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Severe repeated anaphylactic reactions to sublingual immunotherapy.

Severe repeated anaphylactic reactions to sublingual immunotherapy.

Allergol Immunopathol (Madr). 2012 Dec 17;

Authors: Vovolis V, Kalogiros L, Mitsias D, Sifnaios E

Abstract
Sublingual immunotherapy (SLIT) for allergic rhinitis is a well-established and effective therapy. To date only 11 reports of anaphylaxis to SLIT have been published. Our case relates to a female patient receiving SLIT to Olea europaea pollen and House Dust Mites (HDMs). She had an unremarkable medical history, apart from persistent, perennial rhinoconjunctivitis and controlled asthma with seasonal aggravation. During the build-up phase of immunotherapy our patient suffered severe anaphylactic episodes during every attempt to increase the dose of Olea extract, according to ordinary regiment. Therefore, we adopted a modified build-up protocol administering incremental doses of saline dilution of original extract, in 30-min intervals. Following this modified scheduled regiment we managed to advance SLIT and a maintenance dose of three drops per day (lower than the ordinary dose) was reached. On the contrary, SLIT to HDMs advanced with no reaction, and the maintenance dose was reached in five days. Although SLIT seems to have an excellent safety profile this does not rule out the possibility of an anaphylactic reaction even if current guidelines have been followed precisely. Our case indicates that SLIT schedules with large doses of allergens, omitting up-dosing phase, could be not safe enough for a minority of high sensitive patients to whom a more gradual dose increase may be necessary.

PMID: 23253689 [PubMed - as supplied by publisher]

Short and long-term quality of life and asthma control with omalizumab therapy in a real life setting in Portugal.

Short and long-term quality of life and asthma control with omalizumab therapy in a real life setting in Portugal.

Allergol Immunopathol (Madr). 2012 Dec 17;

Authors: Vieira T, de Oliveira JF, da Graça Castel-Branco M

Abstract
BACKGROUND: The impact of severe asthma on patients' quality of life (QoL) has been previously demonstrated, as well the difficulties in controlling the disease. We aimed to evaluate the effect of omalizumab on QoL and asthma control, and its safety and tolerability in real-life conditions in Portugal. METHODS: Prospective and open-label study in 15 adult patients with uncontrolled severe persistent allergic asthma on omalizumab treatment ≥16 weeks (w). The short (at 16w) and long-term (at 1 and 2 years) (y) effects of omalizumab were assessed through the Asthma Life Questionnaire (ALQ) and the Asthma Control Test (ACT). Other secondary outcomes were evaluated. RESULTS: A significant reduction in ALQ total score (at 16w, p=0.002; at 1y, p=0.033 and at 2y, p=0.024), as well as in the 'non-scheduled medical visits' and the 'medication use' domains in both the short and long terms was observed. Regarding ACT, we verified a significant improvement in total score (at 16w, p=0.004; at 1y, p=0.004 and at 2y, p=0.008) and in almost all of the five individual questions. Asthma exacerbations and unscheduled health care visits were significantly decreased. There was a significant rise in lung function and a decrease in daily inhaled steroids dose. The most frequent adverse effects were headaches and nausea. CONCLUSIONS: Omalizumab promoted a global benefit on QoL and asthma control outcomes. It also yielded a reduction in asthma exacerbations and unscheduled health care visits, a steroid-sparing effect, and an improvement in lung function. The drug was found to be generally safe and well-tolerated.

PMID: 23253691 [PubMed - as supplied by publisher]

Exploring the temporal development of childhood IgE profiles to allergen components.

Exploring the temporal development of childhood IgE profiles to allergen components.

Clin Transl Allergy. 2012 Dec 19;2(1):24

Authors: Onell A, Hjälle L, Borres MP

Abstract
ABSTRACT: BACKGROUND: Children often develop allergies that may or not persist into adulthood. Although the different allergic symptoms over time have been well documented, the underlying pattern of sensitization to various proteins and subsequent allergy development is unexplored.The aim was to study the sensitization pattern to allergen components over time from infancy to adulthood in a group of infants with heredity for allergic diseases. METHODS: IgE profiles were monitored in a group of 67 children from 6 months to 18 years using a microarray chip (ImmunoCAP(R) ISAC) containing 103 allergen components derived from 47 allergen sources. The chip IgE profile was compared with clinical history, skin prick test results and diagnoses (atopic dermatitis, asthma and allergic rhinoconjunctivitis) at each time point for each child. RESULTS: IgE profiles were unique for each child and showed broad agreement with the results of skin prick tests and doctors' diagnoses. In addition, close examination of the IgE profiles often revealed early indication of subsequent allergies. IgE profiles also facilitated the examination of cross-reactivity contra co-sensitization, thereby greatly enhancing the possibility for managing patients. CONCLUSION: This explorative description indicates that sensitization pattern to allergen components differs over time as well as among allergic individuals when examined with microarray technology.

PMID: 23254184 [PubMed - as supplied by publisher]

Tumor cell emboli in the lung and transcriptional profiles of circulating tumor cells derived from different vascular compartments in patients with metastatic breast cancer.

Conclusions: TCE were observed in 4 out of 6 patients with highly elevated numbers of CTCs. In these patients, cumulative entrapment of CTCs in the lung might have contributed to respiratory dysfunction. High numbers of CTC might therefore represent an oncological emergency. Transcriptional profiling of 91 breast cancer related genes revealed no substantial difference in gene expression of CTCs derived from CVB and PVB, suggesting that CTC entrapment by the lung is a rather passive process in advanced cancer patients. These findings will be further challenged by comparing the obtained profiles with gene expression profiles of 13 additionally selected homing markers in these samples.Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-01-09. (Source: Cancer Research)

Impact of Cigarette Smoking on Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Study [Cancer Prevention and Control]

Conclusion Using data on cancer incidence for 2008 and our AFp estimates, about 270,000 new cancer diagnoses per year can be considered attributable to cigarette smoking in the eight European countries with available data for both men and women (Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Sweden, Denmark). (Source: Journal of Clinical Oncology)

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