Allergic Reactions In Patients Research Articles

Long-Term Adherence and Risk of Allergic Reactions in Patients Who Attained Milk Oral Immunotherapy Maintenance

BackgroundOral immunotherapy (OIT) has emerged as the most popular therapy for food allergy. However, data on the long-term adherence and efficacy of this approach are sparse. ObjectiveWe aimed to assess the long-term adherence rates to OIT protocol and the associated risk of allergic reactions. MethodsPatients who completed milk OIT and reached a maintenance dose of 200 ml of milk were surveyed biannually on their dairy consumption and occurrence of allergic reactions. A survival analysis was performed to evaluate the association between the risk of reaction and adherence to OIT maintenance protocol. ResultsThe cohort consisted of 50 patients. Only 56% of the cohort adhered to protocol, which consisted of ingesting a minimum of 200 ml of milk at least 3 times per week. Adherent patients had a significantly reduced risk of allergic reactions, as well as a reduced incidence of anaphylaxis, healthcare/ER visits, and epinephrine/antihistamine administration. ConclusionThe findings demonstrate the importance of consistent maintenance dose consumption in the management of food allergies, with regular milk consumption contributing to the maintenance of unresponsiveness and decreased risk of allergic symptoms.

New light on an old syndrome: Role of Api g 7 in mugwort pollen–related celery allergy

BackgroundCelery root is known to cause severe allergic reactions in patients sensitized to mugwort pollen. ObjectiveTo study clinically well-characterized patients with celery allergy by IgE testing with a comprehensive panel of celery allergens to disentangle the molecular basis of the “celery-mugwort-syndrome”. MethodsPatients with suspected food allergy to celery underwent a standardized interview. Main inclusion criteria were a positive food challenge with celery or an unambiguous case history of severe anaphylaxis. IgE to celery allergens (rApi g 1.01, rApi g 1.02, rApi g 2, rApi g 4, nApi g 5, rApi g 6, rApi g 7), and to mugwort allergens (rArt v 1, rArt v 3, rArt v 4) were determined by ImmunoCAP. IgE levels ≥ 0.35kUA/L were regarded positive. ResultsSeventy-nine patients with allergy to celery were included. Thirty patients suffered from mild oral or rhino-conjunctival symptoms and 49 from systemic reactions. Sixty-eight % had IgE to celery extract, 80% to birch pollen and 77% to mugwort pollen. A combination of Api g 1.01, 1.02, 4, 5, and 7 increased diagnostic sensitivity for celery allergy to 92%. The LTPs Api g 2 and Api g 6 were not relevant in our celery allergic population. IgE to Api g 7, detected in 52% of patients, correlated closely (r=0.86) to Art v 1 from mugwort pollen. Eleven out of 12 patients with monosensitization to Api g 7 were IgE negative to celery extract. The odds ratio for developing a severe anaphylactic reaction rather than only mild oral symptoms was about 6 times greater (odds ratio 5.87; 95% CI 1.08-32.0, p=0.0410) for Api g 7 sensitized versus Api g 7 non-sensitized subjects. ConclusionThere is an urgent need for routine diagnostic tests to assess sensitization to Api g 7 not only to increase test sensitivity, but also to identify celery allergic patients at risk of a severe allergic reaction to celery.

ВЫБОР МАТЕРИАЛА ПРИ ОКАЗАНИИ ОРТОПЕДИЧЕСКОЙ ПОМОЩИ ПАЦИЕНТАМ С ЧАСТИЧНЫМ И ПОЛНЫМ ОТСУТСТВИЕМ ЗУБОВ (обзор литературы)

Orthopedic treatment is extremely difficult for diseases of the oral mucosa, such as chronic recurrent aphthous stomatitis, leukoplakia, lichen planus, etc. Domestic scientists have long recognized the need for a differentiated approach to the selection of material for the manufacture of dentures, taking into account the individual characteristics of the patient’s dental and general somatic status, and microflora of the oral cavity. The choice of material is carried out taking into account not only its physicochemical characteristics, but also the biological effect on the oral mucosa. Purpose of the work: to identify new scientific data by analyzing systematic reviews that reveal the etiological aspects and pathogenesis of lichen planus of the oral mucosa. A review of domestic and foreign scientific literature over the past 10 years was conducted, which analyzed dissertations and articles published only in peer-reviewed scientific journals. Acrylic resins remain the most common structural material in partial and complete removable prosthetics. But such negative properties of acrylic orthopedic structures, such as residual monomer and microporosity, often lead to an increase in the number of allergic reactions in patients, the occurrence of microcracks in the prosthesis and other negative consequences. An alternative to removable dentures made of acrylic plastics are fairly widely used orthopedic structures made of thermoplastic materials, which in their chemical structure do not have the main negative properties inherent in acrylic plastics, and in terms of strength indicators are several times higher than acrylic ones. Depending on the specific clinical situation, the type of base material from thermoplastic masses for prosthetics for patients is selected. The chemical composition and choice of such materials is quite large. The issues of studying the mechanisms of tissue stress, the reactions of elimination of polymers during prolonged stay in the oral cavity, and the development of criteria for the biocompatibility of thermoplastic materials remain relevant today.

Polyethylene glycol and immunology: aspects of allergic reactions and their mechanisms, as well as ways to prevent them in clinical practice.

In modern medical practice, where polyethylene glycol is widely used as a component of various drugs, such as vaccines, chemotherapy drugs, and antibiotics, including vaccines, the issue of allergic reactions to this substance is becoming increasingly important. The purpose of this study is to review and systematise data on various aspects of allergic reactions to polyethylene glycol with the aim of better understanding their pathogenesis, clinical manifestations, diagnostic methods, and possible treatment approaches. The study analysed literature data in modern databases, such as MEDLINE, PubMed, and Scopus, on allergic reactions to polyethylene glycol, using the keywords: "PEG", "polyethylene glycol", "allergy", "side effect". The main aspects of allergy to this substance were highlighted, including mechanisms of development, diagnostic methods, and possible treatment strategies. The analysis found that allergic reactions to polyethylene glycol can manifest in a variety of ways, including anaphylaxis and systemic reactions. A possible role for the immune response has been identified, including the production of IgE and IgM antibodies, complement activation, and accelerated clearance in response to polyethylene glycol, in blood plasma. Data are also provided on how to diagnose an increased risk of an allergic reaction in patients who have previously received drugs with this type of drug transporter and in patients receiving high molecular weight types of polyethylene glycol. The results of this review contribute to a better understanding of allergic reactions to polyethylene glycol and provide information for the development of more effective diagnostic and treatment methods.

A reliable enzyme-linked immunosorbent assay for the determining of sesame proteins in raw food ingredients and in processed foods

Sesame is a frequent cause of adverse food reactions in allergic patients. We developed a novel sandwich enzyme-linked immunosorbent assay (ELISA) using two monoclonal antibodies and a unique extraction buffer for the detection and quantification of sesame proteins in processed foods and in raw food ingredients to clarify the validity of sesame labeling and for precautionary allergen labeling. The developed sandwich ELISA method is highly specific for sesame proteins. The limit of detection (LOD) and limit of quantification (LOQ) are 0.013 µg/g and 0.025 µg/g, respectively. The recoveries for incurred food samples, such as dressing, breads, sauce and pudding, ranged from 67 % to 81 %, while the repeatability and reproducibility coefficients of variation were less than 4.7 % and 4.5 %, respectively. The developed method has applicability for food products and is a reliable tool for the detection of hidden sesame proteins in raw food ingredients and in processed foods.

Risk factors of systemic allergic reactions caused by subcutaneous allergen immunotherapy

Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.

In Silico Design of a New Epitope-Based Vaccine against Grass Group 1 Allergens.

Allergic diseases are a global public health problem that affects up to 30% of the population in industrialized societies. More than 40% of allergic patients suffer from grass pollen allergy. Grass pollen allergens of group 1 and group 5 are the major allergens, since they induce allergic reactions in patients at high rates. In this study, we used immunoinformatic approaches to design an effective epitope-based vaccine against the grass group 1 allergens. After the alignment of all known pollen T-cell and B-cell epitopes from pollen allergens available in the public databases, the epitope GTKSEVEDVIPEGWKADTSY was identified as the most suitable for further analyses. The target sequence was subjected to immunoinformatics analyses to predict antigenic T-cell and B-cell epitopes. Population coverage analysis was performed for CD8+ and CD4+ T-cell epitopes. The selected T-cell epitopes (VEDVIPEGW and TKSEVEDVIPEGWKA) covered 78.87% and 98.20% of the global population and 84.57% and 99.86% of the population of Europe. Selected CD8+, CD4+ T-cell and B-cell epitopes have been validated by molecular docking analysis. CD8+ and CD4+ T-cell epitopes showed a very strong binding affinity to major histocompatibility complex (MHC) class I (MHC I) molecules and MHC class II (MHC II) molecules with global energy scores of -72.1 kcal/mol and -89.59 kcal/mol, respectively. The human IgE-Fc (PDB ID 4J4P) showed a lower affinity with B-cell epitope (ΔG = -34.4 kcal/mol), while the Phl p 2-specific human IgE Fab (PDB ID 2VXQ) had the lowest binding with the B-cell epitope (ΔG = -29.9 kcal/mol). Our immunoinformatics results demonstrated that the peptide GTKSEVEDVIPEGWKADTSY could stimulate the immune system and we performed ex vivo tests showed that the investigated epitope activates T cells isolated from patients with grass pollen allergy, but it is not recognized by IgE antibodies specific for grass pollen allergens. This confirms the importance of such studies to establish universal epitopes to serve as a basis for developing an effective vaccine against a particular group of allergens. Further in vivo studies are needed to validate the effectiveness of such a vaccine against grass pollen allergens.

Immunoreactive proteins of Capsicum-based spices as a threat to human health: mass spectrometry analysis and in silico mapping

Dietary patterns are changing severely, especially the consumption of highly processed foods with lots of spices is increasing, carrying an increased risk of immediate hypersensitivity (type I), in sensitised individuals, due to the possible presence of allergens, especially the hidden ones. Paprika is a fruit of the Capsicum genus, which belongs to the Solanaceae family and is commonly consumed fresh or as a spice. Despite recorded cases of anaphylaxis, its allergenicity has yet to be clearly investigated. In this study, we research to identify proteins that could trigger a severe allergic reaction in patients with an equivocal clinical picture. Two types of protein extracts extracted from 3 different paprika spices were immunoblotted with sera from patients with severe allergic symptoms, presumably to paprika. Proteins from the IgE reactive bands obtained were subjected to LC–MS/MS identification and then in silico analysis to assess their possible sensitising capacity and proinflammatory potential using online tools. The spices were shown to contain a number of incompletely investigated highly immunoreactive allergenic proteins, including proteins of foreign origin (contaminants), the presence of which can stimulate inflammatory mechanisms and cross-reactivity with other food allergens, which can threaten life and health and should be investigated in detail.

SAT334 Hypoxic Reduction Of Adrenal Steroidogenesis- The Cause Of Idiopathic Allergic Reactions

Abstract Disclosure: S. Kalinchenko: None. L. Vorslov: None. D. Gusakova: None. O. Samburskaya: None. Hypoxic reduction of adrenal steroidogenesis - The Cause of Idiopathic Allergic Reactions Background: This thesis discusses the occurrence of idiopathic allergic reactions, with an established absence of allergy to any trigger by allergo-tests, with the sole presence of a history of decompensated chronic stress, which led to a stress-induced decrease in adrenal steroidogenesis called “adrenal fatigue” with decreased production of the main anti-inflammatory, anti-allergic and stress hormone, cortisol. Materials and methods: The study included 10 patients aged 20 to 55 years, 8 women and 2 men, diagnosed with idiopathic allergic reactions (urticaria, toxidermia, erythema multiforme exudative, Quincke's edema). All patients were examined for steroid hormone levels using a steroid profile in saliva by mass spectrometry and performing allergy tests (to identify a possible allergen). Findings: From the anamnesis, all 10 patients had long-term chronic stress, which was already in the stage of decompensation, and according to the Beck depression scale, 8 patients showed mild (11-17 points) and medium (18-23 points) severity of depression in 2 patients. In the steroid profile of saliva in all 10 patients, a decrease below 07\ры the reference level of cortisol (700-2200 pg/ml) and cortisone (27400-39200 pg/ml) was found. After relief of acute symptoms by corticosteroids, all patients were prescribed infusion therapy with ascorbic acid at a dosage of 1,000 mg three times a week for three weeks to stimulate the adrenal glands. As a result, repeated analysis of the steroid profile of saliva showed an increase in the level of cortisol and cortisone within the reference values.Allergotests are negative for all known allergens. Interpretation: As is known, allergens play a primary role in the development of diseases such as urticaria, toxidermia, erythema multiforme, Quincke's edema. However, there are increasingly cases when it is not possible to establish the trigger that caused the development of an allergic reaction, and conducting allergy tests does not reveal the presence of allergen triggers in patients. However, these patients are united by a decrease in adrenal steroidogenesis against the background of decompensated chronic stress called “adrenal fatigue”, which manifests itself in a decrease in the level of cortisol and cortisone in the steroid profile of saliva below the reference values, which are the main anti-inflammatory, antiallergic hormones and hormones that are synthesized in response to stress, and with chronic stress, the reserves of these hormones are depleted, which provokes the development of inflammatory and allergic reactions in response to ordinary stimuli. Conclusion: Stimulation of the adrenal glands with reduced steroidogenesis is an opportunity to reduce the risk of inflammatory and allergic reactions in patients with decompensated chronic stress. Presentation: Saturday, June 17, 2023

Surgical prophylaxis in pediatric orthopedic patients with penicillin allergy: a multicentered retrospective prognostic study.

Up to 20% of orthopedic surgeons still avoid the use of cephalosporins in patients with penicillin allergies despite its reported safety in the adult and general surgery pediatric population. The primary objective is to determine the incidence of adverse effects and allergic reactions when using cephalosporins in pediatric orthopedic patients labeled as penicillin-allergic as compared to those without previously reported penicillin allergy. A multicenter retrospective chart review was performed across three level 1 trauma centers from January 2013 to February 2020 to identify penicillin-allergic as well as non-penicillin-allergic pediatric patients treated for orthopedic injuries. Data were collected regarding patient demographics, antibiotic administered, timing of antibiotic administration, reported drug allergy, and described allergic reaction. Postoperative or intraoperative allergic reactions to antibiotics, surgical site infections, and complications were recorded. A total of 2289 surgeries performed by four fellowship-trained surgeons were evaluated. Eighty-five patients diagnosed with penicillin allergy were identified and underwent 95 surgeries and 95 patients without previously reported penicillin allergy underwent 95 surgeries. One patient, with a documented history of anaphylaxis to cefazolin, sustained an anaphylactic reaction intraoperatively to cefazolin. There were no other reported reactions, surgical site infections, or complications. There was no statistically significant difference in rate of allergic reaction in patients with previously reported penicillin allergy treated with cefazolin and those with no previous reported reaction ( P > 0.05). Prophylaxis with cephalosporins is not associated with increased risk for allergic reaction. Cephalosporins can be safely administered to pediatric patients with penicillin allergy undergoing orthopedic intervention. Level of evidence: Level II, Multicenter Retrospective Prognostic Study.

A REVIEW OF ANISAKIS SPP. AND ITS VARIOUS ALLERGENS’ PROFILING AND CHARACTERISATION

Purpose - This review article focuses on the identification and characterization of the allergens present in Anisakis spp., parasitic worms found in coastal fish that can cause anisakiasis in humans who consume raw or contaminated seafood. The study aimed to fill the gap in research by profiling and analyzing the allergens present in Anisakis simplex s.s., Anisakis pegreffii, and the hybrid haplotype.
 
 Design/methodology/approach - To conduct this analysis of Anisakis spp. and its various allergens, a comprehensive bibliographical search was conducted using online sources such as Google Scholar, PubMed Central, ScienceDirect, Springer Link, and Wiley Online Library. These sources provided a diverse range of articles, research papers, and other relevant literature on the subject. The findings of this analysis are based on the extensive review of these sources and provide insights into the allergenicity of Anisakis spp. and the various allergens that it contains.
 Findings - The main objective of this review is to analyze the different categories of allergens that cause allergic reactions in patients affected by Anisakis spp.. The findings of the study revealed that Anis 1, Anis 7, and Anis 12 are the most significant allergens, while Anis 4, Anis 5, Anis 6, Anis 8, Anis 9, Anis 10, and Anis 11 are the minor allergens. The review paper emphasizes the importance of understanding the biology and pathogenicity of Anisakis spp. to develop effective therapeutic strategies. The results of this study can assist clinicians and researchers in identifying possible targets for the prevention and treatment of anisakiasis. It also emphasizes the importance of making educated food decisions, properly preparing seafood before consumption, and creating diagnostic tools to quickly spot allergic reactions like anisakiasis. The goal of this study is to enhance public health and increase awareness of anisakiasis. As a result, it may be helpful to clinicians and researchers who are researching Anisakis spp. and related diseases.

Is Anisakis simplex a Trigger for Anaphylactic Reactions in Hereditary Alpha-Tryptasemia?

The prevalence of fish, seafood and Anisakis allergy varies greatly depending on country-specific eating habits, assuming that the highest consumption corresponds to the highest prevalence. Mediterranean countries are particularly affected. Hereditary Alpha-Tryptasemia (HaT) is a common autosomal dominant genetic trait recently identified. Although it is estimated to affect approximately 1 in 20 individuals of white European origin, a diagnostic method is not routinely available. Here by we present the cases of two families with different allergic reaction phenotypes to fish and seafood, IgE and no IgE mediated reactions. The current review focused on the impact of the diagnosis of HaT in families, particularly when the mutation is symptomatic and the affectation from an early age and in both sexes and finally this review tried to warn about the possible involvement of Anisakis in allergic reactions in patients with HaT.

The incidence rate of allergic reactions induced by oxaliplatin is higher in patients with rectal cancer compared with colon cancer

Aim To explore the diverse profiles of adverse reactions caused by oxaliplatin between colon and rectal cancer, we investigated the toxicity of oxaliplatin in patients with colon and rectal cancer. Methods From January 2017 to December 2021, 200 cases of sporadic CRC patients with adverse reactions after oxaliplatin were collected from Harbin Medical University Cancer Hospital, Harbin, China. All patients received a chemotherapy regimen containing oxaliplatin (100 colon cancer and 100 rectal cancer). We reviewed the adverse reactions induced by oxaliplatin in patients with colon and rectal cancer. Results We found there was no significant difference in gastrointestinal toxicity, hematotoxicity, neurotoxicity, hepatotoxicity, respiratory toxicity, and cardiotoxicity caused by oxaliplatin between patients with colon cancer and patients with rectal cancer, but patients with rectal cancer were more prone to allergic reactions than patients with colon cancer after oxaliplatin. In addition, we found neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) were higher in patients with colon cancer than in patients with rectal cancer. This may reflect differences in immune status and inflammatory responses between colon cancer and rectal cancer, which might be the reason for more allergic reactions caused by oxaliplatin in colon cancer patients compared to rectal cancer patients. Conclusion Except for a higher incidence of allergic reactions in patients with rectal cancer, no significant difference in the incidence of adverse drug reactions associated with oxaliplatin was noted between patients with colon cancer and rectal cancer. Our results suggested more attention should be paid to the allergic reaction caused by oxaliplatin in patients with colon cancer.

The association between eosinophils (CD16+ eosinophils), basophils (CD203+ basophils), and CD23 B lymphocytes in patients with atopic dermatitis on dupilumab therapy: pilot study.

Eosinophils, basophils, and the molecule CD23 on B cells are involved in the pathophysiology of atopic dermatitis (AD). The molecule CD23isinvolved in the regulation of IgE synthesis and is expressed by activated B cells. The molecule CD16 is used to assess the activation of eosinophils and CD203 of basophils. The association between the count of eosinophils, basophils, CD16+ eosinophils, CD203+ basophils and the expression of the activation marker CD23 on B cells in patients with AD (with and without dupilumab therapy) is not described. The aim of this pilot study is to evaluate the association between the blood count of eosinophils, basophils, relative CD16+ eosinophils, relative CD203+ basophils, and the expression of molecule CD23 on B cells and on their subsets (total, memory, naive, switched, non-switched) in patients suffering from AD (with and without dupilumab therapy) and in control group. A total of 45 patients suffering from AD were examined; 32 patients without dupilumab treatment (10 men, 22 women, average age 35years), 13 patients with dupilumab treatment (7 men, 6 women, average age 43.4years), and 30 subjects as a control group (10 men, 20 women, average age 44.7years). Immunophenotype was examined by flow cytometry in which monoclonal antibodies with fluorescent molecules were used. For statistical analysis we used non-parametric Kruskal-Wallis one-factor analysis of variance with posthoc by Dunn's test with Bonferroni modification and the Spearman's rank correlation coefficient; for coefficients higher than 0.41, we report R2 (percent of variation explained). The absolute count of eosinophils was significantly higher in patients with AD (with and without dupilumab) in comparison to healthy subjects. The difference in the relative count of CD16+ eosinophils in patients with AD (with and without dupilumab therapy) compared with control is not statistically significant. In patients with dupilumab therapy the significantly lower count of relative CD203+ basophils was confirmed compared with control. The higher association between the count of eosinophils (absolute and relative) and the expression of CD23 marker on B cells was confirmed in patients with dupilumab therapy; in contrast, this association was low in patients with AD without dupilumab therapy and in healthy subjects. The higher association between the count of eosinophils (absolute and relative) and the expression of CD23 marker on B cells was confirmed in patients with AD under dupilumab therapy. It suggests that IL-4 production by eosinophils may play a role in B lymphocyte activation. The significantly lower count of CD203+ basophils has been demonstrated in patients with dupilumab therapy. This reduction of CD203+ basophil count may contribute to the therapeutic effects of dupilumab by reducing the inflammatory response and allergic reactions in patients with AD.

Allergic reactions to propofol in adult patients with egg or soybean allergy: a retrospective cohort study from a large database of a single institute

BackgroundIn recent years, many reports have indicated that propofol is safe to administer to patients with egg/soybean allergy in Western countries. Egg allergy is more frequent in Asia, but there are limited reports regarding allergic reactions to propofol use among adults. This study aimed to determine whether propofol causes allergic reactions in patients with egg/soybean allergy.MethodsAdult patients who underwent surgery involving anesthesiologists from 2018 to 2021 were included. In all patients, we reviewed food allergy information in their electronic medical record and extracted anesthetics. Patients with egg/soybean allergy were subdivided into two groups on the basis of intraoperative use of propofol. We evaluated each group for allergic reactions within 24 h after the induction of anesthesia. The primary outcome was a relative risk of allergic reactions after propofol use for patients with egg/soybean allergy.ResultsIn total, 22,111 patients with 28,710 anesthesia records were identified. Among patients with egg/soybean allergy, 173 (0.8%) patients and 237 (0.8%) anesthesia records were included in the study. Among the records of egg-/soybean-allergic patients, 151 were administered propofol, and 86 were not. The relative risk of allergic reactions after propofol use for patients with egg/soybean allergy was 1.14 (95% confidence interval, 0.10–12.4; p = 0.74).ConclusionThe use of propofol in patients with egg/soybean allergy does not significantly increase the relative risk of allergic reactions. Therefore, anesthesiologists can appropriately determine the indication for propofol, even in patients with egg/soybean allergy.Trial registrationUMIN-CTN, UMIN000049321 registered 26 October 2022 — retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000056167

Лабораторні маркери алергічних та токсико-алергічних реакцій на медикаменти у хворих на туберкульоз легень

Abstract. The purpose of the study was to determine the laboratory markers of allergic reactions (AR) and toxic-allergic adverse reactions (TAR) to medications in patients with active pulmonary tuberculosis (TB) to predict their development. Methods and materials. There are the results of examination of 68 patients with TB, average age (38.2 ± 1.8) years, who were divided into 4 groups depending on the presence of adverse reactions to medications. 1A group included 12 patients with clinical signs of allergy (A) and nonelevated indicators of liver function in the blood; 2nd group included 16 people with signs of allergy with the increased liver function indicators that developed during treatment (TAR); 3T group included 25 people with the only elevated liver function indicators (toxic (T) reactions); 4BP group included 15 patients without adverse reactions to medications. All patients were examined with standard clinical, radiological, laboratory, biochemical, microbiological, and immunological methods with subsequent computer statistical processing using ranked data series. Conclusions. There were determined the laboratory markers (lymphocyte coefficient — LC and lymphocyte-hepatic coefficient — LHC) of AR and TAR in patients with TB. Decrease in LC (calculated for CD3+, CD8+) below 1 unit and in LC (for CD4+ or CD19+) below 0.5 unit confirmed an allergic reaction in patients with clinical manifestations of allergy. The absence of LC decrease made it possible to diagnose TAR at the presence of allergy clinical signs in patient. The growth of LC for CD 16+56+ above 1.0 unit was the evidence of toxic reactions. Decrease in LHK (calculated for CD3+, CD4+, CD8+ or CD19+) below 2.5 units is possible to use as a TAR marker.

Recent Advancements in Drug Delivery of Sinomenine, A Disease-Modifying Anti-Rheumatic Drug.

Sinomenine (SIN) is a benzyltetrahydroisoquinoline-type alkaloid isolated from the dried plant root and stem of Sinomenium acutum (Thumb.) Rehd.et Wils, which shows potent anti-inflammatory and analgesic effects. As a transforming disease-modifying anti-rheumatic drug, SIN has been used to treat rheumatoid arthritis over twenty-five years in China. In recent years, SIN is also in development for use against other disorders, including colitis, pain, traumatic brain injury, and uveitis. However, its commercial hydrochloride (SIN-HCl) shows low oral bioavailability and certain allergic reactions in patients, due to the release of histamine. Therefore, a large number of pharmaceutical strategies have been explored to address these liabilities, such as prolonging release behaviors, enhancing skin permeation and adsorption for transdermal delivery, targeted SIN delivery using new material or conjugates, and co-amorphous technology. This review discusses these different delivery strategies and approaches employed to overcome the limitations of SIN for its efficient delivery, in order to achieve improved bioavailability and reduced side effects. The potential advantages and limitations of SIN delivery strategies are elaborated along with discussions of potential future SIN drug development strategies.

Cofactors, age at onset, allergic comorbidities and gender are different in patients sensitized to omega-5 gliadin and Pru p 3

Aim of this study is to clarify the impact of cofactors on allergic reactions in patients sensitized to LTP and ω-5-gliadin. We retrospectively examined the charts of our outpatients from January 2015 to July 2019 and identified 157 patients seen for urticaria/angioedema or anaphylaxis after a meal, in presence or absence of cofactors and sensitized to LTPs (Pru p 3 and/or Tri a 14) and/or ω-5-gliadin (Tri a 19). we compared LTPs-positive patients and those sensitized to Tri a 19 in order to assess the difference in cofactors involved and in frequency of clinical presentation. Our data show that exercise is the most frequent cofactor in FDEIAn and the involvement of exercise, alcohol and multiple cofactors was more frequently found in males than in females. We found that exercise, pollen counts peaks and multiple cofactors were more often related to anaphylaxis than mild reactions. Finally, we performed a comparison between patients LTPs+ and Tri a 19+ that showed in the latter group a lower frequency of allergic comorbidities, a higher median age at the onset of symptoms and frequency of alcohol exposure. Our data show that the search for possible cofactors involved in food allergy is essential not only for diagnostic purposes, but also for risk assessment strategies.

Long-acting injectable paliperidone palmitate induced severe cutaneous allergic reaction in a patient with first episode delusional disorder tolerating oral paliperidone regimen: a case report

BackgroundPaliperidone is a second-generation antipsychotic agent that is effective in the treatment of schizophrenia and schizoaffective disorder as well as an adjunct to mood stabilizers and antidepressants for bipolar and depressive disorders. Paliperidone is available in both oral and injection forms. Here we report an unexpected case of cutaneous allergic reaction induced by paliperidone long-acting injection (LAI) following oral tolerance.Case presentationA 55-year-old man with first episode delusional disorder was treated with paliperidone tablets with tolerance. On day seven he received the paliperidone LAI and developed an allergic reaction in minutes including flushing of the face, widespread urticaria with mild airway constriction. The allergic symptoms were relived following the administration of antihistamine within several minutes.ConclusionThe allergic reaction that occurred post administration of the paliperidone LAI but not the oral tablets suggest it is likely due to the excipients in the formulation of the LAI rather than paliperidone itself. This case highlights the necessity of monitoring allergic reactions in psychiatric patients when converting from oral to LAI format of paliperidone.

Allergies in Phlebology: A National Survey and Review of Literature

Abstract Background Type I and type IV hypersensitivity can play an important role in phlebology with potential severe consequences for patients and treatment results. Methods A review of literature was performed for allergic reactions in patients treated for venous insufficiency and venous leg ulcers (VLU), together with a study in the Dutch and European centre for adverse drug reactions. Besides, we performed a survey among 37 Dutch medical hospitals to investigate the incidence of treatment allergies. Results Hypersensitivity reaction is seen in 46–76% of patient with VLU; about 20% of these reactions are caused by wound dressings products. In 11 centres urticarial and respiratory complaints were seen and 3 systemic allergic reactions in phlebological treatments. In Europe 25 cases of systemic reactions were reported. Conclusion Patients with VLU with slow healing tendency should undergo allergy tests. Type I hypersensitivity with anaphylactic reaction, also to sclerosing fluid or tumescent, is very rare.