Severity Of Allergic Symptoms Research Articles

Type I Kounis syndrome in a young woman without chest pain: a case report

BackgroundKounis syndrome is defined as the concurrence of acute coronary syndromes in the setting of allergic or anaphylactic reactions. It primarily affects men aged 40–70 years and is often associated with chest pain. This syndrome is often unrecognized and undiagnosed in clinical practice due to a low level of awareness. Herein, we present a case of type I Kounis syndrome in a young woman without chest pain.Case presentationA 28-year-old Japanese woman with a history of atopic dermatitis received a glycyrrhizin, glutathione, and neurotropin preparation (a preparation of inflamed skin extract from rabbits inoculated with vaccinia virus) at a dermatology clinic to treat pruritus caused by atopic dermatitis. Immediately after the administration, the patient developed abdominal pain and generalized body wheals. The patient was diagnosed with anaphylaxis and was transported to our hospital. She had no chest pain on arrival at our hospital; however, a 12-lead electrocardiogram showed ST elevation in leads I, aVL, V2, and V3, and an echocardiogram showed decreased wall motion in the anterior and lateral walls of the left ventricle. Sublingual nitroglycerin administration improved ST-segment elevation and left ventricular wall motion abnormalities. The patient underwent emergency coronary angiography, which revealed no significant stenosis, and was diagnosed with type I Kounis syndrome.ConclusionKounis syndrome without chest pain is rare in young women. Since it can be fatal in cases with severe allergic symptoms such as anaphylaxis, the possibility of concurrent acute coronary syndrome should be considered when treating systemic allergic reactions, regardless of age, sex, or the presence or absence of chest symptoms.

Evaluation of the suitability of β-lactoglobulin and whey protein in a BALB/c mouse model of cow's milk allergy

Cow's milk allergy (CMA) is common in infants and young children, which can adversely affect their growth and quality of life. Currently, research on CMA is mainly carried out in mouse models due to ethical constraints in population studies, but the determination of the optimal modelling protocol remains controversial. Here, we aim to evaluate the applicability of β-lactoglobulin (BLG) and whey protein from multiple perspectives in the construction of CMA models in BALB/c mice. To this end, the mice were sensitized by oral gavage of allergens, and then challenged by BLG or whey protein orally administered as well as whey intradermally in the ear, respectively. The allergic reactions were determined by the evaluation of anaphylactic symptoms, levels of specific immunoglobulins and Th2 cytokines, and intestinal tissue histopathology. Overall, mice in the BLG group showed more severe allergic symptoms and decreased body temperature than the other groups. The stronger allergic reactions to BLG in mice were also proved in higher levels of mouse mast cell protease-1 (mMCP-1), allergen specific antibodies, and Th2 cytokines as well as more serious intestinal damage than whey protein. These results suggest that BALB/c mice vary in the susceptibility to different cow's milk allergens, and the single component represented by BLG instead of whey protein, may be a more appropriate and effective allergen for the construction of BALB/c mouse model of CMA.

Pulsed light treatment helps reduce sulfur dioxide required to preserve Malbec wines

Sulfur dioxide (SO2) has a long history of use as a preservative in wine production to prevent oxidation and microbial spoilage. However, sulfite sensitivities exist in some consumers that range from mild breathing irregularities to more severe allergic symptoms that can include anaphylactic reactions. These adverse effects have inspired the wine industry to develop alternative approaches to either lower or replace the use of sulfites. This study focused on assessing the efficacy of employing continuous Pulsed Light (PL) in conjunction with reducing SO2 applications to inactivate spoilage microorganisms and ensure optimal red wine preservation. Applying PL at an intensity of 4 J/cm2 to wine in combination with a 25 mg/L SO2 treatment generated a 12% and 22% reduction, respectively, in both the number of viable yeast and LAB cells, respectively, while having no substantial effects on color, changes in acidity, total phenolic, and anthocyanin contents after four months of aging. We conclude that PL processing of wine can help reduce the amount of SO2 needed to inactivate wine spoilage microorganisms and prevent loss of wine quality due to chemical oxidation. This combination of markedly reducing SO2 concentration use along with introducing non-thermal PL processing can be done effectively and simply to ensure a safer and stable final wine product for sulfite-sensitive consumers.

Allergen-Encapsulating Nanoparticles Reprogram Pathogenic Allergen-Specific Th2 Cells to Suppress Food Allergy.

Food allergy is a prevalent, potentially deadly disease caused by inadvertent sensitization to benign food antigens. Pathogenic Th2 cells are a major driver for disease, and allergen-specific immunotherapies (AIT) aim to increase the allergen threshold required to elicit severe allergic symptoms. However, the majority of AIT approaches require lengthy treatments and convey transient disease suppression, likely due to insufficient targeting of pathogenic Th2 responses. Here, the ability of allergen-encapsulating nanoparticles to directly suppress pathogenic Th2 responses and reactivity is investigated in a mouse model of food allergy. NPs associate with pro-tolerogenic antigen presenting cells, provoking accumulation of antigen-specific, functionally suppressive regulatory T cells in the small intestine lamina propria. Two intravenous doses of allergen encapsulated in poly(lactide-co-glycolide) nanoparticles (NPs) significantly reduces oral food challenge (OFC)-induced anaphylaxis. Importantly, NP treatment alters the fates of pathogenic allergen-specific Th2 cells, reprogramming these cells toward CD25+FoxP3+ regulatory and CD73+FR4+ anergic phenotypes. NP-mediated reductions in the frequency of effector cells in the gut and mast cell degranulation following OFC are also demonstrated. These studies reveal mechanisms by which an allergen-encapsulating NP therapy and, more broadly, allergen-specific immunotherapies, can rapidly attenuate allergic responses by targeting pathogenic Th2 cells.

Expert consensus on the management of infusion-related reactions (IRRs) in patients with sickle cell disease (SCD) receiving crizanlizumab: a RAND/UCLA modified Delphi panel.

Crizanlizumab, a monoclonal antibody against P-selectin, has been shown to reduce vaso-occlusive crises (VOCs) compared to placebo in patients ≥ 16 years with sickle cell disease (SCD). However, there have been rare reports of patients experiencing severe pain and subsequent complications within 24hours of crizanlizumab infusions. These events are defined as infusion-related reactions (IRRs). Informed by current literature and clinical experience, a group of content experts developed clinical guidelines for the management of IRRs in patients with SCD. We used the RAND/University of California, Los Angeles (UCLA) modified Delphi panel method, a valid, reproducible technique for achieving consensus. We present our recommendations for managing IRRs, which depend on patient characteristics including: prior history of IRRs to other monoclonal antibodies or medications, changes to crizanlizumab infusion rate and patient monitoring, pain severity relative to patient's typical SCD crises, and severe allergic symptoms. These recommendations outline how to evaluate and manage IRRs in patients receiving crizanlizumab. Future research should validate this guidance using clinical data and identify patients at risk for these IRRs.

Heat/non-heat treatment alleviates β-conglycinin-triggered food allergy reactions by modulating the Th1/Th2 immune balance in a BALB/c mouse model.

With the increasing popularity of plant protein-based diets, soy proteins are favored as the most important source of plant protein worldwide. However, potential food allergy risks limit their use in the food industry. This work aims to reveal the mechanism of β-conglycinin-induced food allergy, and to explore the regulatory mechanism of heat treatment and high hydrostatic pressure (HHP) treatment in a BALB/c mouse model. Our results showed that oral administration of β-conglycinin induced severe allergic symptoms in BALB/c mice, but these symptoms were effectively alleviated through heat treatment and HHP treatment. Moreover, β-conglycinin stimulated lymphocyte proliferation and differentiation; a large number of cytokines interleukin (IL)-4, IL-5, IL-10, IL-12 and IL-13 were released and interferon γ secretion was inhibited, which disrupted the Th1/Th2 immune balance and promoted the differentiation and proliferation of naive T cells into Th2-type cells. Heat/non-heat treatment altered the conformation of soybean protein, which significantly reduced allergic reactions in mice. This regulatory mechanism may be associated with Th1/Th2 immune balance. Our results provide data support for understanding the changes in allergenicity of soybean protein within the food industry. © 2024 Society of Chemical Industry.

Rare FLG mutation associated with severe atopy

Background: The prevalence of atopic disease, which consists of conditions such as atopic dermatitis, allergies, and asthma, has been on the rise in recent decades. In children, atopic dermatitis often acts as an initial manifestation of atopic disease and frequently precedes the development of food allergies, asthma, and allergic rhinitis. Mutations in the FLG gene, encoding the fillagrin precursor profillagrin, serve as a genetic risk factor for these diseases. Approximately 25%–50% of individuals with atopic dermatitis carry FLG mutations. It has been proposed that FLG mutations exhibit variations specific to different populations, indicating distinct patterns within each population. Severe allergic symptoms could indicate the presence of an underlying immunodeficiency or immune dysregulation and in patients with severe, early-onset, or simultaneous allergic conditions, these could be suggestive of an underlying Primary Atopic Disorder. Specifically, the allergic triad characterized by elevated IgE levels, eosinophilia, and eczema is a common feature in various inborn errors of immunity that could be mistakenly diagnosed as severe allergic conditions. Method: Our patient’s medical record was analyzed retrospectively, including her medical history, as well as results from immune laboratory tests and genetic analyses. Results: We present a 9-year-old female of mixed ethnicity with a history severe eczematous rash diagnosed with atopic dermatitis. Whole exome sequencing analysis revealed an initially novel heterozygous variant in the FLG gene (NM_002016: EXON3:c.C2218T: p.R740X). Conclusion: Healthcare providers caring for patients with atopic dermatitis and recurrent staphlococcus infections should be aware of the significant link between filaggrin gene mutations and the development of severe, persistent atopic dermatitis that begins in childhood, as well as its association with recurring staphlococcus infections. Additionally, they should keep in mind that certain inborn errors of immunity may predominantly manifest as severe and treatment-resistant atopic disorders. Statement of novelty: We have identified a rare variant in the FLG gene associated with severe atopic dermatitis and allergies.

Study of vitamin D levels in patients with allergic rhinitis

Allergic rhinitis (AR) is the most common type of chronic rhinitis, affecting 10-20% of the population. Severe allergic rhinitis has been associated with significant impairments in quality of life, sleep, and work performance. Vitamin D and its role in regulation of immune function was first proposed after the identification of vitamin D receptors in lymphocytes. There are recent researches linking vitamin D to various immune-related conditions, including allergy, although the pattern of this relationship is still yet to establish. Methods and materials: an observational descriptive study conducted in the Outpatient Department of ENT of Sri Siddhartha Medical College, Tumkur, Karnataka, over a period of 1 year comprising of around 40 patients from 18-65 years of age suffering from allergic rhinitis patients were scored using Total nasal symptoms scoring system (TNSS) based on nasal symptoms. Also, Vitamin D levels are measured and based on these levels patients are graded. Results: Among 40 patients, male predominance with 23(57.5%) cases with mean age of 38.4 +/- 6.8. Majority of patients were in 7-10 TNSS with 15 patients accounting for 37.5%. Patients with severe allergic symptoms had mean vitamin D level about 19.6 +/- 4.2 ng/dl, patients with moderate symptoms were seen with mean vitamin D level 28.6 +/- 3.6 ng/dl and with mild symptoms 34.4+/- 2.8 ng/dl and the p value was significant (<0.04) in our study. Conclusion: Vitamin D could improve allergy symptoms directly or indirectly by potentiating the anti-inflammatory effects of the medications used to treat allergy.

Nanobody-based food allergen surveillance: current status and prospects

Abstract The incidence of food allergy has increased in recent decades, posing drastic risks to sensitive individuals, leading to mild to severe allergic symptoms. There is still no effective immune therapeutic strategy for food allergy that addresses accurate analytical methods to indicate the presence of allergens to prevent exposure of sensitive individuals. Currently, the most commonly applied detection method is immunoassay developed with food allergen-specific antibodies, especially the conventional formats of monoclonal antibodies (mAbs) and polyclonal antibodies (pAbs), which serve as dominant detection reagents for food allergen analysis, although with the disadvantages of being labor-intensive, costly, batch differences, and significant cross-reaction, etc. Camelid-derived nanobodies (Nbs) have attracted tremendous attention to explore their application in food hazard analysis because of robust characteristics like unique paratopes, high stability and affinity that strongly contribute to the beneficial effect. However, extensive analysis is needed to validate the potential use of Nbs as detection reagents and the advantages for food allergen surveillance. Previous reports have demonstrated the potential of Nbs for immunoassay development against food allergens, such as macadamia allergen Mac i 1, peanut allergens Ara h 1 and Ara h 3, lupin allergen Lup an 1, milk allergen β-lactoglobulin, etc. In this review, we comprehensively summarize the structural and biochemical properties of Nbs that benefit the application of Nb-based immunoassay, as well as the representative detection strategies, to provide research data for newly developed Nb formats for food allergen analysis, and investigate the future establishment of Nb-based surveillance against major food 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.

Safety and effectiveness of a 300 IR house dust mite sublingual tablet: descriptive 4-year final analysis of a post-marketing surveillance in Japan.

Background: Data are limited for clinical outcomes with house dust mite (HDM) allergen immunotherapy beyond 2years' observation. Materials & methods: A post-marketing drug-use survey assessed the safety and effectiveness of the 300 index of reactivity (IR) HDM tablet during use forup to 4years in Japan. Results: 538 patients were evaluable for safety and 383 for effectiveness. Most adverse drug reactions (ADRs) occurred early and were local reactions; 5.6% of 249 total events were reported during years 2 to 4 as new ADRs after the interim analysis. The CAP-RAST score was identified as a potential risk factor for ADRs. The proportion of evaluable patients with severe allergic rhinitis symptoms decreased from 46.4% at baseline (n= 317) to 1.0% at 4years (n=104). Patients (n=16) who discontinued 300 IR HDM tablet due to symptomatic improvement had sustained improvement relative to baseline 1 to 2years later. Conclusion: Long-term use of the300 IR HDM tablet is safe and effective.

Nasal and Serum Immunoglobulin E Levels in Symptomatic Allergic Rhinitis Patients: A Case-Control Study.

Allergic Rhinitis (AR) is an inflammatory condition of the nasal mucosa triggered by Immunoglobulin E (IgE) mediated response to exposure to allergens. The most common symptoms are nasal obstruction, sneezing, runny nose and these in addition to swollen, itchy, red and watery eyes. Recent studies have shown highly elevated immunoglobulin E levels in the airway mucosa independently of serum IgE levels and atopic status. Nasal mucosa has intrinsic capability to produce IgE in allergic rhinitis. The study was conducted to explore the levels of nasal total IgE and serum total IgE and their correlation in symptomatic AR patients. This was a case control-study and two groups participated in the study. The first group included 203 symptomatic patients who were diagnosed in the otorhinolaryngology clinic as cases of AR, known as AR group. The second group was control group and included 203 apparently healthy volunteers without any history suggestive of AR. The associated risk factors for severe allergic symptoms were assessed by logistic regression model. The mean differences between nasal total IgE and serum total IgE levels of both groups were compared by t-test. A correlation was investigated between nasal IgE and serum IgE in both the groups. The mean level of nasal total IgE and serum total IgE was found to be 103.9 and 291.4IU/ml in AR group, respectively, and 17.5 and 67.5IU/ml in the control group, respectively. Levels of nasal total IgE and serum total IgE were significantly higher in the nasal fluids and serum of symptomatic allergic rhinitis patients than in controls (p < 0.001 and < 0.001 respectively). A logistic regression model showed severity of allergic rhinitis was significantly associated with nasal total IgE levels. The correlation of nasal total IgE levels with serum total IgE levels in the control group was found to be statistically insignificant. However a statistically positive correlation was observed between nasal total IgE and serum total IgE levels in the AR group. It is possible that nasal IgE and serum IgE interact in the pathogenesis of AR and this is evident in the current study. Nasal IgE levels should be evaluated in severe symptomatic allergic rhinitis patients. The interaction between nasal IgE to serum IgE levels should be further investigated in AR patients for other possible prevalent endotypes of AR.

Challenge-verified thresholds for allergens mandatory for labeling: How little is too much for the most sensitive patient?

It is mandatory to label food products with the 14 main allergens in the EU. Reasonable allergen labeling requires knowledge of population-based thresholds derived from food challenges. The aim of this study was to evaluate the threshold-distribution in clinically verified food allergic patients for allergens mandatory for labeling. All positive open oral food challenges and double-blind placebo-controlled food challenges (DBPCFC) performed at the Allergy Center, Odense University Hospital, Denmark (2000-2022) were included. For each included challenge, the cumulative threshold (LOAEL) was obtained and NOAEL estimated. Data were modelled as an interval censored log-normal distribution. Overall, 38 of all 2612 challenges (1.5%) in 1229 patients (717 male, 986 children) reacted to <5 mg protein. The majority of the most sensitive patients reacted with a Sampson severity score of 2-3. Using interval censored log-normal models only five groups (hens´ egg, fish, peanut, milk, tree-nuts) elicited reactions after ingestion of 0.5 mg protein and in low frequencies of the population. Hen's egg was the most potent allergen, with reactivity to <0.5 mg protein in 0.24% [0.13-0.44%] of egg allergic patients while the estimated fraction of allergic patients reacting to a eliciting dose on 0.5 mg protein for most other allergens were below 0.04%. Our data demonstrates that the majority of food allergic patients as expected tolerating traces of allergenic foods without developing severe allergic symptoms and signs. Hen's egg appears to be the food most likely to elicit reactions in the most sensitive individuals at very low doses.

HYPERSENSITIVITY REACTION TO DUST MITE IMMUNOTHERAPY FOLLOWING SHELLFISH INGESTION

<h3>Introduction</h3> Immediate hypersensitivity reactions are an occasional side effect of allergen immunotherapy. Patients develop severe allergic symptoms within half-hour after receiving allergen immunotherapy. Symptoms range from mild, local to severe systemic reaction. Patients with House Dust Mite (HDM) allergy can be sensitized to shrimp due to the phylogenetic similarity attributable to tropomyosin. We report a patient who developed anaphylactic symptoms from HDM immunotherapy correlated with shrimp ingestion hours prior to receiving immunotherapy. <h3>Case Description</h3> A 35 year-old male asthmatic with allergic rhinosinusitis, tested positive for Dermatophagoides farinae and D. pteronyssinus, was started on Subcutaneous Immunotherapy (SCIT) for HDM. Following routine buildup, he received appropriate maintenance dosage every three weeks for 1.5 years with excellent symptom control. However, on three occasions, he developed systemic symptoms within 30 minutes post-immunotherapy, developing acute shortness of breath, widespread urticaria, itching, and light-headedness. He was treated appropriately. Questioning revealed that the SCIT reactions coincided with days the patient had eaten shrimp earlier. Skin-testing to shellfish was mildly positive to shrimp and negative to other crustaceans. Patient was advised to avoid ingesting all crustaceans on the day of immunotherapy. Subsequent three years on immunotherapy have been without incident. <h3>Conclusion</h3> <b>:</b> Among patients receiving HDM immunotherapy, it may be prudent to avoid cross-reactive foods like shellfish due to increased likelihood of allergic reactions to synergistic allergens. This expression is also likely during sublingual immunotherapy for HDM. We suggest evaluating crustacean allergy status for all patients contemplating HDM immunotherapy, and avoiding ingestion of crustaceans the same day as treatment, to forestall potential hypersensitivity reactions.

S68 Alpha-Gal Syndrome Complicating the Management of Suspected Pancreatic Exocrine Insufficiency

Introduction: IgE antibodies to the oligosaccharide galactose-α-1,3-galactose (α-gal) are an important cause of allergic reactions to mammalian meat and other mammal-derived products. The symptoms of α-gal syndrome (AGS) can involve urticaria or anaphylaxis, but increasingly we are aware that GI tract symptoms, including diarrhea, are also a major feature of AGS. Pancreatic exocrine insufficiency (PEI) is a common cause of diarrhea and treatment involves the use of pancreatic replacement enzymes (PRE). PRE are porcine derived and contain α-gal. Patients receiving PRE who are α-gal IgE positive are at risk for allergic reactions and GI symptoms due to α-gal sensitivity. Here we reviewed patients with suspected PEI and concomitant α-gal IgE sensitization in the practice of one gastroenterologist in Virginia. Methods: Retrospective chart review was carried out using inclusion criteria of i) diarrhea, ii) low fecal elastase (< 200 μg/g feces), and iii) α-gal IgE sensitization ( >0.10 kU/L). Results: 15 patients were identified with mean fecal elastase of 123 and median IgE α-gal level 0.96 (Table). 9 improved off of mammalian-containing food products and 3 of these did not require PRE. 11 patients received PRE. Of 5 patients with pre-existing systemic allergy symptoms to mammalian meat, 1 improved off of mammalian products and did not require PRE, 1 had increased diarrhea with Creon and was lost to follow up, 1 tolerated Creon with pruritus, 1 experienced hives from Creon but successfully underwent office-based desensitization, and 1 patient avoided PRE due to the severity of allergy symptoms. 6 patients without the classic cutaneous allergy symptoms of AGS tolerated PRE, though 1 developed some urticaria. Conclusion: In this series of 15 patients with suspected PEI who had concomitant α-gal IgE >0.1 kU/L, 60% improved with removal of α-gal containing products from the diet and 20% did not require PRE. Of the 11 patients who were treated with ongoing PRE, 3 experienced urticaria and 1 had increased diarrhea, but none had severe allergic symptoms. In our experience, patients who are sensitized to α-gal can usually tolerate PRE. Practitioners should also be aware that worsening diarrhea during PRE treatment could be a consequence of α-gal-related hypersensitivity, rather than medication non-compliance. Recognition of AGS superimposed upon PEI will allow improve management in this complex patient population. Table 1. - Clinical data from 15 patients with suspected pancreatic exocrine insufficiency diagnosed with concomitant α-gal syndrome Characteristics Total Cohort (n=15) Age, mean years (range) 59.5 (19-80) Sex, female, n (%) 9 (60%) Race, Caucasian, n (%) 15 (100%) Fecal Elastase, mean μg/g fecal material (range) 123 (49-183) IgE to α-gal, median kU/L (range) 0.96 (0.41-26.1) Diarrhea Severity recorded, n (%) 13 (87%) Mild, 0-4 stools per day, n (%) 4 (31%) Moderate, 5-8 stools per day, n (%) 6 (46%) Severe, >8 stools per day, n (%) 3 (23%) Improvement with mammalian avoidance, n (%) 9 (60%) Treated with PRE, n (%) 11 (73%) Creon, n (%) 10 (91%) Zenpep, n (%) 1 (9%) Allergy Symptoms attributed to PRE, n (%) 4 (36%) Urticaria, n (%) 3 (27%) Diarrhea, n (%) 1 (9%)

Gastrointestinal digestion products of shrimp (Penaeus vannamei) proteins retain an allergenic potential

The allergenic potential of shrimp (Penaeus vannamei) proteins during gastrointestinal (GI) digestion is currently unclear. In this study, the role of gastric, intestinal, and GI digestion on the sensitizing and eliciting capacity of shrimp proteins was investigated using a BALB/c mice model. Gastric digestion products of shrimp proteins produced lower specific IgE/IgG1, histamine and mMCP-1 levels and significantly reduced the proportion of degranulated mast cells as compared to the shrimp protein extract; furthermore, no histopathological changes were observed in the lung, spleen and jejunum. Conversely, their GI digestion products caused high specific IgE/IgG1 levels, mast cells degranulation and severe allergic symptoms in the mice, similar to those in the shrimp protein extract group. These results may be due to the masking or exposure of shrimp epitopes during digestion. Consequently, the GI digestion products of shrimp proteins retained an allergenic potential, although gastric digestion products showed a lowering effect.

Exacerbation and severity of allergic symptoms during pregnancy and their impact on mental health

Background:Pregnant women with allergies face difficulties, as they tend to avoid medication for symptom control during pregnancy. Moreover, some women experience exacerbations during this period. These difficulties can affect their mental health.Objective:This study aimed to investigate the factors influencing allergy exacerbations during pregnancy and examine the effects of allergy symptoms on the mental health of pregnant women.Methods:A cross-sectional study was conducted through web-based research in March 2020, amid the COVID-19 pandemic. Pregnant women were collected from 3 groups (target: 150 participants in each group): atopic dermatitis (AD), allergic rhinitis, and without allergies. We evaluated mental health using Kessler Psychological Distress Scale (K6) and health-related quality of life using the Short Form-8 questionnaire.Results:Overall, 202 (49.1%) of 411 pregnant women had depressive symptoms, and 45 (10.9%) had severe depressive symptoms. Women with allergies had significantly worse mental health than those without allergies. Among 119 AD patients, 36 (30.3%) experienced exacerbations during pregnancy. Of them, 11 (30.6%) did not consult a practitioner and endured the exacerbation. A significant association was observed between severe prepregnancy symptoms, job situation, coping with symptoms of AD during pregnancy, and AD exacerbation. Among 210 rhinitis patients, 17.1% experienced rhinitis exacerbation during pregnancy. The presence of rhinitis symptoms in winter and the second trimester was significantly associated with exacerbation.Conclusion:This study revealed higher rates of depressive symptoms among pregnant women with allergies. The psychological well-being of pregnant women with AD or allergic rhinitis should be considered.

Re-exposure to iodinated contrast media in two patients with prior severe hypersensitivity reaction

Most allergic reactions to iodinated contrast media can be managed using a pre-treatment protocol involving corticosteroids and antihistamines. However, under certain circumstances, patients may experience severe allergic symptoms despite pre-treatment. Two Chinese men with a history of severe contrast allergy and unstable angina underwent a desensitization protocol that allowed for successful percutaneous coronary intervention. Rapid desensitization is an effective and safe strategy that may allow other patients with similar allergies to successfully undergo angiography that requires the use of radiocontrast media.

Impulsive simulation model for the dynamics of allergen immunotherapy

This study aims to analyze the effects of allergen immunotherapy, used to treat allergic symptoms such as pollen allergy. Mathematical models are used as a methodological approach to simulate from a system of impulsive differential equations the dynamics of the model. Immunotherapy is based of supplying small amounts of pollen to the patient, which leads to minimizing severe allergic symptoms when patients are subsequently exposed to higher amounts of pollen in the environment. Lymphocyte concentrations are considered state variables, allowing the behavior and efficacy of allergen immunotherapy to be identified. The manuscript proposes a method that allows to model mixed systems. Phenomena that present continuous times in some instants and discrete times in others, these are phenomena that are frequently found in the field of physics. Allergen immunotherapy is most effective when a treatment is created with pollen dose increments in a linear form.

O4‐2: Serum albumin in furry animals as a cross‐reactive component may cause more severe allergic symptoms

O4‐2: Serum albumin in furry animals as a cross‐reactive component may cause more severe allergic symptoms