterovirus antigens (enterovirus 70 and ECHO 2) together with the adjuvant emulsions. TiterMax showed the highest efficiency comparable with the activity of Freund's adjuvant. The activities of Ribi, SAF-1, and vaseline-lanoline emulsion were 3-4 times lower. The neutralizing activity of the sera obtained after 2-3 (TiterMax) or 4-5 (Ribi, SAF-1) immunizations was maximal. Further immunizations resulted in a reduction in the titers of neutralizing antibodies. TiterMax and vaseline-lanoline emulsion caused minimal complications at the site of inoculation whereas SAF-1 and Ribi gave rise to severer inflammatory responses.
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Sun WW, Li YK, Zhang JY. [Anaphylactoid reactions inducing effect of polysorbate 80 and polysorbate 80 contained Houttuynia cordata injection on beagle]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2011; 31:90-93. [PMID: 21434352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the sensitization effect of polysorbate 80 and polysorbate 80 contained Houttuynia cordata Injection in different concentrations on Beagle. METHODS Beagles, a kind of animal highly sensitive to sensitizing agents, were randomly divided into 18 groups, 3 in each group. They received respectively the intravenous infusion of polysorbate 80 made by different factories in different concentrations (0.25%, 0.10%, 0.05%), and Houttuynia cordata Injection containing polysorbate 80 in concentration of 0.25% or 0.30%, with the constant infusing speed of 5 mL/min and volume of 10 mL/kg. Changes of animals' condition were observed before infusion and in the 24 h after infusion, time of symptom appearance and disappearance was recorded, and the grade of response was determined. Moreover, blood samples of animals were collected before infusion and 10 min after ending infusion for measuring histamine content in plasma using ELISA. Then the sensitization effect was comprehensively estimated by combined consideration of the responding grade and histamine level. RESULTS No typical symptom of anaphylactoid reaction and over 1-fold increase of histamine level was found in all groups that received intravenous infusion of polysorbate 80 or polysorbate 80 contained Houttuynia cordata Injection in different concentrations. Estimation showed that all test solutions didn't induce typical anaphylactoid reaction on Beagle. CONCLUSIONS Considering both the appearance of symptoms and the elevation of blood content of histamine could be taken as the criteria for comprehensive diagnosis of anaphylactoid reactions. The solubilization effect and safety (for foreclose anaphylactoid reaction) of polysorbate 80 could be ensured by controlling its quality and concentration below 0.25% or 0.30%.
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Affiliation(s)
- Wei-wei Sun
- School of Preclinical Medicine, University of Chinese Medicine, Beijing
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Waddington CS, Walker WT, Oeser C, Reiner A, John T, Wilkins S, Casey M, Eccleston PE, Allen RJ, Okike I, Ladhani S, Sheasby E, Hoschler K, Andrews N, Waight P, Collinson AC, Heath PT, Finn A, Faust SN, Snape MD, Miller E, Pollard AJ. Safety and immunogenicity of AS03B adjuvanted split virion versus non-adjuvanted whole virion H1N1 influenza vaccine in UK children aged 6 months-12 years: open label, randomised, parallel group, multicentre study. BMJ 2010; 340:c2649. [PMID: 20508026 PMCID: PMC2877808 DOI: 10.1136/bmj.c2649] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To compare the safety, reactogenicity, and immunogenicity of an adjuvanted split virion H1N1 vaccine and a non-adjuvanted whole virion vaccine used in the pandemic immunisation programme in the United Kingdom. DESIGN Open label, randomised, parallel group, phase II study. SETTING Five UK centres (Oxford, Southampton, Bristol, Exeter, and London). PARTICIPANTS Children aged 6 months to less than 13 years for whom a parent or guardian had provided written informed consent and who were able to comply with study procedures were eligible. Those with laboratory confirmed pandemic H1N1 influenza or clinically diagnosed disease meriting antiviral treatment, allergy to egg or any other vaccine components, or coagulation defects, or who were severely immunocompromised or had recently received blood products were excluded. Children were grouped by age: 6 months-<3 years (younger group) and 3-<13 years (older group). Recruitment was by media advertising and direct mailing. Recruitment visits were attended by 949 participants, of whom 943 were enrolled and 937 included in the per protocol analysis. INTERVENTIONS Participants were randomised 1:1 to receive AS03(B) (tocopherol based oil in water emulsion) adjuvanted split virion vaccine derived from egg culture or non-adjuvanted whole virion vaccine derived from cell culture. Both were given as two doses 21 days apart. Reactogenicity data were collected for one week after immunisation by diary card. Serum samples were collected at baseline and after the second dose. MAIN OUTCOME MEASURES Primary reactogenicity end points were frequency and severity of fever, tenderness, swelling, and erythema after vaccination. Immunogenicity was measured by microneutralisation and haemagglutination inhibition assays. The primary immunogenicity objective was a comparison between vaccines of the percentage of participants showing seroconversion by the microneutralisation assay (fourfold rise to a titre of >or=1:40 from before vaccination to three weeks after the second dose). RESULTS Seroconversion rates were higher after the adjuvanted split virion vaccine than after the whole virion vaccine, most notably in the youngest children (163 of 166 participants with paired serum samples (98.2%, 95% confidence interval 94.8% to 99.6%) v 157 of 196 (80.1%, 73.8% to 85.5%), P<0.001) in children under 3 years and 226 of 228 (99.1%, 96.9% to 99.9%) v 95.9%, 92.4% to 98.1%, P=0.03) in those over 3 years). The adjuvanted split virion vaccine was more reactogenic than the whole virion vaccine, with more frequent systemic reactions and severe local reactions in children aged over 5 years after dose one (13 (7.2%, 3.9% to 12%) v 2 (1.1%, 0.1% to 3.9%), P<0.001) and dose two (15 (8.5%, 4.8% to 13.7%) v 2 (1.1%, 0.1% to 4.1%), P<0.002) and after dose two in those under 5 years (15 (5.9%, 3.3% to 9.6%) v 0 (0.0%, 0% to 1.4%), P<0.001). Dose two of the adjuvanted split virion vaccine was more reactogenic than dose one, especially for fever >or=38 masculineC in those aged under 5 (24 (8.9%, 5.8% to 12.9%) v 57 (22.4%, 17.5% to 28.1%), P<0.001). CONCLUSIONS In this first direct comparison of an AS03(B) adjuvanted split virion versus whole virion non-adjuvanted H1N1 vaccine, the adjuvanted vaccine, while more reactogenic, was more immunogenic and, importantly, achieved high seroconversion rates in children aged less than 3 years. This indicates the potential for improved immunogenicity of influenza vaccines in this age group. TRIAL REGISTRATION Clinical trials.gov NCT00980850; ISRCTN89141709.
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Affiliation(s)
- Claire S Waddington
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford OX3 7LJ.
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Gasparini R, Schioppa F, Lattanzi M, Barone M, Casula D, Pellegrini M, Veitch K, Gaitatzis N. Impact of prior or concomitant seasonal influenza vaccination on MF59-adjuvanted H1N1v vaccine (Focetria) in adult and elderly subjects. Int J Clin Pract 2010; 64:432-8. [PMID: 20039974 DOI: 10.1111/j.1742-1241.2009.02309.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND When H1N1v vaccines become widely available, most elderly subjects will have already received their seasonal influenza vaccination. Adults seeking H1N1v vaccination may be offered seasonal vaccine as well. We investigated prior seasonal vaccination in adult and elderly subjects, and concomitant vaccination with seasonal vaccine in adults, on the tolerability and immunogenicity of the Novartis MF59-adjuvanted H1N1v vaccine, Focetria. METHODS A total of 264 adult (four groups) and 154 elderly (three groups) subjects were enrolled. The licensure study cohorts for plain (Agrippal) and MF59-adjuvanted (Fluad) 2009-2010 seasonal vaccines were invited to receive Focetria 3 months later, with seasonal vaccine-naïve controls, and adults who received Focteria and seasonal vaccine concomitantly. Immunogenicity of all vaccines was assessed by haemagglutination inhibition on Days 1 and 22, safety and reactogenicity were monitored using patient diaries. RESULTS All adult and elderly groups met all the European CHMP licensing criteria for H1N1v, as did adults receiving concomitant seasonal vaccine for the three seasonal strains. Vaccines were generally well tolerated, causing no SAEs, and profiles typical of MF59-adjuvanted vaccines. Reactions were mainly mild or moderate and transient, and unaffected by prior or concomitant seasonal vaccination except for elderly subjects previously given MF59-adjuvanted seasonal vaccine, whose reaction rates to Focetria were about half those seen in groups receiving their first MF59 vaccine. CONCLUSION One dose of MF59-adjuvanted H1N1v vaccine met the licensure criteria for adult and elderly subjects 3 months after seasonal vaccination, or concomitantly with seasonal vaccine in adults, without impacting the tolerability or immunogenicity of either vaccine, thus facilitating mass influenza immunisation campaigns.
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Affiliation(s)
- R Gasparini
- Department of Health Sciences, Genoa University, Genoa, Italy
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Masi S, de Cléty SC, Anslot C, Detaille T. Acute amiodarone toxicity due to an administration error: could excipient be responsible? Br J Clin Pharmacol 2010; 67:691-3. [PMID: 19076154 DOI: 10.1111/j.1365-2125.2008.03323.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
BACKGROUND The 2009 pandemic influenza A (H1N1) virus has emerged to cause the first pandemic of the 21st century. Development of effective vaccines is a public health priority. METHODS We conducted a single-center study, involving 176 adults, 18 to 50 years of age, to test the monovalent influenza A/California/2009 (H1N1) surface-antigen vaccine, in both MF59-adjuvanted and nonadjuvanted forms. Subjects were randomly assigned to receive two intramuscular injections of vaccine containing 7.5 microg of hemagglutinin on day 0 in each arm or one injection on day 0 and the other on day 7, 14, or 21; or two 3.75-microg doses of MF59-adjuvanted vaccine, or 7.5 or 15 microg of nonadjuvanted vaccine, administered 21 days apart. Antibody responses were measured by means of hemagglutination-inhibition assay and a microneutralization assay on days 0, 14, 21, and 42 after injection of the first dose. RESULTS The most frequent local and systemic reactions were pain at the injection site and muscle aches, noted in 70% and 42% of subjects, respectively; reactions were more common with the MF59-adjuvanted vaccine than with nonadjuvanted vaccine. Three subjects reported fever, with a temperature of 38 degrees C or higher, after either dose. Antibody titers, expressed as geometric means, were higher at day 21 among subjects who had received one dose of MF59-adjuvanted vaccine than among those who had received one dose of nonadjuvanted vaccine (P<0.001 by the microneutralization assay). By day 21, hemagglutination-inhibition and microneutralization antibody titers of 1:40 or more were seen in 77 to 96% and 92 to 100% of subjects receiving MF59-adjuvanted vaccine, respectively, and in 63 to 72% and 67 to 76% of those receiving nonadjuvanted vaccine, respectively. By day 42, after two doses of vaccine, hemagglutination-inhibition and microneutralization antibody titers of 1:40 or more were seen in 92 to 100% and 100% of recipients of MF59-adjuvanted vaccine, respectively, and in 74 to 79% and 78 to 83% of recipients of nonadjuvanted vaccine, respectively. CONCLUSIONS Monovalent 2009 influenza A (H1N1) MF59-adjuvanted vaccine generates antibody responses likely to be associated with protection after a single dose is administered. (ClinicalTrials.gov number, NCT00943358).
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Affiliation(s)
- Tristan W Clark
- Infectious Diseases Unit, University Hospitals Leicester, and Department of Inflammation, Infection and Immunity, University of Leicester, Leicester, United Kingdom
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Li RC, Fang HH, Li YP, Liu YP, Nong Y, Huang GB. [Study on the safety and immunogenicity of MF59-adjuvanted influenza subunit vaccine in Chinese elderly]. Zhonghua Liu Xing Bing Xue Za Zhi 2008; 29:548-551. [PMID: 19040034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To compare the safety and immunogenicity between a MF59-adjuvanted influenza subunit vaccine and a conventional non-adjuvanted influenza subunit vaccine. METHODS A randomized, blind-designed controlled study was carried out, with 600 subjects (> or = 60 years of age) received MF59-adjuvanted influenza subunit vaccine (FLUAD, n = 400) or conventional non-adjuvanted influenza subunit vaccine (Agrippal, n = 200) respectively. The local and systemic reactions were observed on 0-7 days after vaccination. Haemagglutination inhibition (HI) titers of pre-and post-vaccination were detected by the HI assay. Seroconversion (4-fold increase) rate of subjects was calculated using baseline data when it was under naive level, and the protection rate when HI titer achieving the level of protection (> or = 1:40) after vaccination. Geometric mean titer (GMT) and its increasing folds were calculated. Differences between safety and immunogenicity were also calculated. RESULTS The local and systemic reaction rates were similar between both groups, but the duration in injection site was frequent for Agrippal (P < 0.05), while mild pain and fever in injection site were frequent for FLUAD. On immunogenicity test, for those subjects whose baseline was under naive level while the seroconversion rate against A/H3N2 viral strain after vaccination--FLUAD was significantly higher than Agrippal (P < 0.001). Aside from A/H1N1 viral strain, the rate of protection on both groups were significantly higher than those from baseline data, but for A/H3N2 viral strain, FLUAD was significantly higher than Agrippal (P < 0.001). GMT was higher than baseline (P < 0.001) after both groups being vaccinated but FLUAD group was significantly higher than Agrippal group. CONCLUSION FLUAD was well tolerated by Chinese elderly and its immunogenicity level induced by FLUAD was higher than that of Agrippal, showing that it would benefit the elderly with hypoimmunity.
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Affiliation(s)
- Rong-Cheng Li
- Vaccine Clinical Trial Center, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
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Affiliation(s)
- Phil Lieberman
- Division of Allergy and Immunology, University of Tennessee, Memphis, Tennessee, USA.
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Baldo V, Baldovin T, Floreani A, Carraro AM, Trivello R. MF59-adjuvanted influenza vaccine confers superior immunogenicity in adult subjects (18–60 years of age) with chronic diseases who are at risk of post-influenza complications. Vaccine 2007; 25:3955-61. [PMID: 17383057 DOI: 10.1016/j.vaccine.2007.02.045] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2006] [Revised: 02/05/2007] [Accepted: 02/16/2007] [Indexed: 11/22/2022]
Abstract
The immunogenicity and reactogenicity of two influenza vaccines were evaluated in a randomised, double-blind trial in north-east Italy during winter 2005-2006. Of 238 adult subjects (18-60 years of age) with underlying chronic diseases, 120 received MF59-adjuvanted subunit vaccine (Sub/MF59) and 118 received conventional subunit vaccine (Subunit). At 4 weeks post-vaccination, geometric mean titres (GMT) were significantly (P<0.001) increased for both groups. For the A/H3N2 and B strains, significantly (P<0.02) higher GMT were reported for the Sub/MF59 group. The mean-fold increase in titre, the percentage of subjects with at least a four-fold titre increase and the seroprotection rate (>or=1:40) were also higher in the Sub/MF59 group, with the seroprotection rate and four-fold titre increase achieving significance (P=0.002 and P=0.02, respectively) for the A/H3N2 strain. Our results suggest that adults affected by chronic diseases can mount a satisfactory immune response to influenza vaccines, and that these vaccines are well tolerated. Addition of the MF59-adjuvant, however, enhances the immunogenicity of subunit influenza vaccine, conferring superior protection than a conventional subunit vaccine in this population, who are at high-risk of influenza-related complications.
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Affiliation(s)
- V Baldo
- Department of Environmental Medicine and Public Health, Institute of Hygiene, University of Padua, Padua, Italy.
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Abstract
Anti-IgE therapy with omalizumab, a recombinant humanized monoclonal antibody, has anti-inflammatory effects in allergic asthma and rhinitis. Although omalizumab has been exceptionally safe, reactions after its administration have been reported. The goal of this study was to assess two patients who experienced apparent anaphylaxis after omalizumab administration. Two cases of apparent anaphylaxis after omalizumab administration are reported with diagnostic evaluation using skin testing and unique IgE and IgG anti-omalizumab serological assays. At the time of evaluation, both atopic asthmatic patients had total (free and bound) serum IgE levels of 199 kIU/L (100% free) and 200 kIU/L (80% free and 20% bound), respectively. Epicutaneous skin tests to omalizumab were negative at 150 mg/mL of omalizumab in both subjects and the nonexposed negative control subject. Intradermal skin tests were positive at 0.15 mg/mL in subject 1 and negative at 1.5 mg/mL of omalizumab in subject 2 and the control subject. Intradermal testing to polysorbate produced significant wheal/flare reaction in subject 2 but not in the negative control subject. Serological assays for IgE or IgG antibodies reactive with omalizumab were negative. The in vitro and in vivo immunologic data support the conclusion that the adverse reactions experienced by two patients after omalizumab administration after more than a year of successful omalizumab therapy for asthma were likely anaphylactoid in nature. Polysorbate, an excipient in omalizumab, is known to cause similar reactivity to other medicines and is the most likely cause of these reactions.
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Affiliation(s)
- Kursteen S Price
- Allergy, Asthma & Dermatology Associates, Portland, Oregon 97209, USA.
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Tay FR, Hosoya Y, Loushine RJ, Pashley DH, Weller RN, Low DCY. Ultrastructure of Intraradicular Dentin After Irrigation with BioPure MTAD. II. The Consequence of Obturation with an Epoxy Resin-Based Sealer. J Endod 2006; 32:473-7. [PMID: 16631852 DOI: 10.1016/j.joen.2005.10.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In addition to an initial report on the creation of thick demineralized collagen matrices in root dentin that were irrigated with BioPure MTAD or EDTA as final rinses for 5 minutes, this study examined the effect of a 2-minute irrigation time of these final irrigants on the extent of demineralization of intact intraradicular dentin and on interfacial nanoleakage after obturation with AH Plus and gutta-percha using warm vertical compaction. Transmission electron microscopy confirmed that the reduction in irrigation time did not compromise the smear layer removing capacity of these two irrigants when 1.3% NaOCl was employed as the initial rinse. BioPure MTAD created 5 to 6 microm thick demineralized dentin matrices, while 17% EDTA produced 1 to 2 microm thick matrices that were suboptimally infiltrated by the epoxy resin-based sealer, as manifested by the occurrence of silver tracer deposits within the hybrid layers.
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Affiliation(s)
- Franklin R Tay
- Department of Oral Biology and Maxillofacial Pathology, School of Dentistry, Medical College of Georgia, Augusta, 30912, USA
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Abstract
BACKGROUND Polyoxyethylene-sorbitan-20-monooleate (also known as polysorbate 80 and Tween 80) is a solubilizing agent ubiquitously used in nutritives, creams, ointments, lotions, and multiple medical preparations (e.g., vitamin oils, vaccines, and anticancer agents) and as an additive in tablets. Whereas its relevance as a contact allergen has declined during the past decades, it is of current relevance as a "hidden" inductor of anaphylactoid reactions. OBJECTIVE To identify polysorbate 80 (generally believed to be an inert vehicle) as an inductor of a severe anaphylactoid reaction. METHODS Skin prick testing, enzyme-linked immunosorbent assay, IgE immunoblotting, and flow cytometric detection of basophil activation were performed in controls and in a patient with a medical history of anaphylactic shock due to intravenous administration of a multivitamin product during pregnancy. RESULTS Polysorbate 80 was identified as the causative agent for the anaphylactoid reaction of nonimmunologic origin in the patient. Polysorbate specific IgE antibodies were not identified in enzyme-linked immunosorbent assay and immunoblot examinations, confirming the nonimmunologic nature of the anaphylactoid reaction. CONCLUSIONS Polysorbate 80 is a ubiquitously used solubilizing agent that can cause severe nonimmunologic anaphylactoid reactions.
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Affiliation(s)
- Esther A Coors
- Department of Dermatology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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García-Godoy F, Loushine RJ, Itthagarun A, Weller RN, Murray PE, Feilzer AJ, Pashley DH, Tay FR. Application of biologically-oriented dentin bonding principles to the use of endodontic irrigants. Am J Dent 2005; 18:281-90. [PMID: 16296438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE To compare the removal of smear layer and the structure of the hybrid layer formed after the use of EDTA or MTAD solutions when used as a final flush. METHODS Single-rooted extracted premolars (n=18) were collected and treated for root canal therapy using NaOCl irrigation followed by a final rinse of 17% EDTA, Biopure MTAD, or saline (negative control). The roots were obturated with gutta-percha and a hydrophilic HEMA-containing root canal sealer. The TEM specimens were impregnated with 50% silver nitrate to visualize sealing imperfections and nanoleakage. The structure of the coronal, middle and apical parts of root canal walls was examined using transmission electron microscopy. RESULTS After NaOCl irrigation, a final rinse with BioPure MTAD or 17% EDTA completely removed the 2 microm-thick smear layer on mechanically instrumented root canal walls. The BioPure MTAD hybrid layer was thicker than the 17% EDTA hybrid layer. Both the BioPure MTAD and EDTA caused a collapse of the dentin matrix structure which impeded sealer infiltration and the formation of high quality hybrid layer bonding. The hybrid layers created in smear layer-covered dentin exhibited less potential for nanoleakage than the MTAD or EDTA hybrid layers.
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Affiliation(s)
- Franklin García-Godoy
- Biosciences Research Center, Department of Endodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
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Steele RH, Limaye S, Cleland B, Chow J, Suranyi MG. Hypersensitivity reactions to the polysorbate contained in recombinant erythropoietin and darbepoietin (Case Report). Nephrology (Carlton) 2005; 10:317-20. [PMID: 15958049 DOI: 10.1111/j.1440-1797.2005.00389.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The following case reports are of two patients who have developed hypersensitivity reactions to the red cell growth hormones, darbepoietin and erythropoietin. The subsequent skin testing and clinical course suggested that the cause of these reactions was due to the excipient polysorbate 80. This finding might have implications in the recent increase in the incidence of pure red cell aplasia.
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Affiliation(s)
- Richard H Steele
- Department of Immunology, Liverpool Hospital, Liverpool BC, New South Wales, Australia.
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