September 6, 2022

SARS-CoV-2 Can Trigger Chronic Fatigue Syndrome

A study published in Nature Communications found that, even after mild coronavirus disease 2019 (COVID-19), a subset of patients will develop symptoms which meet the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome.

  • Article
  • Open Access

A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity

Abstract

A subset of patients has long-lasting symptoms after mild to moderate Coronavirus disease 2019 (COVID-19). In a prospective observational cohort study, we analyze clinical and laboratory parameters in 42 post-COVID-19 syndrome patients (29 female/13 male, median age 36.5 years) with persistent moderate to severe fatigue and exertion intolerance six months following COVID-19. Further we evaluate an age- and sex-matched postinfectious non-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome cohort comparatively. Most post-COVID-19 syndrome patients are moderately to severely impaired in daily live. 19 post-COVID-19 syndrome patients fulfill the 2003 Canadian Consensus Criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Disease severity and symptom burden is similar in post-COVID-19 syndrome/myalgic encephalomyelitis/chronic fatigue syndrome and non-COVID-19/myalgic encephalomyelitis/chronic fatigue syndrome patients. Hand grip strength is diminished in most patients compared to normal values in healthy. Association of hand grip strength with hemoglobin, interleukin 8 and C-reactive protein in post-COVID-19 syndrome/non-myalgic encephalomyelitis/chronic fatigue syndrome and with hemoglobin, N-terminal prohormone of brain natriuretic peptide, bilirubin, and ferritin in post-COVID-19 syndrome/myalgic encephalomyelitis/chronic fatigue syndrome may indicate low level inflammation and hypoperfusion as potential pathomechanisms.

Download PDF

September 5, 2022

Clinical evaluation of subcutaneous immunotherapy with a polymerized molecular allergoid of Alt a 1 in patients with allergic rhinoconjunctivitis and/or allergic asthma caused by the mould Alternaria alternata


Á. Ferrer 
angelyferrer@gmail.com


Doi
10.23822/EurAnnACI.1764-1489.267


Summary
This is a retrospective analysis of the clinical evolution of 14 patients diagnosed with allergic rhinoconjunctivitis (AR) and/or allergic asthma (AA) caused by Alternaria alternata, who were attended by the allergology service of Vega Baja Hospital of Orihuela (Alicante, Spain). The purpose was to assess the clinical impact and safety of 1-year of subcutaneous immunotherapy with a polymerized molecular allergoid of Alt a 1. Impact of the treatment on allergic diseases (mean number AR/AA episodes and ARIA/GINA classifications), changes in symptoms and prescribed medication, change in the global subjective clinical status of patients and satisfaction with the treatment were also evaluated.

The association between small airway dysfunction and aging: a cross-sectional analysis from the ECOPD cohort

Research - Open Access
Cuiqiong DaiFan WuZihui WangJieqi PengHuajing YangYoulan ZhengLifei LuNingning ZhaoZhishan DengShan XiaoXiang WenJianwu XuPeiyu HuangKunning ZhouXiaohui WuYumin ZhouPixin Ran

Respiratory Research volume 23, Article number: 229 (2022)

Abstract

Background

Aging has been evidenced to bring about some structural and functional lung changes, especially in COPD. However, whether aging affects SAD, a possible precursor of COPD, has not been well characterized.

Objective

We aimed to comprehensively assess the relationship between aging and SAD from computed tomography, impulse oscillometry, and spirometry perspectives in Chinese.

September 2, 2022

ALEX versus ISAC multiplex array in analyzing food allergy in atopic children

  • Letters to the Editor
  • Open Access

ALEX multiplex array is a relatively new multiplex allergy test which analyses more than 120 allergen extracts and 170 molecular components. ISAC is the most used and studied multiplex array to date, offering 112 molecular components. In ten atopic children with multiple food allergies good agreement was observed between ALEX and ISAC sIgE results for nearly all shared food components. 


Presence of larger number of allergens in ALEX could help clinicians to improve personalized dietary advice. However more positive sensitizations with unknown clinical relevance were found by ALEX, potentially increasing clinical complexity. Pediatric allergists should be aware of this, especially in young atopic children with (severe) eczema who have not introduced all sorts of food yet.






Download PDF

September 1, 2022

BSACI guideline for the diagnosis and management of pollen food syndrome in the UK

Clinical Practice Guideline

Free Access

Isabel J. Skypala, Hannah Hunter, Mamidipudi Thirumala Krishna, Helena Rey-Garcia, Stephen J. Till, George du Toit, Elizabeth Angier, Sarah Baker, Kostadin V. Stoenchev, David K. Luyt.

Clin Exp Allergy. 2022; 52: 1018- 1034. doi: 10.1111/cea.14208

Abstract

Pollen food syndrome (PFS) is a highly prevalent food allergy affecting pollen-sensitized children and adults. Sufferers experience allergic symptoms when consuming raw plant foods, due to the homology between the pollen allergens and unstable proteins in these foods. The triggers involved can vary depending on the pollen sensitization, which in turn is affected by geographical location. The British Society of Allergy and Clinical Immunology (BSACI) Standards of Care Committee (SOCC) identified a need to develop a guideline for the diagnosis and management of PFS in the United Kingdom (UK). Guidelines produced by the BSACI use either the GRADE or SIGN methodology; due to a lack of high-quality evidence these recommendations were formulated using the SIGN guidelines, which is acknowledged to be less robust than the GRADE approach. 

August 31, 2022

Inhaled corticosteroids do not affect the antibody titer against the SARS-CoV-2 spike protein in BNT162b2 mRNA vaccinated patients

  • Research
  • Open Access


Allergy, Asthma & Clinical Immunology volume 18, Article number: 78 (2022

Objectives

Oral corticosteroids reduce the antibody titer of the BNT162b2 mRNA vaccine against SARS-CoV-2. To date, the effect of inhaled corticosteroids on antibody titers is unknown.

Study design

The design of this study is retrospective study.

Methods

We analyzed the relationship between the clinical features and total antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein in 320 subjects who had never been infected with Coronavirus disease 2019 (COVID-19) and were vaccinated the second time with the BNT162b2 mRNA vaccine between October 1 to December 28, 2021.

Food allergies can be reversed in mice by targeting the microbiome


Although many people with dietary allergies experience mild symptoms when exposed to triggering foods, some face potentially fatal consequences. A bacterial compound called butyrate that’s made by healthy microbiomes has shown promise against allergic reactions in lab tests, but it’s nasty to take orally. Today, scientists describe a more palatable way to deliver this compound and report that their “polymeric micelles” are effective against peanut allergies in mice. The treatment could someday counteract many types of food allergies and inflammatory diseases.

Drug hypersensitivity, in vitro tools, biomarkers, and burden with COVID-19 vaccines

REVIEW ARTICLE - Free Access

Francisca Palomares, Juan L. Paris, Marina Labella, Inmaculada Doña, Cristobalina Mayorga, María José Torres. Allergy. 2022; 00: 1- 11. doi: 10.1111/all.15461

Abstract
Hypersensitivity reactions to drugs are increasing worldwide. They display a large degree of variability in the immunological mechanisms involved, which impacts both disease severity and the optimal diagnostic procedure.

August 30, 2022

Sex differences in adult asthma and COPD therapy: a systematic review

  • Review
  • Open Access

Abstract

Background

Although asthma is more prevalent in women and the prevalence of COPD is increasing in women, the current international recommendations for the management and prevention of asthma and COPD provide no sex-related indication for the treatment of these diseases. Therefore, we systematically reviewed the evidence across literature on the sex-related effectiveness of asthma and COPD therapy.

Methods

This systematic review has been registered in PROSPERO and performed according to PRISMA-P. The PICO framework was applied for the literature search strategy: "patient problem” included adult patients suffering from asthma or COPD, “Intervention” regarded the pharmacological treatments for asthma or COPD, “Comparison” was vs. baseline, active controls, or placebo, “Outcome” was any difference sex-related in the effectiveness of interventions.

Results

In asthma 44% of the evidence reported that men responded better than women to the therapy, whereas this percentage was 28% in COPD. ICS was generally less effective in women than in men to treat asthma, and consistent evidence suggests that in asthmatic patients ICS/LABA/LAMA combination may be equally effective in both men and women. Due to the inconsistent available evidence, it is not possible to identify specific treatments whose effectiveness is related to sex difference in COPD patients.

Conclusions

There is a strong need of investigating the sex-related impact of asthma and COPD treatments. Pre-specified analyses in men and women should be planned in future trial protocols, a necessary condition that should be requested also by the regulatory agencies to overcome the anachronistic “one-size-fits-all” approach to therapeutics associated with suboptimal outcomes for patients.


Download PDF

August 24, 2022

The respiratory microbiota alpha-diversity in chronic lung diseases: first systematic review and meta-analysis

  • Research
  • Open Access

Background

PRISMA flow diagram summarizing our search results and study selection for the
systematic review and meta-analysis
While there seems to be a consensus that a decrease in gut microbiome diversity is related to a decline in health status, the associations between respiratory microbiome diversity and chronic lung disease remain a matter of debate. We provide a systematic review and meta-analysis of studies examining lung microbiota alpha-diversity in patients with asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF) or bronchiectasis (NCFB), in which a control group based on disease status or healthy subjects is provided for comparison.


Results

We reviewed 351 articles on title and abstract, of which 27 met our inclusion criteria for systematic review.

August 22, 2022

Pharmacological Management of Allergic Rhinitis: A Consensus Statement from the Malaysian Society of Allergy and Immunology.


Abdullah B, Abdul Latiff AH, Manuel AM, Mohamed Jamli F, Dalip Singh HS, Ismail IH, Jahendran J, Saniasiaya J, Keen Woo KC, Khoo PC, Singh K, Mohammad N, Mohamad S, Husain S, Mösges R. Pharmacological Management of Allergic Rhinitis: A Consensus Statement from the Malaysian Society of Allergy and Immunology. J Asthma Allergy. 2022 Aug 2;15:983-1003. doi: 10.2147/JAA.S374346.

Abstract

The goal of allergic rhinitis (AR) management is to achieve satisfactory symptom control to ensure good quality of life. Most patients with AR are currently treated with pharmacotherapy. However, knowledge gaps on the use of pharmacotherapy still exist among physicians, particularly in the primary care setting, despite the availability of guideline recommendations. Furthermore, it is common for physicians in the secondary care setting to express uncertainty regarding the use of new combination therapies like intranasal corticosteroid plus antihistamine combinations. Inadequate treatment leads to significant reduction of quality of life that affects daily activities at home, work, and school. With these concerns in mind, a practical consensus statement was developed to complement existing guidelines on the rational use of pharmacotherapy in both the primary and secondary care settings.

A new way forward? Examining the potential of quantitative analysis of IgE datasets

Abstract

Background

Allergies constitute an important public health problem, and epidemiological data is crucial to developing strategies for its prevention and therapy. Few population-based studies are available for data on allergies and sensitization. However, as these studies are expensive and time-consuming, novel approaches are searched for.

Objectives

A large monocentric IgE dataset was used to analyse quantitative sensitization data in different age and gender groups and compared the results to available epidemiological data.

Methods

A total of 14,370 patients who sought medical care at the Department for Dermatology and Allergology at the Technical University of Munich, Germany was analysed.

August 20, 2022

HSP70 upregulation in nasal mucosa of symptomatic children with allergic rhinitis and potential risk of asthma development

  • Article
  • Open Access


Scientific Reports volume 12, Article number: 14104 (2022)

Abstract

Allergic rhinitis and asthma are the most common causes of chronic inflammation of the upper and lower airways in childhood. However, a nasal biomarker that can link to pulmonary inflammation is yet to be found.

Boxplot of median ∆Ct values for HSPA1A/B and HSPA6 transcripts
and ppb values for FeNO in the symptomatic AR patients (orange)
and control group (green). Higher ∆Ct values stand for lower mRNA
expression.
The present paper aims to investigate the possible role in inflammation of two inducible 70-kDa Heat Shock Proteins (HSP70) members, HSPA1A/B and HSPA6, in nasal mucosa cells of allergic children through their mRNA expression analysis, and their correlation to both spirometric and FeNO values. The relationship between FeNO in lower airways and ∆Cts of HSPA1A/B in nasal mucosa seems to be influenced by clinical symptoms regardless of age, sex, and sensitization patterns.