Intolerance Reactions Research Articles

5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis.

Background/Aims5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota.MethodsWe performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC.ResultsOf 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05).ConclusionsIn patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.

Application of laboratory methods for determining hypersensitivity to antuberculosis drugs in patients with pulmonary tuberculosis

To date, there are no unified and standardized laboratory methods for the diagnosis of hypersensitivity to anti-TB drugs.Objective — to establish the most informative available in vitro immunolo-gical tests to determine the sensitivity to anti-TB drugs in patients with pulmonary tuberculosis.Materials and methods. Clinical and immunological examination was carried out in 36 patients with pulmonary tuberculosis, which were divided into two groups: 1 — with the presence of typical clinical manifestations of hypersensitivity to anti-TB drugs; 2 — without visible clinical signs of hypersensitivity. The tests were performed to detect intolerance to first-line anti-TB drugs in vitro: inhibition of lymphocyte migration, neutrophil alteration, inhibition of the adhesive ability of polymorphic nuclear leukocytes to plastic, release of potassium ions by blood leukocytes, erythrocyte sedimentation reaction.Results and discussion. A higher frequency of detecting positive reactions with anti-TB drugs was established in tests of neutrophilocyte alteration and erythrocyte sedimentation. Patients of the 1st group showed higher levels on average: serum tryptase, intensities of alteration of neutrophilic granulocytes, sedimentation values of red blood cells with anti-TB drugs at the 3rd and 24th hours.Conclusions. The most informative tests to determine the unpredictable reactions of drug intolerance in TB patients were the neutrophil alteration test and the sedimentation test of red blood cells with anti-tuberculosis drugs. The use of these tests can help to understand the pathogenesis of drug hypersensitivity in each case.

Comparative Analysis of Histamine Levels of Common Farm Fishes

Histamine fish poisoning (HFP) is a foodborne chemical intoxication caused by consuming a bacterially contaminated fish that are capable of producing histamine. Histamine may cause food intolerance and allergic reaction. The aim of this study is to investigate the occurrence and level of histamine in fish that are commonly consumed in Kafrelshiekh governorate and how to control it's level in those fishes. Accurately, 90 samples from three different species of fish represented by Mugil cephalus, Oreochromis niloticus and Clarias gariepinus (30 of each) were collected at different times from different farms in Kafrelshiekh governorate and examined for determination of their histamine levels mg% using Enzyme-Linked Immunosorbent Assay (ELISA). Histamine was detected in all fish samples with mean values as following 9.76 ± 0.12 in Mugil cephalus, 13.32 ± 0.17 in Oreochromis niloticus and 21.05 ± 0.26 in Clarias gariepinus with acceptability of 82.22 % according to Egyptian Organization for Standardization EOS (2005).

Фитотерапия климактерических нарушений

A study to examine the efficacy and safety of drug Menomedin in patients with climacteric disorders of mild to moderate severity in late reproductive period was performed. The average menopausal index, according to a Menopause Rating Scale (MRS), was significantly lower after treatment (8.6±0.1) than before treatment (23.2±0.5). In all examined women hormone levels corresponded to perimenopausal values. Side effects and individual intolerance reactions were not observed. Antiatherosclerotic effect was detected during treatment Menomedin. Author of the study conclude that a good level of efficacy and safety Menomedin allows to use it at the earliest manifestations of menopausal disorders in women in the late reproductive period (perimenopause). Key words: climacteric syndrome, perimenopause, Menomedin.

Application effect of apatinib in patients with failure of standard treatment for advanced malignant tumours

BackgroundIn recent years, targeted therapy has received widespread attention. Among these therapies, anti-angiogenic targeted drugs have become one of the hotspots of research. Apatinib is a novel oral small molecule anti-angiogenic agent that has been clinically tested in a variety of solid tumours. The aim of this study was to investigate the efficacy of apatinib in patients with advanced malignant tumours and failure of standard therapy.MethodsWe collected 41 patients with advanced malignant tumours in our department; all tumours were pathologically confirmed as malignant. All patients received apatinib after failure of standard therapy: 500 mg/dose, one dose/d, orally 30 min after a meal, until progressive disease or intolerable adverse reactions occurred. When there was a second- or third-degree adverse reaction associated with apatinib during treatment, apatinib treatment could be suspended or reduced to 250 mg/dose. Clinical efficacy and progression-free survival were assessed according to RECIST1.1, and adverse reactions were observed.ResultsEfficacy assessment was available for 31 patients with a median progression-free survival time of 2.66 months; the objective response rate and disease control rates were 16.1 and 64.5%, respectively. The disease control rates of the patients with lower Eastern Cooperative Oncology Group scores (1–2 points) and with fewer metastatic sites (< 3 sites) were higher than those of the patients with higher scores (3 points) and with more metastatic sites (≥3 sites), respectively (all P < 0.05). The most common adverse reactions were hypertension, neutropenia and hand-foot syndrome.ConclusionFor patients with advanced malignant tumours with failure of standard therapy, administration of apatinib can still result in good efficacy. The efficacy of apatinib is better in patients with a higher performance status and lower degree of tumour progression.

Iron Infusion and Induced Hypophosphatemia: The Role of Fibroblast Growth Factor-23.

The mechanism of action of fibroblast growth factor-23 (FGF23) is becoming increasingly clearer as a result of studies that have defined its structure and pleiotropic effects. Furthermore, data are emerging on the effects exerted on this hormone by iron administration. Ten main iron formulations are recognized (with clear differences in composition and possible reactions of intolerance and anaphylaxis), which are indicated for iron deficiency anemia, including nephropathic subjects, as suggested by medical guidelines. With some types of iron formulation (especially iron carboxymaltose) a particular side effect has been observed: hypophosphatemia, mediated by FGF23. This review aims to draw attention to this correlation and the contradiction represented by the presence of both positive and negative modulation by FGF23, with the effects induced by its increase even after long-term treatment with iron formulation. However, more evidence is needed to understand the reasons for this differential stimulation.

Clinical study of gefitinib maintenance therapy after concurrent radiotherapy and chemotherapy for locally advanced NSCLC with EGFR sensitive mutations.

87 Background: To investigate the value of Gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), in the maintenance therapy of locally advanced NSCLC after concurrent radiotherapy and chemotherapy. Methods: From Jan 2010 to Jan 2015, 166 patients with locally advanced NSCLC were treated in JCH. Total 86 patients with no progress after concurrent radiotherapy and chemotherapy were selected. Within 2 to 6 weeks after therapy, eligible patients received TKI (Gefitinib 250mg/day) or were observed for 1 year. If disease progresses or intolerable adverse reactions occur, the treatment should be discontinued. Chest and abdomen CT exam were performed 2 weeks before TKI treatment, and every 2 months thereafter. The same assessment techniques were used throughout the study. Therapeutic evaluation refers to the RECIST. SPSS 19.0 was used for data analysis and processing. Survival analysis was performed by Kaplan-Meier method. Results: In TKI drug group, CR 6 cases, PR 18 cases, SD 12 cases, PD 7 cases; in observation group, CR 3 cases, PR 11 cases, SD 13 cases, PD 16 cases. The CR + PR were 54.5% and 31.8% respectively, P = 0.031. The CR + PR + SD were 81.8% and 61.4% respectively, P = 0.033. The objective remission rate and disease control rate of TKI group were higher than those of observation group. The TTP in TKI group was 13.6 months (CI: 12.88-14.32 months) and that in observation group was 10.8 months (CI: 9.87-11.73 months), P = 0.001. The median OS of TKI group was 34.5 months (CI: 32.12-36.88 months) and that of observation group was 30.3 months (CI: 28.64-31.96 months), P = 0.029. Conclusions: 1. The objective remission rate and disease control rate of TKI group were higher than those of placebo group. 2. Ohitinib was not on the market in China at the time of this study and economic reason, so palliative chemotherapy was the main way to treat condition, and no third-generation TKI drugs were used. This may be one of the reasons why the total OS in this study was not long. 3. TKI drugs can improve the disease control rate and prolong the survival time of patients with locally advanced NSCLC after concurrent radiotherapy and chemotherapy, and have less side effects.

Icotinib and pemetrexed in treatment of lung adenocarcinoma and the effects on prognostic survival rate of patients.

Efficacy comparison of icotinib and pemetrexed in the treatment of lung adenocarcinoma and the effects on the prognostic survival rate of patients were investigated. A retrospective analysis was performed in 132 lung adenocarcinoma patients who were treated in the Affiliated Hospital of Weifang Medical University from July 2010 to July 2015. Among them, 69 patients were treated with icotinib (icotinib group), and 63 patients were treated with pemetrexed (pemetrexed group). In the icotinib group, 125 mg icotinib was orally administered continuously, 3 times a day, until progressive disease or intolerable adverse reactions occurred. In the pemetrexed group, 500 mg/m2 pemetrexed was intravenously dripped for a total of 4 cycles, 21 days for 1 cycle, until progressive disease or intolerable adverse reactions occurred. The efficacy, toxic and side effects, and survival rate of the two groups were evaluated. There was a statistically significant difference in toxic and side effects between the two groups of drugs after the treatment of lung adenocarcinoma (P<0.05). The median survival time of patients was 16 months in the icotinib group and 10 months in the pemetrexed group, with a statistically significant difference (P<0.05). The 1-year survival rate was higher in the icotinib group than that in the pemetrexed group (P<0.05). There was no difference in 2- and 3-year survival rates between the two groups (P>0.05). In conclusion, the clinical efficacy of icotinib is similar to that of pemetrexed in the treatment of lung adenocarcinoma, but icotinib has less adverse reactions, with better improvement in disease control.

Summary: Hypersensitivity to Analgesics: intolerance or allergy?

Hypersensitivity to Analgesics: intolerance or allergy? Abstract. Nonsteroidal anti-inflammatory drugs (NSAID) can induce not immunologically mediated intolerance reaction and allergic reactions. Intolerance reactions are more prevalent than allergic reactions. The clinical manifestation does not differentiate between an intolerance reaction and an immediate type allergy. They usually induce either cutaneous and / or respiratory symptoms. The pathogenesis of NSAID intolerance is based on the inhibition of the cyloclooxygenase (COX), particularly the COX-1, which is, however, the mechanism of action on which NSAIDs exert their intended effects. Therefore, cross-reactivity to many structurally nonrelated NSAIDs has to be expected (broad NSAID intolerance). In case of an allergy to a NSAID, however, only cross-reactivity to structurally related drugs occurs. It is very important for the patient with intolerance reactions to NSAIDs to identify well tolerated alternative analgesics.

Histamine causes influx via T-type voltage-gated calcium channels in an enterochromaffin tumor cell line: potential therapeutic target in adverse food reactions.

The P-STS human ileal neuroendocrine tumor cells, as a model for gut enterochromaffin cells, are strongly and synergistically activated by histamine plus acetylcholine (ACh), presumably via histamine 4 receptors, and weakly activated by histamine alone. Sensing these signals, enterochromaffin cells could participate in intestinal intolerance or allergic reactions to food constituents associated with elevated histamine levels. In this study we aimed to analyze the underlying molecular mechanisms. Inhibition by mepyramine and mibefradil indicated that histamine alone caused a rise in intracellular calcium concentration ([Ca2+]i) via histamine 1 receptors involving T-type voltage-gated calcium channels (VGCCs). Sensitivity to histamine was enhanced by pretreatment with the inflammatory cytokine tumor necrosis factor-α (TNF-α). In accordance with the relief it offers some inflammatory bowel disease patients, otilonium bromide, a gut-impermeable inhibitor of T-type (and L-type) VGCCs and muscarinic ACh receptors, efficiently inhibited the [Ca2+]i responses induced by histamine plus ACh or by histamine alone in P-STS cells. It will take clinical studies to show whether otilonium bromide has promise for the treatment of adverse food reactions. The cells did not react to the nutrient constituents glutamate, capsaicin, cinnamaldehyde, or amylase-trypsin inhibitors and the transient receptor potential channel vanilloid 4 agonist GSK-1016790A. The bacterial product butyrate evoked a rise in [Ca2+]i only when added together with ACh. Lipopolysaccharide had no effect on [Ca2+]i despite the presence of Toll-like receptor 4 protein. Our results indicate that inflammatory conditions with elevated levels of TNF-α might enhance histamine-induced serotonin release from intestinal neuroendocrine cells. NEW & NOTEWORTHY We show that histamine synergistically enhances the intracellular calcium response to the physiological agonist acetylcholine in human ileal enterochromaffin tumor cells. This synergistic activation and cell activation by histamine alone largely depend on T-type voltage-gated calcium channels and are inhibited by the antispasmodic otilonium bromide. The cells showed no response to wheat amylase-trypsin inhibitors, suggesting that enterochromaffin cells are not directly involved in nongluten wheat sensitivity.

Food intolerance in dogs and cats.

Food intolerance refers to any abnormal physiological response to a food or food additive believed not to be immunological in nature. Mechanisms include food toxicity, pharmacological reactions, metabolic reactions, dysmotility, dysbiosis, physical effects and non-specific dietary sensitivity. Food intolerance reactions are variable, typically dose-dependent, and can occur at any age. Signs may arise at any time, sometimes several hours or days after consumption of the offending food item, and can last for hours or days. Dietary indiscretion and non-immunological food intolerance are probably more common in dogs than true dietary hypersensitivity. Hopefully, with a greater knowledge of the different pathophysiological mechanisms involved, we will become better at recognising, preventing and managing adverse food reactions.

Food as a trigger for abdominal angioedema attacks in patients with hereditary angioedema

BackgroundHereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) is a rare inherited disease. In most HAE-affected subjects, defined trigger factors precede angioedema attacks. Mechanisms of how trigger factors stimulate the contact activation pathway with bradykinin generation are not well elucidated. In recent studies, hypersensitivity reactions and food were stated as relevant triggers. We investigated HAE affected people for possible hypersensitivity reactions or intolerances and their relation in triggering angioedema attacks.MethodsA questionnaire was filled in, recording date of birth, gender, and self-reported angioedema attacks associated with the ingestion of foodstuffs, administration of drugs, hymenoptera stings and hypersensitivity reactions against inhalation allergens. All participants performed a skin prick test against inhalation allergens and food. In patients who stated an association of possible hypersensitivity with angioedema, a serological ImmunoCAP test was also performed.ResultsFrom the 27 women and 15 men analyzed, 79% stated trigger factors. From those food was mentioned in 36%. The suspected food included tomato, green salad, fish, citrus fruits, apple, onion, garlic, cheese, chili, kiwi, milk, tree nuts, strawberry, pineapple, shrimps, bread, banana, leek, chicken and alcohol, and were associated with abdominal angioedema. Neither the skin prick test nor the ImmunoCAP-test turned out positive for the tested food allergens.ConclusionFood seems to be a relevant trigger factor, causing angioedema in HAE affected patients. The reason, however, is not IgE-mediated hypersensitivity, but most probably an intolerance reaction to food products.

CD58; leucocyte function adhesion-3 (LFA-3) could be used as a differentiating marker between immune and non-immune thyroid disorders

The link between Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) has been debated for decades due to the shared pathological and immunological components. Immune intolerance and inappropriate immune reaction against self-thyroid cells are distinctive features of both diseases, but definitive data for the clinical presentation of autoimmune thyroid disease remains unclear. To analyse the expression of T-regulatory cells, CD58, the CD4/CD8 ratio and the neutrophil/lymphocyte ratio and to determine if these parameters could be used as differentiating markers between auto- and non-immune thyroid diseases, 75 patients were enrolled in this study—40 with autoimmune thyroid disease (HT and GD ), 15 with non-immune thyroid disease, and 20 healthy controls. Multicolour flow cytometry was used to analyse CD58, T-regulatory cells (Treg) expressing CD4, CD25, HLA-DR and CD8 using different stained fluorescent labelled monoclonal antibodies. The neutrophils and lymphocyte ratio was also measured. Lower expression of Treg with higher expression of CD58 (LFA-3) was found in the autoimmune diseases when compared with the non-immune and control groups. ROC analysis showed that CD58 with sensitivity 88% and specificity 100% with cut-off value more than or equal to 29.9 indicates Hashimoto’s disease, while lower value indicates colloid goitre, and higher or equal to 29.84 indicates Graves’ disease and lower indicates colloid goitre with 100% sensitivity and specificity. CD58 could be used as differentiating marker between immune and non-immune thyroid disorders.

Allergic and intolerance reactions to wine.

Hypersensitivity reactions to alcoholic beverages (particularly red wine) are relatively frequent, affecting 10% of the general population. Hypersensitivity reactions due to alcoholic drinks, mainly in the form of airway reactions (rhinitis and asthma), occur significantly more frequently in persons with pre-existing rhinitis and asthma. In terms of pathogenesis, it has to be differentiated between immunologic, mainly IgE-mediated, hypersensitivity reactions (wine allergies), and intolerance reactions in which no causative allergen-specific immune mechanisms can be detected. Allergens responsible for wine allergy could be: grape (Vitis vinifera) proteins (particularly the major allergen lipid transfer protein Vit v1), proteins and ingredients used for the fining of wines such as fish gelatin or isinglass (swim bladder of the fish huso, family of sturgeons), ovalbumin, dairy (casein) products, gum arabic, enzymes (lysozyme, pectinase, glucanase, cellulase, glucosidase, urease, aromatic enzymes), molds (particularly Botrytis cinerea) responsible for the noble rot in wines, yeasts and proteins from insects that contaminated the mash. Type 1 allergic reactions (positive prick tests) have been described for inorganic components like ethanol, acetaldehyde, acetic acid and sulfites, but no specific IgE could be detected in the serum. Ethanol, acetaldehyde and acetic acid, flavonoids (anthocyanins and chatechines), sulfites, histamine and other biogenic amines are the main causative agents of intolerance reactions (pseudoallergic reactions) to wine. After a short historic review of viticulture and the importance of wine in classical antiquity, we go into the chemical processes of alcoholic fermentation and the genetically inherited “flush syndrome” caused by an acetaldehyde dehydrogenase 2 polymorphism, subsequently we focus on the different etiologic factors of allergies and intolerance reactions to wine. The most frequent intolerance reactions to sulfites occur particularly after the ingestion of white wine and in asthma patients. Intolerance reactions to histamine and other biogenic amines occur mainly after ingestion of red wine and in persons with diamine oxidase (DAO) deficiency.

Asthma exacerbation by aspirin and chemical additives: use of a nucleotide template model to investigate potential mechanisms

Aspirin exacerbated asthma (AEA) affects approximately 10% of the asthmatic population. Clinical studies with a focus on abnormalities in arachidonate metabolism do not adequately account for susceptibility. Other pharmacological targets of aspirin receive less attention. Further investigation is required to elucidate mechanisms, improve on diagnosis and treatment. This study employs a molecular modeling approach, based on use of a nucleotide template, to standardise and compare molecular structures of compounds known to induce or prevent asthma. Results identify relative molecular similarity within the structures of drugs and cell mediators relevant to AEA and intolerance reactions. The investigated compounds provide equivalent fits to ligand structures for GABA, glycine, NMDA and nicotinic receptors. Chloride and ligand-gated ion channels are a common link between agents responsible for the induction and control of AEA. The methodology is applicable to compounds responsible for chemical-induced intolerance reactions..

European Regulations for Labeling Requirements for Food Allergens and Substances Causing Intolerances: History and Future.

Food allergens and intolerances have been diagnosed by doctors for decades, but have received heightened attention in the last two decades because diagnosis and awareness have increased. Consequently, regulators in many jurisdictions have addressed this topic by introducing labeling requirements for substances causing allergies and intolerance reactions in affected individuals. Mandatory labeling of food allergens allows persons suffering from these to make informed choices. However, regulations in some geographic areas have resulted in significant problems for manufacturers as well as consumers. This has been mainly due to frequent changes and amendments, and it has been difficult for all stakeholders to follow and understand the status quo of legislation. The present paper describes the development of European directives and regulations for the labeling of food allergens and intolerances to substances like gluten over the past decades and provides an outlook of what can reasonably be expected to change in the coming years. It also identifies existing gaps, like a lack of threshold levels for adventitious contamination and consequently a proliferation of precautionary allergen labeling, which neither benefits the consumer nor the food industry in its current form.

ЗНАЧЕНИЕ РЕАКЦИИ ДЕГРАНУЛЯЦИИ ТУЧНЫХ КЛЕТОК ПРИ ПОДБОРЕ ИНСУЛИНОТЕРАПИИ У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ

Introduction: Strategy of treatment of patients with diabetes (DM) in Belarus is based on a basis of domestic and international conciliatory documents in the area of diabetes. Patients with DM apply domestic production insulin, and at development of individual intolerance or allergic reaction, there is a possibility to replace applied insulin other less antigenic preparation. Aim: To conduct a reaction clinics-experimental research based on mast cells degranulation corpulent cages (RDMC), arising on various kinds of the insulin applied in republic of Belarus. Material and methods: Estimation RDMC of animals on various kinds of insulin which received 31 patient with DM with presence in the anamnesis of various allergic reactions and necessity for correction insulin therapy or change of a preparation of insulin. Monitoring fasting and postprandial glycemia was carried out, degree of indemnification of a carbohydrate exchange was estimated. The applied technique consists in revealing RDMC of a rat at incubation with whey of the patient and investigated insulin. At presence in whey of the patient specific IgЕ to the given kind of insulin occurs degranulation corpulent cages. Results: More than 80 % of patients had sub- or decompensation of a diabetes. Sharply positive tests (RDMC more than 40 %) are absent. On 5 entered preparations of insulin positive reactions (3-13 %) are fixed. All preparations of insulin had weakly positive RDMC (29-55 %). Сonclusion: Carrying out RDMC on various kinds of insulin will help the clinical physician to pick up less immune medical product in case of presence at the patient of allergic reaction. All preparations of insulin investigated in given work can be applied to complex treatment DM.

Photo-activated degradation of tartrazine by H2O2 as catalyzed by both bare and Fe-doped methyl-imogolite nanotubes

Imogolite-like nanomaterials were tested as heterogeneous catalysts for the photo-catalytic degradation of tartrazine (a food dye recalcitrant to biodegradation and responsible of allergic and/or intolerance reactions) in the presence of H2O2. Methyl-imogolite, a hybrid organic/inorganic material with chemical composition (OH)3Al2O3SiCH3, occurs as single-walled nanotubes with an inner surface lined by Si-CH3 groups and an aluminum oxo-hydroxide outer surface, where octahedral Al3+ ions may be isomorphically substituted by Fe3+ ions. Besides bare methyl-imogolite, novel Fe doped nanotubes (with nominal composition (OH)3Al2-xFexO3SiCH3, where x=0.025 or 0.050) were prepared by ion exchange of preformed methyl-imogolite with FeCl3×6H2O in water. Physico-chemical characterization of the materials showed that Fe doping positively modifies nanotubes light absorption capacity by lowering the band gap of methyl-imogolite from 4.9eV to 2.4eV. At higher Fe content (sample with nominal composition (OH)3Al1.950Fe0.050O3SiCH3), some Fe oxo-hydroxide clusters form, due to the natural tendency of Fe to form aggregates.Photo-degradation tests of tartrazine show that both bare and Fe-doped methyl-imogolite efficiently remove the dye from aqueous mixtures through different mechanisms. With bare methyl-imogolite, under UV light almost 65% Total Organic Carbon (TOC) is removed within 2h, likely due to the formation of reactive AlOOH groups promptly generating HO radicals. With sample having nominal composition (OH)3Al1.975Fe0.025O3SiCH3, Fe3+ species undergo efficient photo-Fenton reaction under UV light, leading to 90% TOC removal after 2h. Conversely, the Fe oxo-hydroxide clusters at nanotubes outer surface likely worsen the photo-Fenton activity of the sample with (OH)3Al1.950Fe0.050O3SiCH3 nominal composition as far as the TOC removal is concerned.

Evaluation of the concurrent use of dolutegravir and metformin in human immunodeficiency virus-infected patients.

An analysis of the interaction between dolutegravir and metformin was conducted in the HIV ambulatory clinic setting. This was a multicenter, retrospective case series evaluating adult, HIV-infected patients concurrently prescribed dolutegravir and metformin. Historical electronic medical records were utilized to collect case-specific data. Laboratory parameters including serum creatinine (SCr), hemoglobin A1c (HgbA1c), plasma HIV RNA, CD4 cell count, and lactate were reviewed. Adverse drug reactions were assessed using patient-reported gastrointestinal intolerance and hypoglycemic symptoms. Metformin dose reduction or discontinuation was also recorded. Nineteen patients identified as concurrently taking metformin and dolutegravir were included. Eighteen patients were on metformin prior to dolutegravir initiation, with 13 having received metformin for at least six months prior to dolutegravir. At the time of dolutegravir initiation, one patient had a preemptive metformin dose reduction. Seven patients were initiated on dolutegravir with a metformin dose greater than 1000 mg daily. Eleven patients had baseline and three- to six-month follow-up HgbA1c. Of those 11 patients, eight had stable or decreased values. Thirteen of the 19 patients had an increase in SCr, with a median increase of 0.3 mg/dl (0.03-0.43). Gastrointestinal distress (N = 3) and hypoglycemic symptoms (N = 3) were reported in a total of five patients. Adverse drug reactions resulted in metformin dose reduction (N = 2) and/or discontinuation (N = 2). There were no reported cases of lactic acidosis. Providers concurrently prescribing dolutegravir and metformin should be aware of potential consequences with this combination and may consider an empiric metformin dose reduction to prevent intolerable adverse drug reactions.

The Histidine Decarboxylase Gene Cluster of Lactobacillus parabuchneri Was Gained by Horizontal Gene Transfer and Is Mobile within the Species.

Histamine in food can cause intolerance reactions in consumers. Lactobacillus parabuchneri (L. parabuchneri) is one of the major causes of elevated histamine levels in cheese. Despite its significant economic impact and negative influence on human health, no genomic study has been published so far. We sequenced and analyzed 18 L. parabuchneri strains of which 12 were histamine positive and 6 were histamine negative. We determined the complete genome of the histamine positive strain FAM21731 with PacBio as well as Illumina and the genomes of the remaining 17 strains using the Illumina technology. We developed the synteny aware ortholog finding algorithm SynOrf to compare the genomes and we show that the histidine decarboxylase (HDC) gene cluster is located in a genomic island. It is very likely that the HDC gene cluster was transferred from other lactobacilli, as it is highly conserved within several lactobacilli species. Furthermore, we have evidence that the HDC gene cluster was transferred within the L. parabuchneri species.